Elly Kennedy, like a lot of people these days, feels like she’s stuck when it comes to healthcare insurance. She and her husband are self-employed. They fall into that category of people who make too much money for Medicaid, and not enough for private insurance to be affordable.
The way Kennedy sees it, they, along with thousands of other Floridians, expanding Medicaid coverage here could alleviate the gap.
“I feel like the best approach is, wouldn't it be nice if we all had some relief, and kind of all had someone not having the government dictate necessarily, who does and who doesn't get insured,” said Kennedy, an Orange County resident.
On the day we met, Kennedy was out canvassing--collecting signatures to get Medicaid expansion on the 2026 midterm ballot. Florida Decides Healthcare is the group behind the push for the proposed constitutional amendment that would require the state to expand Medicaid coverage for people between the ages of 18 and 65 who make up to 138% of the federal poverty limit.
The move comes as Florida’s healthcare landscape will change beginning January 1, thanks to H.R. 1, more commonly known as the One Big Beautiful Bill Act. The Florida Policy Institute estimates that the number of uninsured in Florida will double, going from 10% to 19%.
Impending Changes
In January, Obamacare’s enhanced premium tax credit will expire, increasing premiums up to 90%, according to KFF. As a result of the changes, 1.9 million people are expected to become uninsured by 2027.
When an uninsured person goes to the E.R. for care, that is an uncompensated cost that is ultimately paid for by the Florida taxpayer. Last year, that was $2.6 billion.
Florida is one of 10 states that have not expanded Medicaid. In Florida’s current Medicaid landscape, the federal government covers 57% of expenses.
“What Medicaid expansion does is the federal government will match 90% of the funds,” Emmerson said.
The state would be responsible for making up the last 10%.
The expansion would also change who qualifies for Medicaid. Currently, qualified applicants must have an income at or below 100% of the federal poverty line. With the expansion, those up to 138% or around $44,000 for a family of four would qualify.
Expansion and the legislature
Not everyone is convinced that expanding Medicaid is the way to go.
“I don't believe that able-bodied people should be on it who have no one to take care of other than themselves,” said Rep. Chase Tramont. His district covers parts of Volusia and Brevard counties.
Tramont is not against Medicaid. In fact, his family benefits from it. He and his wife adopted an 11-year-old boy with special needs who is largely non-verbal.
Tramont is concerned that the system will be gamed or abused, taking money away from those who need it. In his eyes, that’s reserved for the very poor and the disabled.
“That's who I want to protect it and save it for. You start opening up Pandora's box and letting more people in, where does it end?” Tramont said.
Tramont said that for those with lower incomes, Medicaid is a temporary fix. Providing coverage over a longer period is not the role of the government.
“That's the role for your churches, that's the role for your nonprofits, that's the role for your community clinics, to do all that,” he said.
Medicaid expansion has been broached in Florida before. In 2013 and 2015, the Florida Senate voted in favor of expansion almost unanimously 2015 (31-3). In both years, the Republican-led Florida House rejected the bills. In 2013, the House had its own plan rejected by the Senate, as it was ineligible for federal matching funds.
“They can't get it done through the House or the Senate or the regular legislative process, so they're trying to do it through the ballot measure,” Tramont said. “And I just think that's a fundamentally wrong way to approach governing.”
Expansion and the ballot box
Earlier this year, the legislature passed HB 1205, which creates new regulations on forms (including providing full proposal text and sponsor details, as well as voter ID) and tightening timelines. To pass, the expansion of 60% of the Florida vote. To get on the ballot, the petition will also need about 900,000 signatures by Feb. 1. Currently, the group has gathered more than 200,000 signatures.
“Without a doubt, it's going to be hard,” said Rep. Anna Eskamani, Democrat, who represents parts of Orange County. She has partnered with Florida Decides Healthcare.
“But I do think that the argument in support of this is very, very strong, and we've seen other red states pass it with no problem,” she said.
According to KFF, there are 1.4 million adults (age 19-64) in a coverage gap in the 10 states that haven’t expanded Medicaid. In Florida, it’s about 260,000 adults currently in the gap, meaning they make too much money for Medicaid and too little to afford Marketplace insurance.
Elly Kennedy says for her, it’s personal. Her family, which includes a 16-year-old daughter, doesn’t have health insurance but puts away $1,000 a month in case of a medical emergency.
“I fear a broken arm is $80,000,” she said. “I can tell you, kidney stones are $8,800 if you go to the emergency room, and you know that's more than one day or one month for people to financially devastate them.”
Kennedy believes healthcare is a human right. In the meantime, her days involve getting her work done, making meals for the family, and then canvassing in the evenings.
She knows there’s not much time before the February deadline to clear the signatures, but she is hopeful her state can do more for people like her family.
“I feel like Florida shoots itself in the foot all the time,” she said. “I feel like I know we can be great, and we just keep voting the opposite of greatness, and getting back to when we were a community, and getting back to when we cared about each other. Instead, we have the dumbest fights.”
