Effort to expand Medicaid coverage for low-income Floridians gains momentum


Shane Ersland


An advocacy effort that aims to expand Medicaid coverage for low-income Floridians is gaining support throughout the state.

Florida is one of only 10 states that has not expanded its Medicaid program under the Affordable Care Act to adults ages 19-64 with income under 138% of the federal poverty level. But a new poll shows a high level of support for Medicaid expansion in the state.


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The poll, conducted by Mason-Dixon Polling & Strategy, Inc., showed that 76% of those who participated support expanding Medicaid to 138% of the poverty level, which would provide coverage for individuals making less than $20,120 per year and families of three that earn less than $34,300 per year. A total of 625 registered Florida voters were interviewed by phone for the poll, which was conducted from March 27th through March 30th.

The Florida Decides Healthcare political committee is working to pass a ballot initiative that would expand Medicaid to cover individuals that fit that criteria. Florida Policy Institute (FPI) Chief Strategy and Development Officer Holly Bullard works with the committee, and said it will begin collecting signatures to place the initiative on the general election ballot next year.

“We started working on it a couple years ago,” Bullard said. “Then Florida Decides Healthcare started to drive it completely in 2021, so now we’re rolling. We’re shooting [to place the initiative on the ballot] for 2026, which means we’ll start collecting signatures in 2024.”

The poll indicates that the initiative has the potential to surpass the 60% support threshold required to pass a constitutional amendment via ballot initiative in the state. To place a constitutional amendment on the ballot, proponents must collect a total number of signatures that is equal to 8% of the total number of votes cast in the last presidential election.

The poll found bipartisan support for the initiative, as 95% of registered Democrats supported it, along with 62% of registered Republicans. The poll saw 74% of Independents polled in favor of Medicaid expansion.

“Floridians, regardless of party, have supported it,” Bullard said. “It’s not a partisan issue. It’s about health and trying to save Floridians money.”

Florida voters mirror a national trend in bipartisan support for Medicaid expansion, as recently demonstrated by its passage in the Republican-controlled North Carolina Legislature last month, as well as the approval of a ballot initiative to expand Medicaid in South Dakota last November. 

“Legislators in other states have had [bipartisan] help,” Bullard said. “So you see movement there, and why there’s not a lot of pushback to get the public’s support in general.”

Evidence shows that expanding Medicaid leads to coverage gains, improved access, and more affordable care. Its proposed expansion in Florida is expected to bring $14.3 billion in federal funds into the state over a five-year period. FPI researchers project state general revenue savings in the range of $200 million annually.

“It’s literally a win for everybody, and you can close the coverage gap in Florida by doing this,” Bullard said. “It makes sense for the state budget and the human cost to pull a ton of money into our economy. The ballot initiative is also raising awareness to the public that this is the right thing to do.

Having healthy moms and dads is really important, and it would impact over one million people. It’s even more urgent now because of the unwind of the (public health emergency). Over one million people won’t be eligible anymore. We have redeterminations now, with people falling back into the coverage gap, and we don’t even know the cost of that yet.”