Week 17: Legislative Session Nears Final Stretch

The General Assembly has three regular session days left to pass legislation before the traditional “sine die” adjournment at 5 p.m. on May 14. However, procedural developments this week—driven in part by renewed debate over redistricting—could extend opportunities to finalize critical healthcare measures.

Redistricting Debate Opens a Narrow Window

Discussion of redistricting, prompted by recent legal and political developments, dominated attention early in the week. While the issue itself sits outside healthcare policy, it has had a meaningful procedural impact.

In order to allow continued debate on redistricting after adjournment, lawmakers advanced a sine die resolution that would permit conference committees to meet beyond the final day of session. These six-member committees—composed of three House members and three Senators—are tasked with negotiating compromises on unresolved legislation.

For hospitals, that procedural shift could prove significant. Key healthcare priorities that remain unsettled—ranging from the budget and Medicaid funding to medical malpractice reform to workplace safety protections in the HALO Act—may still be negotiated and finalized after May 14 if they are placed into conference committees in time.

Medicaid Funding Moves Closer to Needed Levels

The state budget remains one of the most consequential issues for hospitals this year. The House revisited its spending plan this week and adopted a revised version that increases Medicaid funding by just over $7 million.

That adjustment brings the House proposal to approximately $182 million—close to the roughly $185 million needed to maintain current Medicaid benefits without reductions.

The Senate’s version, by comparison, funds Medicaid at approximately $142 million, creating a significant gap that will need to be resolved in conference committee.

While the House’s updated position represents meaningful progress, hospital advocates will continue pushing for the higher funding level in final negotiations. Maintaining adequate funding is critical to avoiding provider rate cuts and preserving access to care for Medicaid beneficiaries.

Medical Malpractice Reform Stalls, But Not Dead

Efforts to address medical malpractice remain unresolved, as attention shifted late in the week to redistricting and other legislative priorities.

Advocates are now urging the Senate to pass a version of malpractice legislation—even if incomplete—to keep negotiations alive. Advancing a bill to conference committee would allow lawmakers to continue working through complex issues, including liability caps and provisions related to occurrences and gross negligence.

The path forward is likely to require compromise, with hospitals balancing concerns about escalating liability costs against the broader political effort to reach consensus.

HALO Act and Workplace Violence Protections Await Action

Legislation with the potential to strengthen protections against workplace violence in healthcare settings—the HALO Act—also remains stalled in the Senate.

Hospital leaders, including SCHA leadership, have continued direct outreach to lawmakers, emphasizing the urgency of addressing rising threats to healthcare workers. Concerns raised by some senators, including those tied to parental rights provisions, have slowed progress despite efforts to incorporate revisions.

As with malpractice reform, the immediate goal is to secure Senate passage and move the bill into conference committee, where remaining differences could be negotiated.

Hallway Bed Flexibility Faces Late-Session Challenges

Another priority—legislation clarifying hospitals’ ability to use hallway or overflow beds during emergency situations—has become entangled in unrelated policy debates.

Although hospitals and stakeholders reached compromise language on separate legislation addressing surgical smoke, that issue has become a point of contention affecting movement on the hallway bed bill in the House.

Despite these challenges, there are multiple potential paths forward. In addition to legislative action, both House and Senate budget proposals include proviso language that would grant temporary, one-year flexibility for hospitals to use these beds if needed.

Regulatory Reform Advances

In a broader policy development, the Senate took up a House-passed regulatory reform package aimed at reducing and streamlining state regulations.

The proposal would shorten regulatory timelines and require periodic legislative review to maintain existing rules. For hospitals, the effort could have long-term implications for how healthcare regulations are implemented and updated in South Carolina.

Earlier in the session, SCHA solicited input from member hospitals on regulatory burdens, positioning the association to engage constructively if the legislation becomes law.

Hospital Advocacy Effort Gains Momentum

This session has also marked a significant expansion of direct hospital engagement at the State House.

Through SCHA’s “Hospital of the Week” initiative, healthcare providers were present and advocating during 14 of the 18 legislative weeks—meeting with lawmakers, sharing local perspectives, and highlighting the real-world impact of policy decisions.

The sustained presence has helped reinforce the association’s priorities while elevating the voices of hospitals across the state.

Final Push Coincides with National Hospital Week

The final week of session aligns with National Hospital Week, creating a timely opportunity to spotlight the essential role hospitals play in South Carolina communities.

The governor is expected to issue a proclamation recognizing the week, alongside legislative resolutions and a coordinated public awareness campaign. Hospital leaders from across the state will be in Columbia to mark the occasion and reinforce advocacy efforts.

Looking Ahead

With only days remaining in the regular session, the path forward is narrow but still viable for several key healthcare priorities.

The coming days—and any conference committee negotiations that follow—will be critical in determining whether lawmakers can reach agreement on funding, reforms, and protections that directly affect hospitals and the patients they serve.

While significant work remains, the procedural developments of this week have created a clearer path to the finish line than appeared possible just days ago.