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Medicaid expansion initiative leader sues state over upcoming restrictions

Governor Ron DeSantis at a press conference in Orlando on Monday, November 4.
Gov. Ron DeSantis
/
Central Florida Public Media
Governor Ron DeSantis at a press conference in Orlando on Monday, Nov. 4, 2025.

A group pushing for the expansion of Medicaid sued the state over a law Gov. Ron DeSantis signed Friday that changes the citizen-led ballot initiative process.

Florida Decides Healthcare, a political committee working to get a state Medicaid expansion on 2026’s ballot, called the new requirements “vague, punitive, and excessive” in the lawsuit. Starting July 1, 2025, any volunteer who collects more than 25 signatures outside of immediate family must register as a petition circulator with the state – even if the work is unpaid. Failure to do so would be a third-degree felony.

And, each person who collects signatures must be a United States citizen, a resident of Florida and free from any felonies unless their rights have been restored. Sponsors will be charged $50,000 for each person who collects signatures and does not meet the guidelines.

Florida Decides HealthCare executive director Mitch Emerson said the law undermines participatory democracy in the state. “These are not tweaks. These are traps.”

“These new rules are designed to make it nearly impossible for everyday people to have a voice in the laws that shape their lives,” he said.

Supporters of the Bill

His worries come down to volunteers. The group has received concerns from petition collectors about their ability to continue. Emerson estimated complying with the law and switching from a reliance on unpaid work could cost the political committee millions of dollars, which includes costs for labor and background checks.

Those in support, including the governor, see the bill’s passing as a win. DeSantis is a supporter of the law and said in a post on X, formerly Twitter, that the bill would help “combat petition fraud and prevent special-interest abuse” of the state’s amendment process.

DeSantis’ ballot initiative battle was on display during the 2024 General Election cycle. He campaigned against two citizen-backed amendments on the ballot – those having to do with abortion restriction and recreational marijuana.

Both measures failed to pass despite netting more than 50% of votes.

Florida’s 60% vote requirement for amendments on the ballot is one of the largest shares of votes needed by a state to pass changes to the state’s constitution. And the sponsor of any initiative that wants to make its way to a ballot must collect a number of signatures equal to at least 8% of the votes cast in the most recent presidential election. Florida Decides HealthCare representatives said these existing factors, in part, amplify the new restrictions.

Still, bill sponsors have pointed to alleged fraud in the abortion amendment’s petition process reported by Gov. DeSantis’ office as a justification for a further crackdown on citizen initiatives.

Recent History with Citizen Initiatives

The governor was especially critical of the way the failed marijuana-related Amendment 3 raised a good chunk of its money. Trulieve, the largest medical marijuana company in the state, contributed most of the more than $150 million collected in support of the initiative.

At a press conference in October, DeSantis said the initiative was meant to benefit the company, not the Floridian people.

“This amendment is being written to benefit this one big weed company,” he said’ “It is not meant to benefit you. It is not meant to benefit the state.”

These justifications, along with help from current State Attorney General James Uthmeier, the use of government-access television network The Florida Channel and ads against the initiatives, helped DeSantis and
supporters stop the measures.

Now, Florida Decides Healthcare representatives argue the governor unjustly helped stop more.

Along with petition registration requirements, the new law shortens petition submission turnaround time from 30 days to 10. And petition forms will require signers to provide their full name, address, date of birth and an ID number. The ID can be a driver’s license number, a Florida identification card or the last four digits of a social security number.

Meant to verify information and combat fraud, Florida Decides Healthcare’s lawsuit said the law’s language is not tailored to deal with fraud alone. Co-chair Holly Bullard believed the main goal of the bill was control, not transparency.

“They are dismantling one of the last remaining tools everyday Floridians have to check their [the State Legislature’s] power,” she said.

A Larger Picture

Many citizen-initiative amendments tackle issues that get held up in the Florida Legislature. In 2022, citizen-backed Florida Amendment 2 made it so the state minimum wage would reach $15 an hour by September 2026.

Since adopted in 1968, Florida’s citizen initiative process has seen 44 potential state constitution amendments successfully make it onto the ballot. Of these, 32 have been approved by voters.

The lawsuit calls parts of the new law a “direct penalty on protected speech.” It was filed in Florida’s federal North District Court against Secretary of State Cord Byrd, Attorney General James Uthmeier and each of Florida’s Supervisors of Elections and State Attorneys.

The group plans to file a temporary order that would stop the law while the case is ongoing.

Luis-Alfredo Garcia is Central Florida Public Media’s inaugural Emerging Journalist Fellow.
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