By Carol Moore, March 2025.

Florida voters right now can make a difference to an estimated 1.3 million low-income Floridians who would benefit from the expansion of Medicaid in Florida.  For over 10 years the the Republican governors and  legislature have blocked expansion.

There is now a petition campaign led by www.FloridiaDecidesHealthcare.org for a constitutional amendment to mandate Medicare expansion in Florida:

Download and sign the Florida Medicare Expansion Petition

 

Florida ranks 47^th in the nation for healthcare access and affordability, with the 3^rd highest number of uninsured people in the US.  This petition aims to address the gap in healthcare coverage for Floridians who earn too much to qualify for traditional Medicaid, but too little to afford private heath insurance or do not get healthcare through their employer.

What is Medicaid Expansion?

Medicaid is a joint federal and state program designed to provide health coverage for low-income individuals and families. The 2010 Affordable Care Act (ACA, also known as "ObamaCare") provided states with the option to expand Medicaid to cover more low-income adults, specifically those earning up to 138% of the federal poverty level (FPL), or up to about $44,000 USD for a family of four. Since the ACA's passage, 40 states and Washington, D.C., have opted to expand Medicaid, but Florida remains one of the small minority of states that has chosen not to.

As of 2025, Florida’s decision to not expand Medicaid has left an estimated 1.3 million low-income Floridians without access to affordable healthcare. These individuals, often referred to as the "coverage gap," earn too much to qualify for Medicaid under the state’s current guidelines, but not enough to afford private insurance or even subsidized plans through  Florida’s “Obamacare” health insurance marketplace.

The Petition for a Constitutional Amendment

The petition for an amendment to the Florida Constitutional seeks to require Medicaid expansion, which would provide health coverage to all low-income adults up to 138% of the federal poverty level.

The amendment would make it a constitutional requirement for the state to seek federal approval for the expanded Medicaid program, ensuring that low-income Floridians have access to affordable health insurance. Advocates of the petition assert that the state's refusal to expand Medicaid has left too many residents vulnerable to health issues that go untreated due to lack of coverage.

Reasons Behind the Petition

1. Health Care Accessibility: The most compelling reason for the petition is to expand healthcare access for millions of uninsured Floridians. According to studies, expanding Medicaid would ensure that individuals who are currently unable to afford insurance would have access to preventive care, hospital visits, and essential medical treatments.
2. Economic Impact: Medicaid expansion is projected to bring significant financial benefits to Florida. Federal funding for Medicaid expansion would cover 90% of the costs, with the state required to pay only 10%. This would alleviate financial pressures on state hospitals, many of which have to absorb the cost of treating uninsured patients. Additionally, expanding Medicaid could create jobs in the healthcare sector and stimulate economic growth in the state.
3. Health Outcomes: Evidence from other states that have expanded Medicaid has shown improvements in health outcomes. Medicaid expansion has been linked to lower mortality rates, fewer hospital readmissions, and better overall health in underserved communities. Expanding Medicaid in Florida could lead to similar positive outcomes, particularly for people suffering from chronic conditions like diabetes, hypertension, and mental health issues.
4. Public Support: There is growing public support for Medicaid expansion in Florida. Polls indicate that a majority of Floridians favor expanding Medicaid, citing the need for affordable healthcare and the economic benefits that it would bring to the state. The petition reflects this public sentiment, aiming to put the issue on the ballot and allow voters to decide whether they want Medicaid expansion written into the state constitution.

Legal and Political Challenges

While the petition has gained significant support, it faces several hurdles, particularly in a state where the political leadership has resisted Medicaid expansion. Governor Ron DeSantis and the Republican legislative majorities in Tallahassee  have opposed expanding Medicaid, citing concerns about long-term costs and the desire for greater control over state healthcare programs.

Additionally, Florida’s Republican-led legislature is notorious for its opposition to citizen-led initiatives to amend the Florida Constitution. This constitutional amendment petition will likely face opposition from those who will argue that Medicaid expansion could strain the state budget and undermine state sovereignty in managing healthcare.  Neither of these arguments is valid.

For the petition to succeed, it must collect approximately 900,000 valid signatures by early February 2026, to place the proposed amendment on the ballot in November, 2026. If it does, voters will have the final say in whether Medicaid expansion becomes a part of Florida’s constitution. However, the path to securing those signatures and gaining voter approval is challenging and will require a concerted effort from advocacy groups and concerned citizens.

This petition reflects growing frustration among many Floridians who believe that expanding Medicaid is an essential step in improving health outcomes and strengthening the state's economy.

The outcome of this petition will depend on the mobilization of public support, the ability of advocates to collect signatures, and the political climate in Florida. However, the conversation around Medicaid expansion is far from over, and it is likely that the issue will continue to be a focal point in state politics for years to come. With increasing pressure to provide better healthcare for all Floridians, Medicaid expansion may ultimately become a reality, changing the landscape of healthcare in the state.

Conclusion

The petition for a Florida constitutional amendment to expand Medicaid represents a crucial effort to address the healthcare needs of the state's most vulnerable residents. It highlights the ongoing debate over the state's healthcare system and the need for a solution that offers affordable coverage to all Floridians, regardless of their income. As the petition moves forward, it will be a defining moment in the fight for universal healthcare access in Florida, and potentially, the broader national discussion on Medicaid expansion.

Download and sign the Florida Medicare Expansion Petition

 

Returning your signed petition.

In order to be eligible to sign the petition, you must be a registered Florida voter.  If you have not already submitted your 2025 FPCA, please do that right way at Vote From Abroad.  Petitions must be on the form provided at the Florida Decides Healthcare website, with your signature and date.  Please make certain to provide all the information requested, as missing information is often grounds for disqualifying a petition submission.

Petitions must be returned by mail, but any reliable alternative is sufficient.  US Embassy/Consulate mail is an inexpensive alternative, requiring only standard US first-class postage. 

 

ChatGPT, an AI large language model "chat bot", was used to assist with drafting this article.

About Carol

Carol Moore was the founder and first Chair of the DA Florida State Team.  She is a past Chair of the DA UK Country Committee.  Carol lives in London, England, and votes in Palm Beach County, Florida.