TALLAHASSEE — On Sept. 25, Florida Decides Healthcare (FDH) announced that it will shift its Medicaid expansion ballot initiative efforts to the 2028 ballot. The decision comes after unprecedented barriers created by House Bill 1205, legislation passed by the Florida Legislature and signed by the Governor this year, changed the ballot initiative rules mid-campaign and deliberately undermined FDH’s 2026 effort.

Despite these obstacles, FDH has collected more than 200,000 petitions, raised over $6 million, and built a coalition of more than 100 grassroots organizations spanning labor, faith, healthcare providers, democracy advocates, and community groups across Florida.

HB 1205 imposed roadblocks that made signature gathering nearly impossible on a 2026 timeline. With three years to fundraise and organize, FDH is confident it will have the resources necessary to get on the ballot in 2028. FDH donors and grassroots supporters have been clear: this fight is both winnable and essential.

“Politicians in Tallahassee didn’t just make it harder to get on the ballot, they tried to shut Floridians out and deny them their constitutional right to participate in their own democracy. HB 1205 wasn’t about transparency, it was sabotage aimed directly at citizen-led ballot initiatives. This law may have delayed us until 2028, but it will not stop us. Sadly, it’s everyday Floridians who will pay the price of Florida’s refusal not to expand Medicaid: veterans who served this country, caretakers holding families together, and working people now facing the loss of healthcare if ACA tax credits expire,” said Mitch Emerson, Executive Director of FDH. “Despite this setback, we’re focused on building the biggest, strongest campaign Florida has ever seen by expanding our coalition, raising the resources, and organizing at the scale needed to overcome the barriers Tallahassee politicians created. We know Floridians are with us. HB 1205 may have delayed us, but it won’t defeat us. In 2028, Floridians will have their say, and together, we will win access to healthcare for all those who need it the most.”

Florida already has 1.4 million people stuck in the “coverage gap,” making too much to qualify for Medicaid but too little to afford private insurance. If ACA tax credit enhancements expire in January, more than 3 million Floridians — one in five of us — could be left uninsured. That means veterans unable to access care when they return home, caretakers forced to put their own health aside, and working parents choosing between paying rent or  taking a sick child to the doctor.

Every year Florida refuses Medicaid expansion, the state turns away billions in federal funding. Right now, that’s $4 billion annually, Florida tax payers’ money that could be covering healthcare for families here at home but instead flows to subsidize healthcare access for states like California and New York that have already expanded Medicaid. By 2026, that loss could grow to more than $10 billion a year.

Without expansion, hospitals across the state, especially in rural communities, will face closure. Florida risks losing up to 50,000 healthcare jobs; many of our best doctors will leave the state, and healthcare costs for everyone will continue to climb. Florida is already seeing signs of what happens when consumers start dropping out of risk pools. Insurers are asking for premium hikes of 15% nationwide for 2026, the largest increase in years, which appears to be driven by the looming expiration of ACA tax credit enhancements and the expectation that healthier enrollees will leave the marketplace.

FDH remains committed to its lawsuit against HB 1205, with a full trial scheduled for January 2026. That legal fight is not just about Medicaid, it is about protecting Floridians’ constitutional right to direct democracy. Regardless of the outcome, FDH is moving forward with a robust three-year plan.

Over the next three years, FDH will expand its coalition in every county, maintain and grow a statewide volunteer army, and engage Floridians in every corner of the state. The campaign will continue to elevate real stories from real Floridians caught in the coverage gap, making clear what is at stake if politicians continue to dismantle access to healthcare. The effort will also strengthen fundraising from both grassroots donors and major supporters who know this fight is winnable.

This has always been a long, hard-fought fight, and shifting to 2028 positions the campaign on a timeline that gives it the best chance at success, one that is stronger, better resources, and impossible to ignore.

Polling shows overwhelming, bipartisan support for Medicaid expansion. A June 2025 GSG poll found 67% of Floridians support expansion — including 87% of Democrats, 67% of independents, and 52% of Republicans. Comparable ballot measures have passed in conservative states like Missouri, Idaho, and Oklahoma, where opposition collapsed once voters had the chance to weigh in.

Floridians are united in believing it’s time to stop sending billions of our tax dollars to other states while leaving families here behind. Medicaid expansion is not a partisan issue, it’s a life or death for many Floridians.