Legislative Update for April 24, 2026
With just three weeks remaining in the 2026 legislative session, most activity this week centered on the Senate’s continued debate of the state budget. Several high-priority health care bills also moved—or were positioned to move—in ways that could shape the final weeks of session for hospitals across South Carolina.
DHHS Medicaid Funding Gap and Key Provisos
The Senate worked through budget amendments and provisos throughout the week and unfortunately did not adopt any floor amendments that would increase the Department of Health and Human Services (DHHS) funding line. DHHS requested $203 million in state dollars; the House funded $175 million; and the Senate, $143 million—more than $40 million below the House position. Because Medicaid spending draws federal matching funds, this gap could translate into an estimated $120 million annual impact to hospitals when the federal match is included.
SCHA is also monitoring several budget provisos that could affect hospital operations and the broader health care landscape, including provisions addressing:
- Telemedicine and physician supervision of advanced practice clinicians;
- A PEBA report on the financial impact of 340B drug pricing on the State Health Plan; and
- Temporary liquor liability/tort language for the calendar year.
Bills of Interest
The following bills are among those SCHA is tracking closely as the General Assembly enters the final weeks of session:
- H. 4544 (Medical Malpractice) — Recalled to the Senate calendar, positioning the bill for possible floor debate as early as next week.
- H. 4069 (Patient-Friendly Billing / Itemized Billing) — Consideration in the Senate Medical Affairs process was postponed while the Senate remains focused on budget work. SCHA will continue engagement as the bill returns to the agenda.
- S. 958 (Hallway Beds) — The Senate passed the bill and sent it to the House, where it is currently in committee. The legislation addresses when patient beds may be placed in hallways and other means of egress during a “justified emergency.”
- H. 5173 (Hospitals / Rural Emergency Hospitals) — Passed the House and sent to the Senate. The bill would update state law to recognize Rural Emergency Hospitals (REHs) within the definition of “hospital.”
What’s Next
Budget negotiations between the House and Senate are expected to intensify once the chambers finalize their respective positions and move into conference. SCHA will remain engaged with budget writers and conferees to protect Medicaid funding and to ensure proviso language supports hospital operations.
Hospitals and community leaders can be especially influential in the final weeks of session. Lawmakers need to hear directly how Medicaid funding decisions and key health care reforms will affect access to care, workforce stability, and the services patients rely on.
Statehouse Engagement
Thanks to Tenet Health for participating as SCHA’s Hospital of the Week, with team members introduced in both chambers and meeting with members of their House and Senate delegations to discuss priorities for the remainder of the session!