South Carolina Healthcare Reform in 2025

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The South Carolina Legislature will move quickly to reform and consolidate health-related agencies in 2025. During the last legislative session, a plan to consolidate six health-related agencies, Mental Health, Disability and Special Needs, the Department of Public Health, Department on Aging, Department of Alcohol and Other Drug Abuse Services, and the Department of Health and Human Services into one cabinet agency, failed to pass after a procedural objection by a member of the House Freedom Caucus blocked passage as time ran out in the session.

Governor McMaster has called on the Legislature this coming year to make Mental Health and Disability and Special Needs a cabinet agency that reports to the governor’s office. Those agencies now report to a commission, whose members are appointed by the governor. A federal lawsuit against the state for how it treats clients of the Department of Mental Health has led to this renewed push from Governor McMaster to put the Department of Mental Health and Department of Disabilities and Special Needs in his cabinet. Additionally, the House Republican Caucus has outlined that one of its priorities for 2025 is to “reduce bureaucratic inefficiencies and consolidate the state’s fragment public health system.”

Two bills have been prefiled for the 2025 Session to address this restructuring. Senate bill S.2 Executive Office of Behavioral Health and Developmental Disabilities was prefiled by Senate Finance Chairman Harvey Peeler, Senate President Tom Alexander and Senate LCI Chairman Tom Davis. Here is a link to the bill: https://www.scstatehouse.gov/sess126_2025-2026/bills/2.htm. Also, House bill H.3613  Executive Office of Health Policy was prefiled by Rep. Lee Hewitt. Here is the link: https://www.scstatehouse.gov/sess126_2025-2026/bills/3613.htm. We expect these bills to be taken up early in 2025, and they should have strong support for passage from legislators.