Protect Health Care Access in the State Budget
3/2/2026
This article first appeared as a column in the 2026 March issue of South Florida Hospital News
By Mary Mayhew, FHA President and CEO
Budgets are about priorities. That is true whether it’s a household budget, a corporate budget, or a government budget.
Families have to decide where and how much to allocate paychecks for obligations for housing, transportation, shelter, food, and other essential needs. Companies have to make allocation decisions based on current obligations and future growth goals. States have to make choices based on immediate priorities and needs and maintain adequate reserves for future financial challenges. And the budget must balance. What is allocated as spending must be offset with revenue. That requires prioritization.
Lawmakers are working to finalize Florida’s budget for fiscal year 2026-27. As one of the fastest growing states in the country – attractive to families, companies, retirees, and visitors alike – Florida is in an enviable position. Florida ranks first in the nation in education, net in-migration, entrepreneurship, and new business formations, with 3.8 million new businesses created since 2019.
Key to that continued growth and success is protecting health care programs, including Medicaid, from funding cuts, and crucially, so is investing in the health care infrastructure to meet future needs.
The initial budget proposals from the House and Senate reflect overall appropriation increases over the current year’s budget for health and human services functions – 3.8 percent in the House version and 3.3 percent in the Senate version. That is good news.
What is concerning, however, is the Senate’s initial proposal which seems to single out hospitals for a 3 percent cut to base Medicaid reimbursements. At the time of this writing, the proposal includes a payment cut of nearly $90 million to Florida’s hospitals.
This proposal comes at a time when hospitals have experienced nearly 30 percent increases in major cost areas, such as labor, prescription drugs, and medical supplies over the last few years, and have had Medicaid inpatient base rates increased by just 4 percent over the last 10 years.
State government is a purchaser of health care services. The state of Florida provides health care coverage to frail, low-income elderly, more than 2 million children, individuals with intellectual and developmental disabilities, and extremely low-income parents. For far too long it has become accepted practice by government payers to reimburse health care services well below the cost of care. In Florida, hospitals are reimbursed on average 60 cents on the dollar of cost. Hospitals are expected to figure out how to fill that gap without sacrificing quality or access.
I doubt we would feel confident about our bridges, highway overpasses, and other essential infrastructure if the government paid construction companies well below the cost of safe construction.
In addition, these cuts to reimbursements for hospital care and the failure to cover annual cost increases in labor and other essential expenditures exacerbate the healthcare affordability crisis for everyone paying for private insurance and every employer purchasing health insurance coverage for their employees.
Prioritizing health care funding in the budget is not about prioritizing buildings or facilities. It is about prioritizing a health care infrastructure that is always ready, always available, and always capable of responding to any emergency or crisis, whether it involves one person or many. It is about prioritizing timely access to care, from the most routine of primary and preventive care to the most specialized of complex care, for every Floridian. And, it is about prioritizing a health care workforce with the diverse range of skills and expertise that modern medicine demands.
A budget, whether for a household or a government, reflects choices and priorities. Florida’s hospitals, the tens of thousands of individuals who give meaning to hospitals’ work, and the more than 24.3 million Floridians who call the Sunshine State home are relying on state lawmakers to choose to prioritize health care by rejecting funding cuts and investing strategically and prudently for long-term success.