Florida Senate Passes Medicaid Work-Requirement Bill With Uncertain Legal Path

Overview

• The Senate approved SB 1758 on a 26–11 vote to require able-bodied adults ages 19–64 to report at least 80 hours a month of work, education, or community engagement to keep Medicaid, with exemptions for groups including disabled veterans, new mothers, and parents of younger children.
• Florida has not expanded Medicaid, and attorneys and policy analysts cite federal guidance and the budget law indicating nonexpansion states cannot impose the new work rules, casting doubt on CMS approval.
• Sponsor Sen. Don Gaetz says the state would develop an implementation plan and seek federal waivers, but a House companion has not advanced and he called passage this week an uphill battle.
• Critics warn the requirement could push some low-income parents off coverage because Florida’s income limits are so low, while GAO findings show such policies carry high administrative costs and Florida’s eligibility IT overhaul runs through 2028 at more than $180 million.
• The bill also bundles measures to add photos to SNAP cards, expand behavioral health services via an AHCA waiver, require drug-rebate negotiations, and allow outpatient use of long-acting injectables to curb costs.