Welcome back to Diagnosis, a vertical that focuses on the crossroads of health care policy and politics.

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— Brace for big, beautiful fallout —

New estimates suggest Florida could see widespread effects from H.R. 1 — the “One Big Beautiful Bill Act” — as changes to Medicaid and SNAP ripple through the state’s most economically vulnerable congressional districts.

The law adds stricter eligibility requirements for Medicaid and shifts cost burdens for SNAP from the federal government to the states beginning in 2028. That change alone could create significant gaps in Florida, where over 1 million households currently receive SNAP benefits and more than 4.7 million people are enrolled in Medicaid.

Districts with high concentrations of Medicaid enrollees — including CD 6, CD 8 and CD 12 — each report over 200,000 residents on the program. Even a modest 15% reduction in enrollment could mean tens of thousands losing access to care. In CD 17, Medicaid covers nearly 281,000 people, the highest in the state.

SNAP-heavy districts also face acute vulnerability. CD 24, CD 26, and CD 27 each support more than 50,000 SNAP households. Analysts warn that shifting administrative duties and cost-sharing requirements to the state could result in delays, reduced benefits, or new eligibility hurdles that increase food insecurity.

Dual-eligible residents — those receiving both Medicaid and Medicare — face added complications. Losing Medicaid can disrupt prescription coverage and long-term care supports, potentially pushing more people into emergency rooms or nursing homes.

Bottom line: while the law’s implementation will unfold over the years, the pressure on Florida’s health and nutrition infrastructure is already building — and the state’s most fragile households may feel it first.

View more data here.

— First-in-the-nation —

Gov. Ron DeSantis has signed the Emily Adkins Family Protection Act (HB 1421/SB 890), making Florida the first state in the nation to enact comprehensive legislation targeting the prevention and tracking of blood clots, including pulmonary embolisms and deep vein thromboses.

The law mandates enhanced screening protocols at emergency rooms, pregnancy centers, cancer centers and orthopedic clinics, as well as staff training for hospitals and nursing homes. It also creates a statewide blood clot registry to improve prevention and reporting.

The legislation is in honor of Emily Adkins, a 23-year-old who died in 2023 from a preventable clot. It was championed by her parents, Janet and Douglas Adkins, founders of the nonprofit Emily’s Promise. The bill received bipartisan support and was carried by Sen. Clay Yarborough and Rep. Dean Black.

“This law will save lives,” said Doug Adkins, CEO of Emily’s Promise. “It will decrease the likelihood that other Florida families will suffer the way ours did — from a tragedy that could have been prevented.”

Leslie Lake of the National Blood Clot Alliance and Dr. Ali Ataya, who chaired the law’s policy workgroup, were also recognized for their advocacy in bringing the legislation to fruition.

The law took effect on July 3.

 — ICYMI —

“340B Program costs Florida millions in lost tax revenue” via Magnolia Market Access — A recent analysis by Magnolia Market Access reveals that the 340B drug pricing program is elevating health care costs and reducing tax revenues, with significant impacts in Florida. In 2021, the program allegedly increased health care costs for employers and workers by $7.8 billion, resulting in a $1.8 billion loss in tax revenue nationwide. This includes $1.4 billion in federal losses and $418 million at the state level. Florida was among the most affected states, with an estimated $22 million in lost tax revenue. Since Florida lacks a personal income tax, these losses primarily affect employer payroll taxes and other state revenue streams. The program’s future is expected to be a key issue in Washington as lawmakers examine its effects.

“Central Florida Dems say Medicaid users, public school students first at risk from ‘Big, Beautiful Bill’” via Kairi Lowery of the Orlando Sentinel — Central Florida Democrats and local leaders say the region will suffer from the significant cuts to health care and education programs in Trump’s “Big, Beautiful Bill.” “We see this budget for what it is, an extremist road map that takes away what people rely on to survive,” U.S. Rep. Maxwell Frost said at a Thursday news conference at the Pan-American Behavioral Health clinic in Orlando. The nearly 900-page bill, passed along narrow, partisan lines in Congress and signed by Trump on July 4, calls for eliminations and funding cuts to decades-old programs such as SNAP and Medicaid, which help low-income individuals and families. Frost condemned the bill alongside his fellow Central Florida representative, Darren Soto. Soto said the new law would only benefit the rich.

“Planned Parenthood’s Florida merger will allow it to serve all 67 counties” via Cindy Krischer Goodman of the Miami Herald — Planned Parenthood’s two Florida affiliates will merge to form a single, unified statewide organization. The new organization, Planned Parenthood of Florida, will offer expanded services, more telehealth options and extended hours and days of operation at some of its combined 17 health centers in the state. After a recent U.S. Supreme Court ruling, states are allowed to cut Medicaid funding to Planned Parenthood. However, Michelle Quesada, vice president of communications for Planned Parenthood of Florida, said the two Florida affiliates — Planned Parenthood of South, East and North Florida and Planned Parenthood of Southwest and Central Florida — have been operating in a hostile political climate for several years and do not receive any state money.

“Majority of Republicans, MAGA supporters want Congress to extend enhanced premium tax credits for health care” via Peter Schorsch of Florida Politics — With the “Big Beautiful Bill” now law, Congress now shifts focus to other priorities it must address before year’s end. Key among them is the enhanced Affordable Care Act premium tax credits. The tax credits are scheduled to expire at the end of the year. If Congress does not extend them, premiums will skyrocket for millions of Americans on private health care coverage, forcing many to lose coverage. A KFF Health Tracking Poll conducted last month reveals robust support across party lines for extending enhanced premium tax credits. In fact, 77% of all adults, including 63% of Republicans, back the move.

 — RULES —

The Agency for Health Care Administration’s final rule regarding qualified residential treatment program services (59G-4.128) went into effect on July 8. More here.

The Agency for Health Care Administration is proposing to amend its rule outlining facial covering requirements for health care practitioners and health care providers for infection control (59A-35.125). More here.

The Board of Psychology’s final rule regarding examinations (64B19-11.001) goes into effect on July 22. More here.

 — PENCIL IT IN —

July 16

Happy birthday to Rep. LaVon Bracy Davis!

July 21

Happy birthday to Sen. Gayle Harrell!

July 22

Happy birthday to Rep. Alex Andrade and Rep. Jennifer Canady!

July 25

Happy birthday to Rep. JJ Grow!

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