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Conservative advocacy groups file opposition to Medicaid ballot question

Voters are not adequately informed of the possible fiscal impacts on the state, opponents say.

Two conservative advocacy organizations on Thursday filed a brief with the Florida Supreme Court opposing a proposed constitutional amendment expanding Medicaid.

Americans for Prosperity – Florida and the Foundation for Government Accountability, based in Naples, argue that voters are not adequately informed of the possible fiscal impacts on the state.

“Floridians deserve access to the best health care options possible, but this proposal would mislead voters into expanding a broken system and force our legislature into permanently diverting our state’s limited resources away from education, roads and other government responsibilities,” AFP-FL state director Skylar Zander said in a statement.

The groups argue that the amendment, proposed by the Florida Decides Healthcare political committee, violates the constitution’s single-subject rule for proposed amendments by altering executive, legislative and local government functions.

Additionally, by requiring the Governor to expand Medicaid and the Legislature to allocate funds, the state would be locked into the expanded program, creating a substantial burden on the state government, they wrote.

The high court delayed the amendment, originally scheduled for next year’s ballot, to 2022 when it took up the case.

“We urge the Florida Supreme Court to stop this unconstitutional proposal in its tracks,” Zander said.

Also on Thursday, the Florida House and Senate filed their own briefs raising a series of legal objections to a proposed ballot initiative that would require expansion of Medicaid to cover more low-income adults. The briefs argue, in part, that the proposal would be misleading to voters and improperly infringe on the Legislature’s powers.

For example, the briefs contend the proposed amendment would have broader effects than expanding Medicaid to more people. They argue it would effectively force the Legislature to participate in the broader Medicaid program — which is optional for states.

“The Florida Legislature currently chooses to participate in the federal Medicaid program and to appropriate funds to that effect,” the House’s 47-page brief said. “But neither federal law nor the Florida Constitution requires Florida to participate in Medicaid. The initiative proposal removes the Legislature’s discretion to opt out of Medicaid. Instead, it effectively requires the Legislature to enact policies — and to make billions of dollars in appropriations — to allow Florida to continue participating in Medicaid in order to ensure that ‘Medicaid benefits’ are provided to the proposed expansion population.”

Constitutional amendments require 766,200 signatures before going to voters. The Medicaid expansion’s petition currently has 90,390, according to the Florida Division of Elections.

The proposed ballot language must be approved by the Florida Supreme Court: Requires State to provide Medicaid coverage to individuals over age 18 and under age 65 whose incomes are at or below 138 percent of the federal poverty level and meet other nonfinancial eligibility requirements, with no greater burdens placed on eligibility, enrollment, or benefits for these newly eligible individuals compared to other Medicaid beneficiaries. Directs Agency for Health Care Administration to implement the initiative by maximizing federal financial participation for newly eligible individuals.

Ballot amendments must earn at least 60 percent of the vote to pass.


The News Service of Florida contributed to this post.

Written By

Renzo Downey covers state government for Florida Politics. After graduating from Northwestern University in 2019, Renzo began his reporting career in the Lone Star State, covering state government for the Austin American-Statesman. Shoot Renzo an email at and follow him on Twitter @RenzoDowney.

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Florida Politics is a statewide, new media platform covering campaigns, elections, government, policy, and lobbying in Florida. This platform and all of its content are owned by Extensive Enterprises Media.

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