South Carolina Should Grow…without Californification.

Healthcare
May 18, 2026

Spencer Boeh

Policy Research & Communications Associate

In recent years, there has been a plethora of stories about the great migration of Americans from high-cost-of-living states, namely California and New York, to cheaper, freer states such as Texas, Florida, and Tennessee.

So, what about South Carolina?

It is actually the Palmetto State that is leading the nation in in-migration. According to Tax Foundation figures for 2025, South Carolina has seen a 1.12% population increase in the last year, amounting to roughly 80,000 new residents. According to the National Taxpayers Union, these new residents also bring with them additional wealth. In 2023, new residents brought an estimated $4.1 billion of income, broadening the state’s tax base. Clearly, this shows that Americans from around the country are looking to South Carolina and seeing favourable conditions—and that’s before the new tax cut was signed into law.

This influx of wealth and people can be great for South Carolina’s economic vitality, but it does bring with it some challenges.

First, our infrastructure is under more pressure than ever. This has been a major discussion point for us here at Palmetto Promise Institute, and we welcome the roads and bridges bill passed unanimously by the General Assembly just days ago. But, there will be even further need to refurbish infrastructure.

Additionally, South Carolina schools will face capacity challenges with the children of inbound families, further emphasizing the importance of school choice and ease of entry for educators. The states facing the greatest loss of population, namely New York and California, have some of the highest performing and highest funded K-12 systems in the US, and many families will be hoping to find schools that can offer similar outcomes here in South Carolina. This is a wide open opportunity for charter schools to shine.

As for healthcare, South Carolina led the nation by passing the most comprehensive repeal of Certificate of Need (CON) laws in over 20 years. The next phase of that reform hits on January 1, 2027 when the remaining healthcare facilities—acute care hospitals—will no longer require a CON permission slip from the government to open! “Medical Tourism” will hit South Carolina when supply finally catches up with demand.

More families and more companies, also amplify energy demand. This makes all the more important that South Carolina work toward bold energy solutions. A report from the National Energy Assistance Directors Association estimates that homes will spend $860 dollars on cooling costs this summer, which is roughly $100 more than last year. South Carolina had the dubious distinction of having the highest electricity bills in the nation just a few years ago and we remain in the top ten.

The real question is how this interstate migration will effect the political culture of the state. Are new South Carolinians simply chasing a lower cost of living and better winter weather? Or, are they supportive of our recent moves toward free market friendly economic policies as well?

We know this: the Palmetto State has the Welcome mat out, but we have no interest in Californification.