Economists: Medicaid Florida budget shortfall is expected to worsen in 2026

Legislators may have underfunded Florida’s Medicaid program in the recently approved state budget, according to projections from the state’s top economists. The shortfall is expected to worsen in fiscal year 2026–27.

The Social Services Estimating Conference projects that Medicaid spending for fiscal year 2025–26 will exceed appropriations by $510.7 million, newly released data show. “Most importantly, the current-year estimate produces a General Revenue deficit of $125.5 million relative to the appropriated level,” economists noted in their report.

A major factor behind the deficit is the rising cost of long-term care managed-care plans, which serve low-income seniors and people with disabilities. The state is projected to spend $7.8 billion on these plans by June 30, 2026—$285.4 million more than lawmakers allocated.

In contrast, spending for Medicaid managed medical assistance plans, which cover general health services, is running slightly below budget. Economists estimate total payments of $19.8 billion, about $19.5 million less than appropriated.

Overall, analysts warn that the imbalance between Medicaid funding and actual costs could deepen in the next fiscal cycle if enrollment growth and service demand continue.

Economists from the governor’s office, House, and Senate regularly meet to evaluate spending trends in state-funded programs. Their projections guide lawmakers in developing Florida’s annual budget. The Social Services Estimating Conference, which focuses on Medicaid spending and enrollment, met on June 30, with results released this week.

The group reviewed current-year spending and projected Medicaid costs for the next fiscal year beginning July 1, 2026. Without policy changes, Medicaid is expected to cost $37.1 billion, an increase of more than $2.1 billion over the current base budget. That includes $962.8 million more in general revenue than is budgeted for FY 2025–26.

The Medicaid managed-care plans—covering both long-term care and general acute care—continue to drive the spending gap, accounting for over $1.75 billion of the projected shortfall for FY 2026–27.

Economists also updated enrollment forecasts, estimating 4,149,320 Floridians will receive Medicaid coverage this year—about 67,000 fewer than lawmakers anticipated. Enrollment is projected to rise slightly to 4,186,782 participants in FY 2026–27.

Other top articles

Push to expand Medicaid in Florida delayed by two years

‘As much as anything, it’s really about runway.’

Saying the state’s new limits on ballot initiatives were too great to immediately overcome, Florida Decides Healthcare announced Thursday that it is putting the brakes on efforts to get  a proposed constitutional amendment on Medicaid expansion on the 2026 ballot and will aim for 2028, instead.

In an interview with the Florida Phoenix, organization Executive Director Mitch Emerson said the new law was passed to sabotage efforts to bring proposed constitutional amendments before voters. The Florida Legislature earlier this year passed HB 1205, which put in sweeping changes nearly immediately.

“As much as anything, it’s really about runway,” Emerson said, adding that the law changed the rules in the middle of the signature campaign effort. READ FULL ARTICLE 

Raising the Alarm on the Oncoming Tidal Wave of Health Care Coverage Loss for Florida

The federal reconciliation bill signed into law on July 4, 2025, includes significant cuts to Medicaid, which will have devastating impacts on Floridians’ health and well-being. Many of the provisions to undo Medicaid protections in H.R. 1, or the “One Big Beautiful Bill” Act, are set to take effect at varying points over the next few years, meaning the full scope of impacts will be delayed. However, H.R. 1 also includes changes to the Affordable Care Act (ACA) Marketplace that will take effect sooner— notably, allowing the enhanced subsidies for people receiving insurance coverage through ACA plans (Enhanced Premium Tax Credits, or EPTCs) to expire at the end of 2025 and creating more hurdles to enrollment. Together, the cuts to Medicaid and cuts to ACA Marketplace subsidies set Florida up for an impending health care coverage disaster. READ FULL ARTICLE

How to File a Complaint Regarding a Medicaid Managed Care Plan.pdf

Download PDF • 112KB

About the Author

Ask Medicaid Florida is a trusted independent author focused on simplifying Medicaid news, policy updates, and healthcare resources for Florida residents. With a mission to make complex Medicaid issues understandable, Ask Medicaid Florida provides clear, factual, and timely insights that help readers stay informed and empowered. "You are valued, thank you for visiting our website".

Disclaimer

The information provided on this website is for informational purposes only and does not constitute advice for your Healthcare decisions or any other type of advice. All content, materials, and resources made available are solely for educational purposes and should not be relied upon for making Healthcare decisions. See full disclaimer.

Medicaid Florida Recipient Checklist A-Z.pdf

Download PDF • 183KB