Florida's health care system is expected to lose $3.8 billion under President Donald Trump's "Big Beautiful Bill," which includes deep cuts to hospital funding and other medical programs, state Medicaid Director Brian Meyer told lawmakers this week. Speaking before the House Health Care Facilities and Systems Subcommittee, Meyer said the new federal law caps state-directed hospital payments at 110% of Medicare rates, forcing Florida to scale back five programs that currently exceed that limit.
Those programs collectively receive about $9 billion, but funding will shrink to $5.2 billion by fiscal year 2034-35. The Hospital Directed Payment Program, which accounts for the largest share at $8.1 billion this year, will see a $3.5 billion reduction by 2034. Other affected initiatives include the Physician Supplemental Payment Program, down $234 million, the Public Hospital Physician Program, down $9 million, and two Florida Cancer Hospital Programs, down $56 million and $17 million. Meyer said the cuts will be phased in gradually. "What this provision does is any state-directed payments that are above 110% of Medicare beginning in 2028 will start stepping down annually 10% a year until you get to the 110% of Medicare threshold," he said. "We currently have five state-directed payment programs that are above 110% that will need to be stepped out. Depending upon where they are with respect to the percent of Medicare, some will get to that 110% cap sooner," he added. "Others will take more years to get there at a 10% annual reduction." The discussion came as House lawmakers met for the first committee week ahead of the 2026 legislative session scheduled to begin on Jan. 13, focusing on health care access and affordability — issues likely to dominate debate as Florida braces for the long-term fiscal impact of the federal reforms.
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