Since October 1, some lawfully present immigrants no longer qualify for Medicaid.

A federal change under H.R. 1 ended Medicaid and CHIP eligibility for many people who are in the United States legally — including refugees and people granted asylum who don't yet have a green card, humanitarian parolees, survivors of trafficking, and people with Temporary Protected Status. Emergency Medicaid still covers emergency care and childbirth. People who remain eligible include US citizens, green-card holders who meet the five-year rule, Cuban and Haitian entrants, and COFA citizens of the Marshall Islands, Micronesia and Palau. If this may affect you or someone in your household, open any letter your state sends and ask about a community health center near you — they charge on a sliding scale regardless of immigration status. Read the full explainer →

Back-dated coverage shrinks in 92 days — the new work rules do not apply in South Carolina What actually changes here →

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South Carolina

South Carolina Medicaid: who can actually get it

Healthy Connections Medicaid is run by SC Department of Health and Human Services (SCDHHS). Children are covered through Partners for Healthy Children (PHC). South Carolina never expanded Medicaid, so who qualifies here is far narrower than most people expect.

New work rules don't apply here Medicaid never expanded 1,310,000 people enrolled Back-dated coverage changes Jan 1
Start here

The income limit is far lower than almost anyone expects

$1,411.53

a month — the most a parent in a family of three can earn and still get South Carolina Medicaid

That is about 62% of the federal poverty line.

For comparison, the states that expanded Medicaid cover adults up to 138% of that same line. South Carolina did not expand, so its limit stays where state law set it — and a parent earning more than $1,411.53 a month is over it.

Dependent child in the home and a specified degree of relationship

Source: SCDHHS eligibility page, limits effective March 1, 2026.

Who you are
Income limit
What to know
An adult with no children at home
No pathway
Not covered at any income, unless you are 65 or older, blind, or have a disability. There is no lower bound to fall under — $0 income still does not qualify you.
A parent or caretaker relative
$1,411.53/mo
Dependent child in the home and a specified degree of relationship Figure shown is for a family of three.
A child under 19
$4,735.46/mo
208% of the poverty line, household of three — more than 3 times the limit for that child's own parent.
Pregnant
$4,416.73/mo
194% of the poverty line. Coverage continues for 12 months after the birth. Newborn covered to age 1.
65 or older, blind, or disabled
$1,330/mo
Per person, and savings count too — the resource limit is $9,950 for one person. A higher limit of $2,982 a month applies for nursing-home care.

Children can qualify even when their parents can't. The limit for a child here is several times the limit for that child's parent, so it is entirely normal for a family to end up with the kids covered and the adults not. If that is your household, apply for the children anyway — it costs nothing to try, and they may be eligible today.

A note on these figures. We publish what SC Department of Health and Human Services (SCDHHS)'s current eligibility documentation says — SCDHHS eligibility page, limits effective March 1, 2026. Some other published analyses and a few of the state's own consumer pages show slightly different numbers, because they have not been updated to the latest revision. The agency decides either way: apply and let them calculate it.

The coverage gap

65,000 people here earn too much for Medicaid and too little for help buying a plan

They sit above South Carolina's very low Medicaid limit but below the poverty line, which is where federal help with premiums begins. There is nothing in between.

57%
are in working familiesAt least one person in the household has a job. This is not a gap about not working.
84%
have no children at homeWhich is exactly the group with no pathway at all in this state, at any income.
52%
are people of colorThe gap does not fall evenly across the state's population.

Most work in restaurants and food service, construction. Figures from KFF, May 2025. Credible estimates for South Carolina range from 65,000 to 83,000 depending on the survey year used; we quote the most recent.

January 1, 2027

The new work requirement does not apply in South Carolina

Nobody here will be asked to prove 80 hours a month.

The federal work requirement in H.R. 1 applies only to adults covered through Medicaid expansion. South Carolina never adopted expansion and has no qualifying waiver, so there is no such group in this state and the requirement does not reach it.

If you have seen national news about 80 hours a month, proving your work, or renewing every six months — that reporting is about other states. It does not apply to your South Carolina coverage.

Some things do change here on January 1, though.

Back-dated coverage drops from 3 months to 2 If you already have unpaid medical bills, applying sooner covers more of them. This is the one January deadline that genuinely affects you.
Reasonable opportunity period for immigration status verification eliminatedno more coverage while status is being checked
New address verification and data cross-check requirements, adding administrative friction
Biden-era enrollment streamlining rules delayed to January 1, 2035
DACA recipients excluded from marketplace subsidies

P.L. 119-21 §71112, amending 42 U.S.C. §1396a(a)(34). Applies to applications submitted on or after January 1, 2027.

If you don't qualify

What the marketplace can and cannot do for you

The standard advice is “try the marketplace.” For some people here that is good advice. For others it is simply untrue, and it matters a great deal which one you are.

✗ If you are below the poverty line

The marketplace is not an expensive option. It is not an option.

Help with premiums starts at the poverty line. Below it there is no subsidy at all, at any price. That is what makes this a gap rather than a cost problem.

It works this way because the law assumed every state would extend Medicaid up to that line, and South Carolina did not. What is left for you:

  • Federally Qualified Health Centers, sliding scale — findahealthcenter.hrsa.gov
  • Hospital charity care
✓ If you are above the poverty line

You can buy a plan, but it costs more than it did last year.

The enhanced premium tax credits expired at the end of 2025. Smaller credits still exist for household incomes between 100% and 400% of the poverty line, but the share you pay yourself went up.

The average premium after subsidy here is $139 a month, up from $73 last year.

Source: KFF State Health Facts, marketplace average premiums.

Do this now

Applying is free and you can do it any time of year — Medicaid has no open-enrollment window. If you are not sure whether you qualify, apply anyway and let the state work it out. Deciding for yourself that you don't qualify is the most common way people miss coverage they were entitled to.

Apply or renew apply.scdhhs.gov Free, and open all year Check an existing case tools.apply.scdhhs.gov Status, paperwork, contact details Talk to a person 1-888-549-0820 Member Help Center

Deaf, hard of hearing or speech-impaired: 1-888-842-3620.

EnglishSpanish

SCDHHS commits to free interpreter services and translated materials but does NOT name specific languages beyond English and Spanish on any page reviewed. UNVERIFIED — the page should say interpreter services are free on request via 1-888-549-0820 rather than listing languages we cannot confirm.

If a letter arrives

Most people who lose coverage lose it over paperwork, not eligibility

61.0% of the coverage losses recorded in South Carolina were procedural — a form, a deadline, or an address, rather than a real change in whether someone qualified. Which means the letter is usually the thing that decides it.

SC Department of Health and Human Services (SCDHHS) · Notice of action

NOTICE OF ELIGIBILITY DETERMINATION

Case number: ███████
Date of this notice: 1January 12, 2027

Based on the information available to us, your household is no longer eligible for Healthy Connections Medicaid.

2If you believe this determination is incorrect, you may request a fair hearing on or before February 11, 2027.

3Coverage for other members of your household may continue. A separate notice is enclosed for each person.

1
The clock starts on this date. Not the day the letter reached you, and not the day you opened it. Assume you have less time than it feels like.
2
You can ask for a fair hearing. It's free, you don't need a lawyer, and asking for one can keep your coverage running while it's reviewed. Call 1-888-549-0820 and say you want to appeal.
3
Read it person by person. Everyone in the household has a different limit. Your children may still be covered even when you are not — one envelope can mean different things for different people in the same home.
4
Check the arithmetic. This state gets 20.5% of its determinations wrong — among the worst in the country. It is well worth asking it to show how your income was calculated.
Know your state

What the federal data says about coverage here

Public federal data describes how each state runs its program. Almost all of it is written for policy analysts. Here is what three of those numbers mean if you are the person enrolled.

Procedural disenrollment · CMS
61.0%

Of people who lost coverage here, this share lost it over paperwork rather than eligibility.

Open every letter. Keep your address current with the agency, not just the post office.

Payment error rate · CMS
20.5%

Among the highest in the country. A notice that looks wrong may well be wrong — appeal it.

Quintile 5 of 5.

Primary care supply · America's Health Rankings
276 /100k

Provider supply here is middling. Nurse practitioners also need physician supervision in this state, which narrows your options further.

Book an appointment before you need one, not when you do.

Common questions

Questions people ask about this

Does the new Medicaid work requirement apply in South Carolina?
No. The 80-hour-a-month requirement in H.R. 1 applies only to adults covered through Medicaid expansion. South Carolina never expanded Medicaid and has no qualifying waiver, so there is no such group in this state and the requirement does not reach it.
Can an adult with no children get Medicaid in South Carolina?
Not through income alone. Unless you are 65 or older, blind, or have a disability, there is no pathway at any income — including no income at all.
What is the income limit for parents on South Carolina Medicaid?
About $1,411.53 a month for a family of three, roughly about 62% of the federal poverty line.
Can my children qualify if I don't?
Yes, and it is common. The limit for a child is several times the limit for that child's parent, so families frequently end up with the children covered and the adults not. Apply for the children regardless of your own result.
What changes on January 1, 2027 in South Carolina?
Back-dated coverage shrinks from 3 months to 2. If you already have unpaid medical bills, applying sooner covers more of them. The work requirement does not apply here.
How do I apply for Healthy Connections Medicaid?
Online at apply.scdhhs.gov, or by phone on 1-888-549-0820. It is free, there is no open-enrollment window, and you can apply at any time of year.
Other states

Guides for nearby states

The rules change completely at the state line. If you moved recently, or you're helping family somewhere else, start with their state rather than this one.

ArkansasWork rules are already being enforced TexasThe lowest parent income limit in the country LouisianaExpanded Medicaid, so the work rules apply MississippiNo pathway for adults without children North CarolinaExpanded in 2023, with a trigger law GeorgiaPathways, and the December 31 cliff

South Carolina's payment error rate is 20.5% — the worst of any state in this set and roughly one determination in five.

Applying costs nothing and takes about twenty minutes. If you are anywhere near the line, let the state decide rather than deciding for them.

Apply at apply.scdhhs.gov →