‘Widespread, Long-Lasting Hardship’: Florida Groups Caution That Impact of Proposed Federal Cuts Would Reverberate in Every County
As the Florida House and Senate prepare to iron out differences in their respective budget proposals, largely missing from discussions so far is congressional leaders’ push for over a trillion dollars in potential cuts to vital programs and services to “offset” the costs of extending and expanding tax cuts for the wealthiest Americans.
The U.S. House and Senate, who are currently on a two-week recess, are scheduled to reconvene on April 28. Before the break, each chamber passed its own budget blueprint, known as a budget resolution. The House’s proposal calls for $880 billion in Medicaid cuts and $230 billion in SNAP cuts over a 10-year period.
If enacted, deep federal cuts to Medicaid and SNAP would force Florida lawmakers to choose: raise billions in additional revenue each year to plug the hole, cut funding for other programs and services in the budget, cut Medicaid and SNAP in the form of program eligibility and/or benefits, or act on a combination of these options. State economists have already forecast a $2.8 billion deficit for Florida in FY 2026-27, which they project will increase to $6.9 billion in FY 2027-28.
“The Florida House and Senate have passed their respective budget proposals without addressing the potential loss of billions in federal funding on the horizon,” said Sadaf Knight, CEO of FPI. “Our state’s safety net is already frayed, and if congressional leadership has its way, we could see a catastrophic loss of health care coverage and food assistance in Florida, impacting families in every single county and wreaking havoc on the state and local economies. Our Florida lawmakers need to be vocal right now and tell Congress that these deep cuts are simply not acceptable.”
There are currently over 3.9 million Floridians on Medicaid — most of whom are children, older adults, or people with disabilities — and over 2.9 million Floridians who depend on SNAP food assistance. People in each county in Florida rely on these critical programs, and every community in Florida would be impacted by dramatic cuts.
Research shows that Florida families, communities, and state and local economies will experience widespread, long-lasting hardship if the deep safety net cuts being floated are enacted. A recent study by The Commonwealth Fund found that if the current Medicaid and SNAP cuts proposal is allowed to go into effect, without the state filling in the gap, the state will lose nearly 45,000 jobs and its GDP will shrink by over $4.5 billion.
Medicaid Per Capita Caps or Work Requirements Would Put Floridians’ Health Care Coverage at Risk
Some federal proposals have called for a fixed amount of funding per Medicaid enrollee, otherwise known as “per capita caps.” Under this scenario, Florida could see a cost shift of between $20 billion and $38 billion from 2026 to 2035, according to the Center on Budget and Policy Priorities, forcing state lawmakers to cut benefits, enrollment, or payments to providers.
Another fiscal estimate, by KFF, found that under the current House proposal, Florida would lose $4 billion in federal Medicaid funding a year — more than Florida’s entire current-year budget for its Department of Environmental Protection.
Another proposal being floated, Medicaid work requirements, could put more than 1 million Floridians’ coverage at risk.
While congressional leadership is working on budget proposals to make drastic cuts to Medicaid, the program is widely popular across voters of all political parties, and cutting Medicaid is deeply unpopular. A recent poll by Florida-based polling firm Fabrizio Ward found that 74 percent of U.S. voters had a favorable view of Medicaid, while only 11 percent had an unfavorable opinion. Not only is preserving Medicaid popular, but expanding the program is also popular in Florida. A March 2025 Mason Dixon poll revealed that 78 percent of Florida voters support expanding Medicaid to adults with income below 138 percent of the federal poverty level ($37,777 for a family of three), including 91 percent of Democrats, 69 percent of Republicans, and 74 percent of Independent voters in the state.
“Any lawmaker who supports these harmful Medicaid cuts to pay for tax breaks for billionaires should be ashamed because they are putting lives at risk. Taking away this vital healthcare will make the ill sicker, stunt growth opportunities for children with learning differences as well as people with disabilities, close the door on seniors who can’t afford to pay nursing home care and shatter the lives of many more vulnerable Floridians,” said Coy Jones, 1199SEIU Political Director and Vice President at SEIU Florida. “But our union of 35,000 active and retired healthcare workers will continue to raise our collective voice, lobby elected officials and stand with our allies to speak out against these cuts and others on the chopping block, including SNAP benefits – a vital food assistance program that helps nearly three million Floridians put food on the table.”
“The proposed federal cuts to Medicaid and SNAP would be devastating for millions of Floridians who rely on these essential programs for healthcare and food security,” said Alison Yager, executive director of Florida Health Justice Project. “As the economic sands are shifting beneath our feet, Florida's most vulnerable residents — children, seniors, and people with disabilities — would bear the brunt of these shortsighted policies. Our state leaders must speak out against these proposals and recognize that cutting vital safety net programs doesn't save money in the long run—it simply shifts costs and creates preventable suffering for Floridians from Miami to the Panhandle.”
“Having access to affordable health care coverage is a lifeline for Floridians,” said Scott Darius, executive director of Florida Voices for Health. “The conversations that federal lawmakers are having on Medicaid should be centered on how to improve the program — not on enacting deep cuts that would put the health and well-being of children and adults at risk.”
Maverick is a 5-year-old who has Cri du Chat syndrome and more than 30 other medical issues. Last week, he and his mom Jacqueline Rich flew from their home in Jacksonville to meet with Florida Congressmembers and staff on Capitol Hill, asking them to protect these lifeline programs. She knows the feeling of inadequate health care - she lost access to health care services for children with special needs during last year’s public health emergency unwinding. Jacqueline said, “Maverick and I are crystal clear examples of what happens when you cut Medicaid. His medical progress is at risk. Critical caretaker self-care time is at risk with the loss of the financial help we were getting for medical day care. I went to D.C. to make sure Congress and their staff know the faces of the constituents they could be impacting if they make cuts to Medicaid. Instead of cutting, both federal and state lawmakers should be working together to make the program work better for Florida families.”
Maverick and his parents, Jacqueline and Kyle, braving the cold DC weather to talk to their Florida congressional representatives about protecting Medicaid and SNAP.
Food Insecurity Would Increase Under Deep Cuts to SNAP
Some congressional leaders are calling for states to be required to pay a portion of SNAP food benefits for the first time. While questions remain as to how much states could be required to pay of SNAP food benefit costs, if Congress implemented a new state match of 10% of SNAP benefits, it would cost Florida roughly $657 million in 2026 — or more than what the state spent in its FY 2024-25 budget on affordable housing.
“Cuts to SNAP are not just numbers on a budget — they are meals taken from the children, seniors, and working families who rely on this much-needed program to get through the month,” said Kim Johnson, president/CEO of Florida Impact. “Food prices are at an all-time high and the need continues to grow, cutting SNAP would deepen hunger and hardship in every corner of our state & country. We must protect and strengthen — not weaken — programs that keep our families fed and communities healthy.”
Food assistance plays a critical role in Florida: more than 59% of families participating in SNAP have children, and more than 41% of participating families include seniors or adults with disabilities. Additionally, SNAP benefits are spent at 15,100 grocery stores in Florida. Every $1 in additional spending on SNAP benefits generates $1.50 in economic activity when households use their benefits to shop at local businesses in their communities.
FPI is an independent, nonpartisan and nonprofit organization dedicated to advancing state policies and budgets that improve the economic mobility and quality of life for all Floridians.
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American Rescue Plan Act Changes. The American Rescue Plan Act of 2021 extended PEUC and PUA benefits through the week ending September 6, 2021. It also increased the maximum duration of PEUC benefits ($300 a week) to 53 weeks and the maximum duration of PUA to 79 weeks. Although PEUC and PUA did not end until September 6, 2021, Florida withdrew from the Federal Pandemic Unemployment Compensation Program (FPUC) effective June 26, 2021. FPUC provided persons who were out of work due to COVID-19 with an additional $300 a week in unemployment insurance.
Reemployment Assistance weeks reverted to 12 effective January 1, 2022. DEO determines the maximum number of weeks available to RA claimants based on a statutory formula that looks at the average unemployment rate for the most recent third calendar year quarter (i.e., July, August, and September). Based on the downturn in unemployment, the maximum number of weeks for RA reverted to 12 effective January 1, 2022.
RA work-search and work registration requirements reinstated on May 30, 2021. Persons filing an application for RA benefits beginning March 15, 2020, are not required to complete work registration in Employ Florida through May 29, 2021. In addition, work search requirements for individuals requesting benefits for the weeks beginning March 15, 2020, were also reinstated on May 30, 2021.
RA biweekly reporting requirements reinstated. Although previously waived, biweekly reporting was reinstated effective May 10, 2020. DEO’s guide to claiming weeks is here.
Mobile app deployed. DEO has deployed a mobile app for RA applications.
DEO announces extended benefits. DEO announced implementation of Extended Benefits (EB).
Resources and guidance. For a list of resources and guidance from the United States Department of Labor on unemployment insurance and COVID-19, go here.
For DEO’s “Reemployment Assistance Frequently Asked Questions and Additional Resources,” updated 12/30/2020, go here.
For DEO’s latest claims data, go here.
DCF opens offices. DCF has reopened its brick-and-mortar storefronts, which were previously closed due to coronavirus.
DCF adds call center numbers. DCF has added a call center number for Monday through Friday, from 7 a.m. to 6 p.m. Call center numbers now include 850-300-4323, 866-762-2237, or TTY 1-800-955-8771.
Certification periods extended by 6 months only through August 2020. Certification periods for cash, food and medical assistance were extended by 6 months for individuals and families scheduled to recertify in April through August 2020. FNS’ approval of the SNAP extension for August is here. However, effective September 1, 2020, SNAP, TANF and Medicaid recertifications have been reinstated, although DCF says that no one will lose Medicaid due to recertification.
DCF allows phone interviews. Phone interviews are now being used for TANF cash and SNAP food assistance.
Mandatory work requirements suspended only through May 2021. Under a directive from Governor DeSantis to waive work requirements for safety net programs, DCF waived work requirements for individuals participating in the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) through May 2021. To do this, DCF explains that it partnered with the Department of Economic Opportunity to apply “good cause” statewide for TANF and SNAP recipients who would otherwise be subject to participation in mandatory work requirements as a condition of receiving those benefits. Through May 2021, persons who were sanctioned in the past due to work requirements will be able to reapply and participate in SNAP or TANF again.
Work requirements were reinstated effective June 1, 2021.
Emergency allotments (EA) ended. DCF automatically supplemented SNAP allotments of current recipients up to the maximum for a household’s size for July 2021. However, EA was discontinued beginning August 1, 2021.
The SNAP benefits increase by 15 percent ended in October 2021. Floridians who participate in SNAP to put food on the table will receive a temporary 15 percent supplement to SNAP under COVID relief passed by Congress and extended by the American Rescue Plan Act through September 2021.
FNS permanently increases SNAP through revamp of the Thrifty Food Plan. Effective October 2021, FNS has mandated a permanent increase to SNAP through a revamp of the Thrifty Food Plan. DCF says that the increase amounts to about 6% for Floridians.
Time limits suspended. SNAP time limits are suspended during the COVID-19 public health emergency. No one in Florida should be barred from SNAP due to time limits, even if they exhausted their time limit in the past.
Florida granted waiver to allow families to purchase groceries online. DCF has been granted a federal waiver to permit the State of Florida to launch a pilot project statewide effective April 21, 2020, that allows families to purchase groceries online with their Electronic Benefit Transfer (EBT) card instead of going into stores.
No Medicaid terminations from March 2020 through the end of the federal public health emergency. The national public health emergency has existed since January 27, 2020 and has been renewed by the Secretary of the U.S. Department of Health & Human Services in 90-day increments since that time. The most recent renewal is effective January 16, 2022.
On March 31, 2020, AHCA alerted providers and DCF posted on the ACCESS website that:
Redetermination/recertification times are reinstated. As of October 1, 2020 AHCA's website is alerting recipients that the Department of Children and Families is now mailing letters for case reviews to check if a household is still eligible for Medicaid and/or Medically Needy. AHCA is urging people receiving these letters to take steps now to re-apply. But note, Medicaid coverage will not end during the COVID-19 Public Health Emergency. In January 2021 DCF conducted one-year “automated renewals” for people whose sole income is social security and SSI and are enrolled in an SSI-related Medicaid program (e.g., MEDS/AD, Medically Needy and Medicare Savings Programs). People getting VA income were not included in the automated renewal.
Extended application time. Effective with applications filed in February 2020, the time for submitting documentation required to process an application is extended for 120 days from the date of the application and eligibility will still be effective the first day of the month the application was received. Effective July 1, 2021, this policy has been rescinded. Medicaid applications submitted on or after July 1, 2021 may be denied on the 30th day after application or the day after verification information is due. Applications filed prior to July 1, will be allowed 120 days to provide requested verification to establish Medicaid eligibility.
Exclusion of additional unemployment payments in determining eligibility. The $600/week of additional unemployment insurance payments under the CARES Act will not be counted as income in determining Medicaid eligibility. (However, these payments will be counted as income in determining marketplace subsidy calculations.)
Coverage of Medicaid services during the state of emergency
COVID-19 Vaccines for Medicaid Enrollees. In an executive order published March 16, 2021 Governor DeSantis revised the vaccine distribution plan, which applies to the general public including Medicaid enrollees, to lower the age requirement to 40 effective March 29, 2021 and then effective April 5, 2021 all Floridians are eligible to receive any COVID-19 vaccination approved by the Food and Drug Administration.
Medicaid enrollees eligible to receive the vaccine may visit myvaccine.fl.gov to find a location distributing the vaccine and to schedule an appointment.
On March 12, 2021, AHCA published instructions for Medicaid enrollees on how to obtain Medicaid transportation once they have scheduled an appointment for a vaccine. AHCA states: "Florida Medicaid will take you to get the COVID-19 vaccine at no cost. All you need to do is set up a time to get your vaccine. Next, let your Medicaid plan know you need a ride and they will take care of the rest. If you are not enrolled in a plan, call the Medicaid Helpline at 1-877-254-1055 to find out the name and phone number for a transportation service."
The state has also recently launched a new email system to help bring COVID-19 vaccines to homebound seniors. Seniors will be able to sign up to have the vaccine come to them by emailing a request to HomeboundVaccine@em.myflorida.com.
AHCA has posted Medicaid Alerts and FAQs providing more detail on Medicaid service changes in response to COVID-19. They address a wide range of topics including, but not limited to: telemedicine guidance for medical, behavioral health, and early intervention services providers; long-term care provider network flexibilities allowing more types of providers to deliver specified long term care services; and continuity of care for adult day care center enrollees during the time these centers are closed.
AHCA is loosening coverage restrictions for behavioral health services. Effective May 5, 2020, all prior authorization requirements for mental health or substance use disorder treatment are waived and service limitations (frequency and duration) are lifted. For behavioral analysis services, current authorizations will be extended through an "administrative approval process" which does not require providers to reassess beneficiaries currently getting services. Effective July 1, 2021 service limits will be reinstated for behavioral health services and effective July 15, 2021 Medicaid prior authorization requirements will be reinstated for behavioral health services.
Per a May 29, 2020 provider alert, during the state of emergency AHCA will be reimbursing providers for telemedicine well-child visits provided to children older than 24 months through age 20. Providers are directed to actively work to schedule follow-up in-person visits to administer immunizations and other physical components of the exam which cannot be accomplished through telemedicine.
Coverage of home and community-based waiver services (HCBS) - In response to the public emergency, Florida obtained approval from the federal government to make changes in HCBS waiver programs, including the Long Term Care and Developmental Disabilities programs. The changes are effective retroactively from January 27, 2020 to January 26, 2021. Details can be found here. They include, but are not limited to:
Note on COVID-19 testing, treatment, and vaccines for the uninsured. Florida has not opted to receive 100 percent federal Medicaid funding for COVID-19 testing of people without health insurance. Under the 2021 American Rescue Plan Act this option has been expanded to cover COVID-19 treatment and vaccines for the uninsured as well. Since the state has not taken up this option Floridians must look to an uneven patchwork of free testing, treatment, and vaccine resources scattered around the state. AHCA advises that uninsured people may receive free testing from their county health department or a federally qualified health center and that “many communities provide testing for free for individuals who do not have insurance. Please [click here] to find a test site in your area. Uninsured individuals should ask before the test whether testing is free of charge." There are no state agency instructions on where uninsured people can receive free treatment. However, more information on possible sources for free treatment is available here.
Residency proof no longer required at some vaccine sites, “paving the way for migrants.” - On April 29, 2021 Surgeon General Rivkees issued a new public health advisory specifying that COVID-19 vaccines are available to “a Florida resident” or someone “who is present in Florida for the purpose of providing goods or services for the benefits of residents and visitors of the State of Florida.” This new policy applies to all state-run and federally supported vaccination sites. It rescinds an advisory issued in January that had restricted vaccinations to people who could show proof of Florida residency
2021 unemployment compensation claimants can access free or reduced cost health insurance through the ACA marketplace. The Affordable Care Act (ACA) Marketplace was re-opened in February 2021 to give people who need health insurance a new “special enrollment" opportunity to get covered. The 2021 American Rescue Plan eliminated or vastly reduced premiums for many people with low or moderate incomes.
Starting July 1, 2021, people who received or have been approved for unemployment compensation for any week beginning in 2021 can access free or reduced cost comprehensive health insurance plans through the ACA marketplace. This benefit is available regardless of someone's current income. To get this benefit, people must enroll in the marketplace no later than August 15, 2021. For help with enrollment, contact Covering Florida at 877-813-9115.
School children in distance learning still eligible for free or reduced cost meals. Students in distance learning for 2020-21 can still receive school meals through the National School Lunch Program if they are eligible. The student or parent/guardian may pick up meals at the school but should contact their school for more information.
For a list of current child nutrition program waivers for Florida from USDA, go here.
Congress allows increased fruit and vegetable benefits. At present, WIC provides $9 for children and $11 for women monthly for fruits and vegetables. The American Rescue Plan Act makes funding available for a four-month increase in the benefit of up to $35 monthly, if a state chooses to do so.
DOH attains waiver allowing remote issuance: Department of Health (DOH) obtained a waiver of the requirement that participants pick up their EBT cards in person at recertification or during nutritional education appointments.
WIC participants allowed to substitute certain food. Under a waiver from USDA, WIC participants in Florida are allowed to substitute milk of any available fat content and whole wheat or whole grain bread in package sizes up to 24 oz. when 16 oz. packages are unavailable.
USDA waived physical presence requirements: Although the scope and logistics are unclear at this time, USDA has given DOH permission to waive the requirement that persons be physically present at each certification or recertification determination in order to determine eligibility under the program through May 31, 2020.
USDA extends certification periods through May 31, 2020, for some participants.
For a list of current WIC waivers for Florida from USDA, go here.
HHS provides guidance. HHS has issued guidance on the flexibilities in TANF to respond to COVID-19.