Officials of some small, rural hospitals say they may lay off workers and cut services next month when the state's Medicaid agency cuts payments to healthcare providers who treat South Carolina's poor and disabled. At issue is a controversial bill that won a key approval Thursday from the S.C. House of Representatives by a 67-45 vote. Next week, the bill heads to Gov. Nikki Haley's desk for her signature. Haley, who requested the cuts, has said she will sign it. The bill gives Tony Keck, the new director of the state's Medicaid agency, flexibility to help balance the budget of his deficit-ridden agency. Keck has said he will institute a 3% across-the-board cut for doctors and hospitals that treat Medicaid patients. The pay cut, Keck said, will allow his agency, the Department of Health and Human Services, to save about $70,000 a day between its implementation in early April and June 30. House Democrats unsuccessfully argued the cuts will devastate small, rural hospitals and shut out poor patients from receiving much-needed health care services.