The Florida Legislature’s session, which began Tuesday, January 9, is scheduled to run until March 8. Under the leadership of Senate President Kathleen Passidomo and House Speaker Paul Renner, the 60-day session will address a wide range of issues, including healthcare matters as well as the state budget, economic development, public safety, education reform, and social policy.
The Budget
Governor Ron DeSantis has proposed a $114.4 billion state budget for 2024-25, slightly less than last year’s final spending plan – largely due to reduced federal coronavirus relief and trimmed funding for vacant state positions. DeSantis has proposed increased funding for key areas including education, public safety, and healthcare, and would leave about $16 billion in reserves.
The Governor’s plan, which the Legislature is not obligated to follow, also includes reducing the state’s debt by $455 million and offering $1.1 billion in tax relief. Notable tax cuts under consideration include:
- Over $400 million to lower certain taxes and fees on homeowners’ insurance, including removing a 1% surcharge for insurer claim payments.
- Removal of the sales tax on over-the-counter pediatric medications.
- Establishment of several sales tax holidays, potentially saving consumers around $475 million annually on back-to-school, skilled worker tools, disaster preparedness, and summer recreation purchases.
Medicaid
Florida’s Medicaid program has experienced wide fluctuations in recent years. The program is currently down to 4.95 million enrollees now from a peak of 5.78 million in April 2023, but still over 1 million more than pre-pandemic levels.
A key question will be how much of the state’s surplus will support Medicaid funding without reducing hospital reimbursement rates. Adequate Medicaid reimbursement rates remain vital for hospitals to continue serving their communities effectively.
Live Healthy
In the face of significant healthcare workforce shortages projected over the next decade, President Passidomo has stated her desire to focus on healthcare this session. Her Live Healthy legislative package is intended to grow the state’s healthcare workforce, increase access, and provide incentives for innovation.
SPB 7016 and SPB 7018 would enhance partnerships between hospitals and higher education institutions that train healthcare workers, create 700 new residency slots, and establish creative loan repayment options to encourage providers to work in underserved areas.
It would also increase funding for medical providers in such high-demand fields as mental health, labor and delivery, and assistance for Floridians with disabilities. It would also invest over $200 million in high-quality medical education programs across Florida to expand efforts to train the next generation of healthcare professionals.
While the legislative package offers many benefits, one of its proposals already faces robust opposition from healthcare leaders, including hospitals. It would allow advanced birth centers to handle deliveries, including cesarean sections. In 2021, an American Journal of Obstetrics & Gynecology study found deliveries outside the hospital may lead to higher rates of adverse neonatal outcomes, including deaths and seizures, compared to those in hospital settings.
Other Healthcare Priorities
Besides Live Healthy, lawmakers will consider a multitude of other healthcare bills this year, addressing such issues as scope of practice, access to medications and tests, patient-directed care, restrictive covenants, provider reimbursement rates, and much more. These bills include:
- CRNA Scope of Practice: HB 257 would expand the scope of practice for Certified Registered Nurse Anesthetists (CRNAs) in Florida, allowing them to practice independently in order to increase patient access to anesthesia services across the state.
- Access and Coverage: HB 491 and HB 885 focus on reducing barriers to obtaining certain medications and diagnostic tests in Florida, a change that could potentially improve healthcare outcomes for patients with serious mental illnesses and those requiring biomarker testing.
- Patient-directed DNRs: HB 219 would allow EMTs and certain healthcare professionals to withhold or withdraw cardiopulmonary resuscitation or other medical interventions if presented with a patient-directed doctor’s order (PDDO) form indicating the patient’s wish not to be resuscitated.
- Physicians’ Restrictive Covenants: HB 11 would invalidate certain restrictions in employment contracts that limit a physician from practicing medicine in a specific region after the contract ends. The bill does not apply to restrictive covenants entered into by physicians employed by hospitals or ambulatory surgical centers, or those with an ownership stake in a physician group practice.
- Workers’ Compensation Payments: HB 161 proposes to raise maximum reimbursement rates for physicians and surgical procedures under workers’ compensation, potentially improving access to care for injured workers.
K-12 Education
Lawmakers will consider several education-related budget items proposed by the governor, including a $1.6 billion investment in early childhood education (with nearly one-third going to VPK programs); $1.25 billion to raise teacher salaries; and a $290 million boost for the Safe Schools Initiative.
Historic school choice expansion was enacted last year, and lawmakers may explore additional education reforms this year. This includes consideration of the governor’s proposal to allot $350 million for school districts that lose students to school choice and $125 million for vouchers for children with disabilities.
Higher Education
The Legislature’s focus on higher education will likely include initiatives for colleges and universities as well as various other post-secondary programs, with proposed funding of $5.4 billion for the Florida College System and State University System, an additional $152 million for Florida’s Historically Black Colleges and Universities, and $150 million for recruitment and retention of faculty. Lawmakers will also consider several workforce education proposals, with associated funding requests of over $850 million.
Infrastructure & Housing
Building on prior years’ initiatives, lawmakers are expected to address – and fund – many major infrastructure issues across the state, including the following proposed spending:
- $14.5 billion to expand and maintain the state’s transportation network, plus $630 million to expedite 20 traffic relief projects, and another $75 million for Florida ports and logistics centers;
- $213 million for rural communities, including infrastructure, broadband access, and small government assistance; and
- $209 million for the State Housing Initiatives Partnership program, nearly $90 million for the State Apartment Incentive Loan program, and $100 million to continue the Hometown Heroes Housing Program which provides down payment and closing cost assistance for certain first-time homebuyers.
- Bills to allow more people to get coverage through Citizens Property Insurance, amid diminishing or unaffordable options for private coverage.
House Bill 267 is a response to the state’s housing shortage, proposing to simplify and expedite the process of issuing residential building permits in Florida, making it easier for developers and homeowners to navigate the regulatory landscape.
For decades, gas taxes have been Florida’s primary funding source for road construction and maintenance. However, with an increasing number of electric vehicles on the state’s roadways, lawmakers will consider imposing an annual $200 license fee on the owners of EV and hybrid vehicles.
Public Safety
In 2024, Florida’s approach to public safety is expected to touch on disaster preparedness and resiliency, first responder funding, and more. Early funding proposals include:
- $20 million for the Law Enforcement Recruitment Bonus Program, which offers those hired as first-time law enforcement officers a signing bonus of up to $5,000
- $10 million for enhanced security at Jewish day schools amid rising antisemitism, along with $1.35 million for the Florida Holocaust Museum
- $107 million to continue the My Safe Florida Home program to fund improvements to residents’ doors and windows
- $12 million toward the Defense Infrastructure Grant Program, the Florida Defense Support Task Force, and the Military Base Protection Program.
Critical infrastructure is essential for public safety, security, and economic stability, but recent events including hurricanes and power grid failures have led lawmakers to take additional steps to protect Florida’s critical infrastructure. House Bill 275 responds to these concerns by establishing criminal penalties for causing intentional harm or damage to such critical infrastructure as hospitals, energy systems, and transportation networks.
Environmental
The cost of protecting and maintaining Florida’s natural resources is significant and growing. Lawmakers are expected to address various policy interventions, including budget proposals to allocate $745 million for Everglades funding, $330 million for targeted water quality improvements, and $80 million for alternative water supply grant programs.
Technology
Some lawmakers want to reform the event ticketing market after the great Taylor Swift concert ticket debacle of 2023, where fans experienced long wait times and technical issues while trying to purchase tickets online. Proposed legislation would prohibit live performance venues from entering into exclusive contracts with specific ticket sellers, which could benefit consumers by offering more choices and potentially lowering prices for tickets to live events across Florida.
As artificial intelligence (AI) continues to grow, and more Floridians use related technologies each day, lawmakers will consider various regulatory proposals, along with other bills that would address technology and social media more broadly. Proposals include requiring disclaimers on political ads using AI-generated content that depict people, limiting how children can access social media, and age verification requirements for pornography.
