Healthcare in the 2026 Session

Florida leads the nation in Affordable Care Act enrollment and, if the enhanced premium tax subsidies people rely on to help purchase the health insurance aren’t extended, the state could see the ranks of the uncovered rise — exponentially.

The 60-day regular legislative session kicks off in Tallahassee today. What, if anything, the Florida Legislature does in the next two months to make health care more affordable and accessible to Florida residents remains to be seen.

Med mal and wrongful death of fetuses

Florida legislators are expected to once again look at killing a medical malpractice law that bars adult children of single parents and parents of childless adult children from pursuing negligence lawsuits if a family member has died.

The Legislature passed a similar bill during last year’s session, but Gov. Ron DeSantis — siding with medical malpractice insurers and medical providers — vetoed the measure. The House is poised to vote out the bill on Thursday. DeSantis has said he could consider approving the measure but only if legislators limit the amount of money recoverable in medical malpractice lawsuits.

The caps were previously ruled unconstitutional by the Florida Supreme Court but the business community is eager to have a largely DeSantis-appointed Supreme Court reconsider their legality.

The chamber also will vote this week on legislation to allow wrongful death lawsuits for the loss of developing fetuses.

Doubling down on doulas

The Florida Health Justice Project, arguing health care is a right, supports a spate of bills during the 2026 session including Medicaid expansion and proposals (HB 681 and HB 823) filed by Orlando Democratic Rep. Ana Eskamani to repeal existing bans on health care including eliminating the state’s six-week abortion ban and striking from statutes the prohibition on gender-affiming care to minors and limitations on that care for transgender adults.

Policy Director Melanie Williams said last week that the association hopes to see those proposals heard in committees this session.

Medicaid is the safety net program administered jointly by the state and federal government that cares for the poor, elderly, and disabled. The state fiscal 2025-26 budget directs $37 billion to the program.

“Expanding Medicaid is an economic, societal, and health win that would lower health care costs, strengthen Florida’s workforce and support hospitals and the health care system,” project policy director Melanie Williams said.

The sentiment also was echoed by the advocacy groups Progress Florida and Florida Watch.

‘We are calling on legislators to protect affordable health care coverage, expand access to Medicaid, and lower costs for millions of Floridians who are working hard every day to make ends meet during an historic affordability crisis,” Progress Florida Executive Director Mark Ferrulo said in a prepared release. “We need our elected representatives to be laser-focused on an affordability agenda with practical solutions for working families and seniors that lower costs, raise wages, and expand access to health care.”

FHJP also hopes a pair of bills meant to improve maternal and child health by training more doulas will be considered. Doulas serve as birth advocates and coaches during labor and delivery and even after childbirth. 

HB 1043 and SB 1456 sponsored by Rep. Ashley Gantt, a Democrat from Miami, and Sen. Rosalind Osgood, a Democrat from Tamarac, respectively, would create a Doula Workforce Development Support Program at the Department of Commerce. 

The bills would declare that “persistent maternal morbidity and mortality disparities that disproportionately affect Black, Brown, rural, and low-income communities” exist in the state.”

The department would get $7.5 million to provide grants and technical assistance to doula-training entities to expand that workforce. The bill would direct grants to urban counties with high maternal morbidity disparities; rural areas with limited or no obstetric providers or maternity wards; and to communities affected by hospital closures or reductions in maternity services.

Nonprofit organizations, community-based programs, training collectives, academic institutions, and private educational providers that conduct doula training, mentoring, and continuing education would qualify for the grants.

“Florida continues to face unacceptable disparities in maternal and infant health outcomes. Too many families lack consistent access to prenatal, postpartum, and infant care, especially in rural communities and in communities of color,” Williams said. “Addressing these gaps requires policies that prioritize continuity of care, workforce, support, and coverage that meets families where they are.”

Debt protections

The lives of Florida residents could also be improved if the Legislature strengthened oversight of Medicaid, Williams said, referencing a recent federal court finding that the administration of Gov. Ron DeSantis sent Medicaid termination letters following the end of the COVID public health pandemic that were “vague, confusing and often incorrect and misleading.”

Williams said the Health Justice Project supports HB 1271 and SB 1222, carried by Jacksonville Democrat Rep. Angie Nixon and Miami Republican Sen. Ana Maria Rodriguez. The bills limit how far debt collectors can go to collect medical debt.

“Unfortunately, across Florida debt is not just a financial issue, it’s a health care one as well. Medical debt forces families to delay care; it drains household savings and pushes working people into long-term financial instability through no fault of their own,” Williams said. “When Florida and federal policies limit access to affordable, available medical services, we shouldn’t allow debt collectors to threaten people with their livelihood.”

Expand scope, not Medicaid

Ten states, mostly southern and including Florida, have refused to expand Medicaid under the Affordable Care Act, often referred to as “Obamacare,” to provide health coverage to childless, lower-income, working adults. 

While the Republican-led Legislature isn’t willing to expand the health care safety net to cover more people, top legislators, including House Speaker Daniel Perez, a Miami Republican, have championed bills that would expand services that health care providers may offer by altering their “scope” of allowable services.

Specifically, HB 693, filed by Miami Republican Mike Redondo, would authorize all advanced practice registered nurses to work independently of medical doctors. While some advanced nurses can do that today, it’s authorized on a limited basis and only for provision of primary care. Redondo’s bill would allow others, such as registered nurse anesthetists, to work independently of physicians.

The move to expand what advanced nurses can provide has put the bill on organized medicine’s radar, and Jacksonville health care lobbyist Christopher Nuland said quashing the scope of practice expansion for nurses, what he describes as a small part of a much larger bill, is a priority of his.

Expanding scope for advanced nurses has been a long-standing priority for the House. So has been eliminating certificate of need requirements for the construction of new health care facilities, which HB 693 also would do for nursing homes and institutions for the developmentally disabled.

HB 693 also would require people on food assistance who are not disabled and who don’t have young children to show they are working through age 64. Florida law now requires people to show they are working through age 59. The change is being made to conform with the provisions in the One Big Beautiful Bill.

Dental care

Another bill, HB 363, would establish a new health care category in the state called “dental therapists.” The Florida Dental Association does not support the idea, sponsored by Republican Rep. Linda Chaney of St. Pete Beach. The bill is being championed by a group called Floridians for Dental Access, led by dentist Dr. Frank Catalanotto. 

The Senate has rejected similar legislation in the past but advocates hope to enlist Senate President Ben Albritton, a Republican from Wauchula, who’s been keenly interested in investing in rural counties. Those are some of the hardest hit by dental shortages and cost increases, with nearly 41% of Florida’s 32 rural counties reporting a 77% increase in dental-related hospital and emergency room billings. 

The grassroots advocacy group Florida Voices for Health has made dental screenings at schools its top priority and is lobbying for SB 1136 and HB 1091. The bills would alter Florida’s “Parent’s Bill of Rights” to allow dental screening to be performed at schools after parents have been given written notice and reasonable opportunity to deny, consent, or opt their students out of the screenings. The screenings would be limited to noninvasive visual inspection for signs of dental disease or abnormality. 

“Anyone who’s lived with dental pain knows what it’s like day-to-day, how hard it is to focus and stay on top of things when you’re living with like a pain in your mouth. And so this bill … clarifies school districts are allowed to use passive consent,” FVH Executive Director Scott Darius said. “And it feels like a small change, but one that’s happening in the context of, you know, the end of community water fluoridation, which is just going to impact low-income kids the most.”

He added that the legislation would give FVH a platform to talk to school districts about the importance of dental screenings and encourage them to start dental screening programs if they don’t already have them.

Safety net hospitals’ agenda

Safety Net Hospital Association of Florida CEO Justin Senior said his association will closely track House and Senate budgets and spending on Medicaid.

A top priority is ensuring the viability of an $86 million program meant to help train future physicians and to solidify Florida’s health care workforce. Passed as part of the 2023 “Live Healthy” proposal, the “Slots for Docs Program” requires the state to annually allocate to hospitals $100,000 for each newly created residency for a physician specialty or subspecialty for which there is a statewide shortage.

The law lays out 29 specialities and sub-specialities experiencing a statewide “supply and demand deficit,”  including  obstetrics and gynecology; geriatric medicine; family medicine; emergency medicine; and cardiology.

The Slots for Docs Program is funded with state dollars that are coupled with matching federal Medicaid funds.

However, the program isn’t yet operational because the federal government, concerned that there was no mandate for the physicians to care for Medicaid patients, didn’t approve the plan. Senior said the safety-net hospitals have a two-fold goal for the 2026 session: 

• Ensure the money in the current fiscal year budget for the Slots for Docs program that isn’t being spent isn’t raided for other purposes.
• Help work out the details of a graduate medical education program that the federal government could approve. 

“We’re hoping to find a way to maintain that $86 million in the system,” Senior told the Florida Phoenix. “And we’ll have to find a new distribution model for it.”

Senior said the hospitals — as of now — haven’t been harmed by the federal government’s decision to not approve the program. And, he said, as long as the Legislature agrees to revert the unused funds from the current budget and allow them to be used in the coming FY 2026-27 budget, his member facilities should be fine.

“There’s been no impact yet but I think the hospitals that were counting on this money and were responding to the incentives in the Slots for Docs program would really like to see a program, or whatever replaces it, drive the money in a very similar way.

To that end, Senior said the hospitals are on board with Gov. Ron DeSantis’ budget proposal to distribute the money, which essentially borrows from a different and already approved graduate medical education plan.

“It looks acceptable to us but we are hopeful that the House and Senate take up either that or something very similar to it,” Senior said.

In addition to the $86 million in funding, Senior said, his group will closely track the budget process and work to ensure Medicaid funding for hospitals isn’t cut.

“We hope there are no rate cuts. A lot of that is tied to the economy and the economic performance,” he said, noting that Medicaid is counter-cyclical. During recessions, when people lose their jobs, the number of people relying on Medicaid for health care security increases. The caseload increases come as the state has less money coming into its coffers to pay for the services.

“We’re not seeing that right now. Medicaid enrollment has dropped below 4 million in the most recent reading in Florida and we are seeing right now, if you look at the measure of gross domestic product and things like that around the country, the economy is still growing. So we are hopeful that there are no cuts to Medicaid rates.”