South Carolina Elects Pediatrician Over Graham's Sister

Caption: Annie Andrews at a campaign event in Greenville, South Carolina, May 2026. Credit: Stimpus1 / CC0 1.0, via Wikimedia Commons.

South Carolina elected pediatrician Annie Andrews to the U.S. Senate on November 3, defeating Republican Darline Graham, who had been appointed to the seat after the death of her brother, longtime Sen. Lindsey Graham. The election ended the state’s 28-year stretch without a Democratic Senate election victory and completed an unusual political sequence involving a prominent family, an interim appointment and a physician entering national office.

Lindsey Graham died unexpectedly in July 2026. Gov. Henry McMaster selected his sister Darline to serve through the end of his term, and she then sought a full term of her own. Andrews, a Charleston pediatrician and mother, ran as the Democratic challenger. Before the senator’s death, the seat had appeared far less competitive, according to Associated Press pre-election reporting.

An appointment becomes a statewide campaign

Darline Graham’s candidacy was not a routine reelection for a senator with a long personal voting history. Her public role began only months before the election, after she was appointed to continue her brother’s service. She secured the Republican nomination and received support from President Donald Trump. Andrews had already been organizing a campaign centered on healthcare, children and affordability.

AP-based results reported by People put Andrews ahead with about 50.6% of the vote to Graham’s 47.2%. South Carolina had last elected a Democrat to the U.S. Senate in 1998. Trump’s strong presidential performance there in 2024 made the reversal particularly notable.

Andrews had previously run against Republican Nancy Mace for a House seat. She campaigned for the Senate on issues she encountered in medicine, including healthcare costs, hospital access and families’ financial pressure. Graham defended the Republican position and emphasized continuity with her brother’s legacy, while also facing the difficulty of establishing her own candidacy quickly.

At an October debate, the candidates disputed federal Medicaid changes. Andrews argued the reductions would hurt children’s coverage and rural hospitals, while Graham supported work requirements for certain adult recipients and defended the Republican tax-and-spending package. Graham also said Congress should move toward a balanced-budget amendment. Andrews promoted reversing Medicaid cuts, expanding healthcare access and lowering insurance premiums.

South Carolina gains a new senator

Andrews will enter a chamber that the Democratic Party also gained control of in the November midterms. Her victory adds an unusually conservative state to the party’s Senate coalition and ends a long electoral history for Republicans in South Carolina.

In an October 28 interview with WIS, Andrews described preventing Medicaid cuts and protecting rural hospitals as her leading Senate priority. The election gives her an opportunity to pursue that agenda when the new Congress convenes in January.

References: Darline Graham, Sister of Lindsey Graham, Loses Election for South Carolina Senate | South Carolina Senate race gets unexpectedly close after Lindsey Graham’s sister Darline stumbles | Senate candidates talk affordability, war and each other in only expected debate | FULL INTERVIEW: Annie Andrews shares priorities for Senate ahead of Election Day