Florida Decides Healthcare announced that it will shift its Medicaid expansion ballot initiative efforts to the 2028 ballot.
The decision comes after what the group called “unprecedented barriers created by House Bill 1205, legislation passed by the Florida Legislature and signed by the Governor this year,” which changed the ballot initiative rules mid-campaign and “deliberately undermined FDH’s 2026 effort.”
Despite these obstacles, Florida Decides Healthcare said it 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,” according to the political group. With three years to fundraise and organize, FDH said it is confident it will have the resources necessary to get on the ballot in 2028. Donors and grassroots supporters believe this fight is both winnable and essential in Florida.
“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,” said Mitch Emerson, Executive Director of Florida Decides Healthcare. “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.”
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 could be left uninsured. Democrats and progressives say 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.
The Democratic political group said that every year Florida refuses Medicaid expansion and the state turns away billions in federal funding, estimated at $4 billion annually. They say that is 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.
FDH warns that without expansion, hospitals across the state, especially in rural communities, could face closure. Florida risks losing up to 50,000 healthcare jobs, they note. 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.
“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,” added Mitch Emerson. “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.”
FDH added that it 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, Florida Decides Healthcare is moving forward with a robust three-year plan.
According to the political group, 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 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.
The message behind the campaign is that Medicaid expansion is not a partisan issue, it’s a life or death for many Floridians. But now these “life or death” politics are moving to 2028.
