It is important to understand that Medicaid provides 2/3 of medical costs for eligible individuals up to the maximum ‘pot’ of money allocated by Congress, with the state providing the other 1/3. However, if the state cannot prove that it has 1/3 of the costs it is claiming, Medicaid will not pay the full 2/3 of the costs.
For example; Florida says it is has $9 of Medicaid eligible expenses. If Florida can show that is has $3 to contribute, the Federal government will contribute the other $6 and all $9 of expenses will be paid to the provider. However, if Florida only has $2 to contribute, the Federal government will only contribute $4, which means that there is only $6 available to reimburse providers for $9 worth of services.
One way of reducing Federal Medicaid expenses is to reduce the total amount of funds available to reimburse states at the 2/3 rate, the other way is to restrict states from generating revenue to pay the 1/3 share.
Human Harm
There are 25,392 people in Charlotte County enrolled in Medicaid, which is provided under a number of different plans; Humana Medical Plan, Molina Health Care, SFCCN – Community Care Plan, Simply Healthcare Plans, Sunshine State Health Plan. This number represents just over 12% of the total population of the county.
These plans provide necessary health care, including long term care (2,622 people) to low income and individuals with disabilities. In our county 16,505, or 65% of Medicaid recipients are either under 18 (12,256) or over 65 (4,249).i Note that these are the two populations that would not be expected to work, or to work in the type of full-time employment that might be expected to include health insurance as part of the compensation package.
The human cost to Medicaid recipients in our community will be devastating, especially to the most vulnerable populations, children and the elderly.
Financial Harm
There are two types of financial harm that our local economy will experience. Remember that Medicaid only reimburses up to the maximum amount allocated by Congress, that total has now been cut by $793 billion per year, leaving a federal ‘pot’ of only $121 billionii. Charlotte County will see a direct loss of $16,347,214 in State and Federal Medicaid reimbursement. iii Losses of this magnitude will mean lay offs which will come from the orderlies, food service workers, clerical staff and technicians, pushing more people into poverty with no safety net.
The second type of financial harm comes from the provision that bars states from implementing any new Medicaid provider taxes — a cornerstone of Florida hospital and nursing home funding— and prohibiting states from increasing current provider taxes. This is how Florida raises the funds for its 1/3 share of Medicaid expenditures.
As a state that has not expanded its Medicaid program, forgoing billions in federal Medicaid funding each year, Florida relies heavily on provider tax payments to draw federal funding to make up the gap.
Restricting Florida’s ability to impose or increase these taxes would decrease the state’s ability to close the financing gap for the Medicaid program. This will cause the state to take harmful measures to balance budget, such as reducing eligibility, limiting benefits, or reducing already low payment rates for healthcare providers.iv Smaller providers will be lost first, but the larger providers will feel it too, resulting in more people out of work and losing their employer provided health insurance with no ability to replace it.
i All data in the first two paragraphs is taken from The Florida Agency for Health Care Administration, Medicaid Data Analytics tables dated 6/20/2025, Data as of May 31, 2025.
ii KFF.org Allocating CBO’s Estimates of Federal Medicaid Spending Reductions and Enrollment Loss Across the States: House Reconciliation Bill
Rhiannon Euhus, Elizabeth Williams, Alice Burns, and Robin Rudowitz Published: Jun 04, 2025
iii Florida Agency for Health Care Administration; Local Revenue Maximization and Funding for Special Medicaid Reimbursement Programs. Report to Florida Legislatures State Fiscal Year 2021-2022.
iv Florida Policy Institute Press Release dated 5/14/2025
