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What the 2020 Elections Mean for Medicaid Expansion in Florida

What Happened?

Florida Senate

Currently, the partisan makeup of the Florida Senate is 23 R – 17 D. There were four competitive state Senate seats: SD 3, SD 9, SD 39, and SD 37. Republican Ileana Garcia in SD 37 will be joined by Senator-elect Jason Brodeur in SD 9 and Senator-elect Ana Maria Rodriguez in SD 39 – both former House members. Former House Rep. Loranne Ausley will be the new Democratic Senator representing Tallahassee. The incoming Senate President is Wilton Simpson (Citrus, Hernando, and part of Pasco County).

Florida House

Before the election, Republicans had 72 members, Democrats 48. After election night, Republicans took their majority to a 78-42 majority. There were 15 competitive House seats, with Republicans winning the overwhelming majority of these races. Republicans ran strong in Miami-Dade County, saving every single incumbent seat and flipping two others. The incoming Speaker Designate is Rep. Chris Sprowls (Clearwater, Dunedin, and Tarpon Springs in northern Pinellas County).

Federal and Supreme Court

While the power to expand Medicaid in Florida lies with the Florida legislature the outcome of the presidential election might have some impact. The current administration has been creative in how it encouraged states to change their Medicaid programs and there is no reason why the incoming administration couldn't do the same to incentivize expansion.

During the November 10 oral arguments, the Supreme Court appeared willing to leave the Affordable Care Act in place. Two of the court’s conservatives signaled they would not strike down the landmark legislation. Chief Justice John Roberts and Justice Brett Kavanaugh suggested that the court may cast aside the individual mandate while leaving the rest standing.

What It Means?

Expanding access to health care for low-income Floridians will still be a hard fight in the Florida legislature. We will need to educate newer and returning members about the benefits to their constituents and the state budget. Despite the reluctance of leadership to accept this opportunity in the past, the environment has changed significantly in the wake of COVID-19:

  • Florida’s general revenue fund this year will be $3.4 billion shy of what was originally expected, resulting in a predicted $2 billion shortfall for 2021-22.

  • Enrollment in Florida’s Medicaid program also has grown significantly, increasing from 3,764,038 in March to 4,287,874 in August, the latest available numbers show.

  • An estimated 1.2 million Floridians, including many who have lost employer-based coverage are now eligible for Medicaid expansion.

These factors, plus potential incentives from the federal government and organized public pressure could put Florida closer to Medicaid expansion that it has been in years. As Floridians we have to do our part by signing the petition, contacting legislators, sharing stories, and mobilizing our communities.


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