South Carolina Medicaid work requirement
South Carolina did not adopt the ACA Medicaid expansion, so there is no expansion group for the federal 80-hour rule to apply to. Adults covered through other pathways (disability, pregnancy, parent/caretaker rules) are not subject to it either.
What this means for you
Nothing is required of you today under the federal rule. Watch for state-level proposals (Georgia shows a non-expansion state can build its own), and keep your contact info current with Healthy Connections so any change reaches you.
The rule in one paragraph
Adults 19-64 covered through the ACA expansion group must show 80 hours a month of work, community service, or work programs — or half-time school enrollment, or at least $580/month in income — unless exempt. Compliance is checked at application and at renewals (at least every 6 months). Miss it and the state must give 30 days notice before coverage ends.
The 10 federal exemptions
- Under 19 or over 64
- Pregnant or postpartum
- Parent or caretaker of a child 13 or younger, or of a disabled person
- Medically frail or with special medical needs
- Veteran with a total disability rating
- American Indian / Alaska Native
- Already meeting SNAP or TANF work rules
- Recently released from incarceration
- In a drug or alcohol treatment program
- Short-term hardship
Do my hours count?
- Paid employment Counts
- Self-employment / gig work Counts
- Volunteering Counts
- School / training Half-time+
- Caregiving Exempts you instead
- Job searching Not federally
Full detail, including the $580/month income route and the seasonal-worker rule: what counts toward the 80 hours.
Verify with Healthy Connections (your state Medicaid agency) before making coverage decisions. States control reporting systems, exact dates, and hardship processes. Data snapshot 2026-07-03.
Sources
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