South Carolina Medicaid Program Overview
Enrollment, funding, and managed care facts for South Carolina Medicaid.
Get South Carolina's Medicaid Fee Schedule →Enrollment
South Carolina Medicaid covered approximately 0.96-0.99M people. KFF's total monthly Medicaid & CHIP enrollment tracker gives 957,737 (May 2026). healthinsurance.org's state guide (citing state/CMS enrollment data) gives 994,159 (October 2025). Close but not identical -- different months, both post-unwinding. For historical context: CMS's 2024 Medicaid Managed Care Enrollment and Program Characteristics report put South Carolina total Medicaid enrollment at 1,354,616 (as of July 1, 2024) -- the ~360k drop between mid-2024 and late-2025/2026 reflects the post-pandemic continuous-enrollment 'unwinding' redeterminations, not a data error.
Funding & federal match
South Carolina has not adopted ACA Medicaid expansion.
For FFY2026 (Oct 1, 2025 - Sep 30, 2026), South Carolina's Federal Medical Assistance Percentage (FMAP) is 69.53%.
Waivers
South Carolina operates Medicaid managed care under the South Carolina 1915(c) Home and Community-Based Services waivers (Community Choices, Community Supports, Head and Spinal Cord Injury, HIV/AIDS, Intellectual Disability/Related Disabilities, Mechanical Ventilator Dependent, Medically Complex Children), a Section 1915(c) demonstration waiver. South Carolina operates seven active 1915(c) HCBS waivers administered jointly by SCDHHS's Community Long Term Care division and SCDDSN/DBHDD, covering elderly/physically disabled, intellectually/developmentally disabled, HIV/AIDS, ventilator-dependent, and medically complex pediatric populations as alternatives to institutional care. No active Section 1115 demonstration was in effect as of this review.
South Carolina operates Medicaid managed care under the Palmetto Pathways to Independence (pending Section 1115 demonstration, includes community engagement/work requirement), a Section 1115 demonstration waiver. SCDHHS submitted a Section 1115 application in 2025 that would extend coverage to a new population while applying work/community-engagement requirements to newly eligible members (a companion 'Healthy Connections Works' demonstration applies similar requirements to existing parent/caretaker and transitional-medical-assistance beneficiaries). As of this review the application had gone through a 2025 public comment period but had not been shown as CMS-approved.
Has South Carolina expanded Medicaid under the ACA?
No. South Carolina has not adopted full Medicaid expansion under the Affordable Care Act as of 2026.
How many people are enrolled in South Carolina Medicaid?
Approximately 0.96-0.99M people.
What percentage of the federal Medicaid match does South Carolina receive?
69.53% for FFY2026 (Oct 1, 2025 - Sep 30, 2026) — meaning the federal government pays roughly 70 cents of every South Carolina Medicaid dollar, and the state pays the rest.
What Medicaid waivers does South Carolina operate under?
South Carolina 1915(c) Home and Community-Based Services waivers (Community Choices, Community Supports, Head and Spinal Cord Injury, HIV/AIDS, Intellectual Disability/Related Disabilities, Mechanical Ventilator Dependent, Medically Complex Children), a Section 1915(c) demonstration waiver. South Carolina operates seven active 1915(c) HCBS waivers administered jointly by SCDHHS's Community Long Term Care division and SCDDSN/DBHDD, covering elderly/physically disabled, intellectually/developmentally disabled, HIV/AIDS, ventilator-dependent, and medically complex pediatric populations as alternatives to institutional care. No active Section 1115 demonstration was in effect as of this review.
What Medicaid waivers does South Carolina operate under?
Palmetto Pathways to Independence (pending Section 1115 demonstration, includes community engagement/work requirement), a Section 1115 demonstration waiver. SCDHHS submitted a Section 1115 application in 2025 that would extend coverage to a new population while applying work/community-engagement requirements to newly eligible members (a companion 'Healthy Connections Works' demonstration applies similar requirements to existing parent/caretaker and transitional-medical-assistance beneficiaries). As of this review the application had gone through a 2025 public comment period but had not been shown as CMS-approved.
Get South Carolina's Free Medicaid Fee Schedule
Request actual South Carolina Medicaid reimbursement rates by billing code — free, delivered as a CSV.
Sources
- KFF State Health Facts - Total Monthly Medicaid & CHIP Enrollment
- healthinsurance.org - Medicaid eligibility and enrollment in South Carolina
- CMS - Medicaid Managed Care Enrollment and Program Characteristics, 2024
- Federal Register / GovInfo - FY2026 FMAP Notice (89 FR 94742)
- Congressional Research Service - Medicaid's Federal Medical Assistance Percentage (FMAP), Report R43847 (Table, FY2021-FY2026)
- KFF State Health Facts - State Activity Around Expanding Medicaid Under the ACA
- Medicaid.gov - South Carolina Waiver Factsheet
- SCDHHS - Community Choices (CC) Waiver / Community Supports (CS) Waiver pages
- SCDHHS - Community Engagement Section 1115 Demonstration Waiver Application / public notice
- MACPAC - South Carolina Waivers: Palmetto Pathways to Independence and Healthy Connections Works Demonstrations
Data last verified 2026-09-17. Also see our free Medicaid Fee Schedule tool.