By Josh Israel for the Florida Independent through Florida Phoenix
In Summary:
Nearly 130,000 fewer Floridians were enrolled in Medicaid in April 2026 than in June 2025, according to KFF enrollment data. President Donald Trump signed H.R. 1, known as the One Big Beautiful Bill Act, in July 2025 after Florida’s congressional delegation divided along party lines. Supporters, including U.S. Rep. Byron Donalds, describe the law as a spending reform, while healthcare organizations and progressive advocates warn that its Medicaid provisions could reduce coverage and strain Florida’s healthcare system.
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Nearly 130,000 fewer Floridians were enrolled in Medicaid this spring after congressional Republicans voted last summer to pass H.R. 1, known as the One Big Beautiful Bill Act, which included funding cuts to the program.
Related: Report - DeSantis administration delayed Medicaid review, hindered state auditors.
The total drop in Florida enrollment from June 2025 to April 2026 is 129,348, according to KFF, a health policy nonprofit that analyzed the most recent federal data available as of early August.
Florida’s congressional delegation voted for the bill along party lines in July 2025. Trump signed it into law on July 4, 2025.
The Congressional Budget Office estimated that the law would cut Medicaid spending by about $1 trillion over a decade.
Florida officials projected the state would lose about $3.8 billion in Medicaid funds by 2035 because a provision of the law caps state-directed payments to hospitals, according to an October 2025 presentation by Brian Meyer, deputy secretary of the Florida Agency for Health Care Administration Division of Medicaid.
One outspoken supporter of the budget bill was Republican Rep. Byron Daniels, who represents parts of southwest Florida and is running for governor.
On the 61st anniversary of the establishment of Medicare and Medicaid in late July, Florida Watch, a progressive communications and research group, criticized Donalds and others for voting for the budget law and its healthcare cuts.
“Instead of delivering on his promise to lower costs for everyone, Donalds and his allies in Congress gutted Medicaid and drove up the cost of insurance for Floridians already working hard to make ends meet during an affordability crisis,” Florida Watch executive director Natasha Sutherland said in a statement.
Donalds did not immediately respond to a request for comment about cuts to Medicaid. He told Newsmax TV on the day of the House vote for the bill that it makes “meaningful reforms to Medicaid and to some of the other programs that are spending a lot of money.”
“Tax policy is for the American people to thrive, where you don’t strangle them by taking too much money from them,” Donalds said. “And on the other side, when it comes to spending, we are getting things under control.”
Before Trump signed the budget bill into law, the CEO of the American Medical Association wrote to House of Representatives leaders in May 2025 that Medicaid is a critical safety net for millions of patients.
“Medicaid coverage is associated with improved long-term health, lower rates of mortality, better health outcomes, fewer hospitalizations, better educational outcomes, and greater financial security,” wrote Dr. James L. Madara, who was the association’s CEO and executive vice president through June of last year. “Medicaid is an indispensable source of coverage for maternal health services, covering over 40 percent of all births in the United States, including almost 50 percent of births in rural areas.”
Key Points:
- Enrollment declined: Florida Medicaid enrollment fell from 3,529,355 in June 2025 to 3,400,007 in April 2026—a decrease of 129,348 people.
- Federal spending reductions: The Congressional Budget Office estimated that H.R. 1’s Medicaid provisions would reduce federal spending on the program by approximately $1 trillion over 10 years.
- Florida funding impact: State officials project that a cap on state-directed hospital payments could reduce federal Medicaid funding flowing to Florida by about $3.8 billion through 2035.
- Political divide: Florida’s Republican congressional members supported the legislation, while Democrats opposed it; Trump signed the measure into law on July 4, 2025.
- Competing assessments: Donalds called the law’s Medicaid provisions meaningful spending reforms, while Florida Watch and the American Medical Association warned that funding reductions could affect coverage, healthcare costs and access to services.
