2026 Medicaid Expansion petition initiative paused, preparing for 2028

by Alachua County Labor Coalition and National Women’s Liberation-Gainesville

The Alachua County Labor Coalition and National Women’s Liberation-Gainesville are pausing distributing Medicaid Expansion petitions. Florida Decides Healthcare, the statewide campaign to amend Florida’s Constitution to expand Medicaid, has suspended petition collection and distribution operations until February, 2026. If you have petitions, please shred and recycle them but save the envelopes.

Florida Decides Healthcare will be pursuing a ballot initiative aimed at the 2028 election, the earliest chance to amend the state constitution. They are also preparing for the lawsuit they hope will loosen restrictions imposed by the new anti-direct democracy law that seeks to repress the constitutional amendment initiative process.

The campaign expects to resume petition operations in February. In the meantime, our organizations will continue organizing for healthcare justice, including as Hubs for the Medicaid Expansion campaign. To kick off this phase of the campaign, we are helping to collect personal testimonies from Floridians to highlight the need for Medicaid Expansion. If you have a positive experience with Medicaid or have struggled because you’ve fallen in the “coverage gap” (e.g., made too little of an income to qualify for Affordable Care Act subsidies), please submit a testimony at laborcoalition.org/medexstory. 

Please see the state campaign’s official announcement below for more information.

Abridged Florida Decides Healthcare 9/5 Statement

Florida Decides Healthcare (FDH) announced that it will shift its Medicaid expansion ballot initiative efforts to the 2028 ballot. The decision comes after unprecedented barriers created by House Bill 1205, legislation passed by the Florida Legislature and signed by the Governor this year, changed the ballot initiative rules mid-campaign and deliberately undermined FDH’s 2026 effort.

Despite these obstacles, FDH has collected more than 200,000 petitions, raised over $6 million, and built a coalition of more than 100 grassroots organizations spanning labor, faith, healthcare providers, democracy advocates, and community groups across Florida.

HB 1205 imposed roadblocks that made signature gathering nearly impossible on a 2026 timeline. With three years to fund­raise and organize, FDH is confident it will have the resources necessary to get on the ballot in 2028.

“Politicians in Tallahassee didn’t just make it harder to get on the ballot, they tried to shut Floridians out and deny them their constitutional right to participate in their own democracy. HB 1205 wasn’t about transparency, it was sabotage aimed directly at citizen-led ballot initiatives. This law may have delayed us until 2028, but it will not stop us. Sadly, it’s everyday Floridians who will pay the price of Florida’s refusal not to expand Medicaid: veterans who served this country, caretakers holding families together, and working people now facing the loss of healthcare if ACA tax credits expire,” said Mitch Emerson, Executive Director of FDH. “In 2028, Floridians will have their say, and together, we will win access to healthcare for all those who need it the most.”

Florida already has 1.4 million people stuck in the “coverage gap,” making too much to qualify for Medicaid but too little to afford private insurance. If ACA tax credit enhancements expire in January, more than 3 million Floridians — one in five of us — could be left uninsured. Every year Florida refuses Medicaid expansion, the state turns away billions in federal funding. Right now, that’s $4 billion annually of Florida tax payers’ money that could be covering healthcare for families here at home but instead flows to subsidize healthcare access for states like California and New York that have already expanded Medicaid. By 2026, that loss could grow to more than $10 billion a year.

Without expansion, hospitals across the state, especially in rural communities, will face closure. Florida risks losing up to 50,000 healthcare jobs; many of our best doctors will leave the state, and healthcare costs for everyone will continue to climb. Insurers are asking for premium hikes of 15% nationwide for 2026, the largest increase in years, which appears to be driven by the looming expiration of ACA tax credit enhancements and the expectation that healthier enrollees will leave the marketplace. 

FDH remains committed to its lawsuit against HB 1205, with a full trial scheduled for January 2026. That legal fight is not just about Medicaid, it is about protecting Floridians’ constitutional right to direct democracy. Regardless of the outcome, FDH is moving forward with a robust three-year plan. Polling shows overwhelming, bipartisan support for Medicaid expansion. A June 2025 GSG poll found 67% of Floridians support expansion — including 87% of Democrats, 67% of independents, and 52% of Republicans. Comparable ballot measures have passed in conservative states like Missouri, Idaho, and Oklahoma, where opposition collapsed once voters had the chance to weigh in.

Floridians are united in believing it’s time to stop sending billions of our tax dollars to other states while leaving families here behind. Medicaid expansion is not a partisan issue, it’s life or death for many Floridians.

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