Florida group seeks to put Medicaid expansion on the 2026 ballot

Florida is one of 10 states that have not expanded Medicaid.
A group of health care advocates is seeking to get Medicaid expansion on Florida ballots through a petition drive.
A group of health care advocates is seeking to get Medicaid expansion on Florida ballots through a petition drive. [ Times (2012) ]
Published Feb. 1|Updated Feb. 5

After years of opposition toward expanding Medicaid from Florida’s Republican leaders, a coalition is seeking to put it in the hands of voters on the 2026 ballot.

The group, Florida Decides Healthcare, announced Thursday a petition campaign kickoff for a constitutional amendment that would expand Medicaid access to adults earning at or below 138% of the federal poverty level, or an income of $20,120 a year for one person.

The expansion would affect hundreds of thousands of adult Floridians who currently cannot qualify for Medicaid. Currently, the only adults in Florida who qualify for Medicaid are pregnant or postpartum women, or parents with young children who make just a few thousand dollars per year.

Acadia Jacob, the advocacy director with the group Florida Voices for Health, said there are so many barriers to health care that there’s no one perfect solution. But she said “occasionally we are presented with these opportunities to make serious positive impacts on the system.”

“For years, closing the Medicaid coverage gap through expansion has been that opportunity,” Jacob said.

The campaign coalition members who spoke at a virtual news conference Thursday highlighted the benefits Medicaid expansion could offer to rural hospitals and rural counties, as well as the fiscal benefits to the state.

Holly Bullard, the chief strategy and development officer at the Florida Policy Institute, has said Medicaid expansion would allow Florida to claim billions of dollars in federal incentives.

The coalition sought to secure an amendment expanding Medicaid for the 2020 ballot but halted their campaign because of the difficulties from the COVID-19 pandemic. Several other states, including Idaho, Maine, Oklahoma and Utah, have passed Medicaid expansion through the ballot initiative process.

This year, Florida lawmakers again shut down the possibility of expansion. As Senate President Kathleen Passidomo pushed through a priority bill seeking to build up Florida’s health care workforce and expand care, she told lawmakers in her opening speech that expansion “is not going to happen.”

Forty states and Washington, D.C., have expanded Medicaid access to low-income adults. That includes Republican-led states like Louisiana, Arkansas, West Virginia and others. Recently, North Carolina’s Republican-led Legislature voted to expand Medicaid, and Georgia’s GOP legislators had hearings about possibly expanding Medicaid.

To make it onto the 2026 ballot, the coalition will need to first get nearly 1 million validated petitions from Florida voters throughout the state. That’s an expensive process that has gotten more costly in recent years, with legislation signed into law by Gov. Ron DeSantis that prohibits paying petition gatherers by signature.

If the coalition passes that threshold, the Florida Supreme Court will then have to uphold the amendment’s language and affirm that it has to do with only a single subject and isn’t misleading. After that, 60% of voters will have to approve the amendment for it to take effect.

Florida’s Medicaid rolls swelled to nearly 5 million during the pandemic, as many people lost their jobs and there was a federal pause on removing people from the rolls.

Since the state has begun redetermining people’s eligibility, more than 500,000 people have been removed. Almost half of those removed from Medicaid are children. Estimates show that about 1 million Florida residents could ultimately lose coverage.

Florida ranks 46th among states for the percent of its population with health insurance, according to America’s Health Rankings. That organization said about 11% of Floridians do not have coverage.

Alison Holmes, the parent of disability advocate JJ Holmes, spoke Thursday about falling into Florida’s health care gap. As a full-time caregiver for her son, Holmes said she has learned to live with physical pain, including from lifting an adult every day. She said she lives in fear of dying from something she might otherwise survive if she was able to get regular checkups.

“I just don’t understand why my mom can’t get health care,” JJ Holmes said. “Every day I try as hard as I can to make it easier for her when she lifts me, but I know I’m hurting her, and I don’t know what to do. I wish people could see how hard her life is and see how much pain she’s in. If they did, they’d understand how important this is.”