Florida’s 2026 regular legislative session ended March 13 without a final state budget, ensuring lawmakers would need to return to the Capitol to complete the one bill they are constitutionally required to pass. House Speaker Daniel Perez and Senate President Ben Albritton announced that lawmakers will return for a special session in mid-April to finish the work.
The budget impasse shaped the final days of session and contributed to the collapse of a number of significant healthcare and non-healthcare measures that had not cleared both chambers before adjournment.
HCA Healthcare is providing this end of session recap to keep colleagues informed on key legislative developments that may affect care and access in the communities we serve.
Budget
Lawmakers ended the regular session without a final FY 2026-27 budget, leaving major healthcare spending questions unresolved. The Senate’s Health and Human Services budget proposal included a 3% cut to hospital inpatient and outpatient Medicaid reimbursement, a reduction of approximately $90 million annually.
When legislators return for a special session to finish the budget, negotiations will resume, and the proposed cut will likely resurface. Please be on the lookout for a call to action to reach out to your state senator if the cut moves forward.
The Senate proposal also included several healthcare investments, including Rural Health Transformation Program funding, a rate increase for Federally Qualified Health Centers (FQHCs) and rural health centers, and a critical access hospital rate adjustment.
Affordability remained one of the session’s biggest unresolved issues. House leaders pointed to their push on property tax relief as a major affordability priority, but the Senate did not take up that proposal before the end of regular session.
The unresolved budget fight underscored a deeper split between the chambers over spending levels and competing fiscal priorities, leaving tax policy and the broader affordability agenda unfinished at adjournment.
Patient Protection
HB 355 would require hospital emergency departments to strengthen pediatric readiness by implementing pediatric-focused policies and procedures, conducting regular staff training and drills, designating a pediatric emergency care coordinator, and participating in pediatric readiness assessments. The bill would also direct the Florida Agency for Health Care Administration (AHCA), in consultation with the Florida Emergency Medical Services for Children State Partnership Program, to establish minimum standards for pediatric care in hospital emergency departments.
The bill passed the House 109-0 on January 15 and the Senate 36-0 on March 11 but has not been signed into law at this time.
Healthcare Workforce Development
CS/SB 1246 would update the Linking Industry to Nursing Education (LINE) Fund so it can better support Florida’s nursing workforce needs. The bill clarifies that the fund may be used to address shortages in nursing and authorizes the use of a broader range of contributions from healthcare partners and donors in proposals for state matching funds. Certain nonmonetary contributions, such as donated instructor time, space, equipment, and other quantifiable support, may count toward matching proposals if they have a documented fair market value and reflect institutional commitment. Proposals may not rely solely on nonmonetary contributions, and monetary contributions would receive priority for state matching funds. The bill is intended to make it easier for schools and employers to work together to expand nursing education capacity and workforce development.
The bill passed the Senate 36-0 on February 26 and the House 112-0 on March 10. The governor has not yet signed this bill into law.
Prescription Drug Policy
CS/HB 697 makes several changes to pharmacy benefit manager (PBM) regulation. The bill excludes plans that exclusively serve a Program of All-Inclusive Care for the Elderly (PACE) organization, a Medicare- and Medicaid-funded care model that coordinates services for seniors who would otherwise qualify for nursing home care, from the definition of a PBM plan or program. The bill also requires PBM contracts to include a defined administrative appeal option for participating pharmacies, including consolidated appeals in certain cases, and adds new prohibited practices involving pharmacies and pharmacists. HB 697 also provides a nonrecurring appropriation for the Ryan White Part B AIDS Drug Assistance Program through June 30, along with reporting and emergency rule requirements. The measure continues the Legislature’s broader effort to strengthen PBM oversight and update pharmacy coverage rules.
The bill passed the House 108-0 on March 5 and the Senate 38-0 on March 10. The House agreed to the Senate amendment on March 12, and the governor approved the bill on March 24.
Highlands County Hospital District
CS/HB 4087, a local bill, would revise the charter of the Highlands County Hospital District to establish procedural requirements before the district can enter into lease, management, or sale agreements involving hospital assets. The bill seeks to require the district’s board of commissioners to conduct an independent evaluation of proposed transactions, provide public notice, disclose potential conflicts of interest, and publish key documents online before approving an agreement. It also would allow limited judicial review to ensure the required procedures are followed.
The measure passed the House 116-0 on February 25 and the Senate 36-0 on March 11. As of today, Governor DeSantis has not signed the bill into law.
