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.
New law could strip health care and food assistance from Florida’s most vulnerable families.
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.
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.
In memory of Emily Adkins, a new Florida law protects families from preventable blood clot deaths.
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.
Central Florida Democrats warn that a new law harms the region’s most vulnerable students and families.
“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!
Congrats to LaVon Bracy Davis, who is celebrating another trip around the sun.
July 21
Happy birthday to Sen. Gayle Harrell!
July 22
Happy birthday to Rep. Alex Andrade and Rep. Jennifer Canady!
Florida could soon rewrite how it responds to domestic violence.
Lake Worth Democratic Rep. Debra Tendrich has filed HB 277, a sweeping proposal aimed at modernizing the state’s domestic violence laws with major reforms to prevention, first responder training, court safeguards, diversion programs and victim safety.
It’s a deeply personal issue to Tendrich, who moved to Florida in 2012 to escape what she has described as a “domestic violence situation,” with only her daughter and a suitcase.
“As a survivor myself, HB 277 is more than legislation; it is my way of turning pain into policy,” she said in a statement, adding that months of roundtables with survivors and first responders “shaped this bill from start to finish.”
Tendrich said that, if passed, HB 277 or its upper-chamber analogue (SB 682) by Miami Republican Sen. Alexis Calatayud would become Florida’s most comprehensive domestic violence initiative, covering prevention, early intervention, criminal accountability and survivor support.
It would require mandatory strangulation and domestic violence training for emergency medical technicians and paramedics, modernize the legal definition of domestic violence, expand the courts’ authority to order GPS monitoring and strengthen body camera requirements during investigations.
The bill also creates a treatment-based diversion pathway for first-time offenders who plead guilty and complete a batterers intervention program, mental-health services and weekly court-monitored progress reporting. Upon successful completion, charges could be dismissed, a measure Tendrich says will reduce recidivism while maintaining accountability.
On the victim-safety side, HB 277 would flag addresses for 12 months after a domestic-violence 911 call to give responders real-time risk awareness. It would also expand access to text-to-911, require pamphlets detailing the medical dangers of strangulation, authorize well-check visits tied to lethality assessments, enhance penalties for repeat offenders and include pets and service animals in injunctions to prevent coercive control and harm.
Calatayud called it “a tremendous honor and privilege” to work with Tendrich on advancing policy changes “that both law enforcement and survivors of domestic abuse or relationship violence believe are meaningful to protect families across our communities.”
“I’m deeply committed to championing these essential reforms,” she added, saying they would make “a life-or-death difference for women and children in Florida.”
Organizations supporting HB 277 say the bill reflects long-needed, practical reform. Palm Beach County firefighters union IAFF Local 2928said expanded responder training and improved dispatch information “is exactly the kind of frontline-focused reform that saves lives.”
The Florida Police Benevolent Association called HB 277 a “comprehensive set of measures designed to enhance protections” and pledged to help advance it through the Legislature.
The Animal Legal Defense Fundpraised provisions protecting pets in domestic violence cases, noting research showing that 89% of women with pets in abusive relationships have had partners threaten or harm their animals — a major barrier that keeps victims from fleeing.
Florida continues to see high levels of domestic violence. The National Coalition Against Domestic Violence estimates that 38% of Florida women and 29% of Florida men experience intimate-partner violence in their lifetimes — among the highest rates in the country.
With costs rising statewide, HB 277 also increases relocation assistance through the Crimes Compensation Trust Fund, which advocates say is essential because the current $1,500 cap no longer covers basic expenses for victims fleeing dangerous situations.
Tendrich said survivors who contributed to the bill, which Placida Republican Rep. Danny Nix is co-sponsoring, “finally feel seen.”
“This bill will save lives,” she said. “I am proud that this bill has bipartisan support, and I am even more proud of the survivors whose bravery drives every line of this legislation.”
A Senate district that leans heavily Republican plus a Special Election just weeks before Christmas — Marwah acknowledges it adds up to a likely Tuesday victory for Ralph Massullo.
The Senate District 11 Special Election is Tuesday to fill the void created when Blaise Ingoglia became Chief Financial Officer.
It pits Republican Massullo, a dermatologist and Republican former four-term House member from Lecanto, against Democrat Marwah, a civil engineer from The Villages.
Early voter turnout was light, as would be expected in a low-key standalone Special Election: At 10% or under for Hernando and Pasco counties, 19% in Sumter and 15% in Citrus.
Massullo has eyed this Senate seat since 2022 when he originally planned to leave the House after six years for the SD 11 run. His campaign ended prematurely when Gov. Ron DeSantis backed Ingoglia, leaving Massullo with a final two years in office before term limits ended his House career.
When the SD 11 seat opened up with Ingoglia’s CFO appointment, Massullo jumped in and a host of big-name endorsements followed, including from DeSantis, Ingoglia, Agriculture Commissioner Wilton Simpson, U.S. Sens. Ashley Moody and Rick Scott, four GOP Congressmen, county Sheriffs in the district, and the Florida Chamber of Commerce.
Marwah ran for HD 52 in 2024, garnering just 24% of the vote against Republican John Temple.
Massullo has raised $249,950 to Marwah’s $12,125. Massullo’s $108,000 in spending includes consulting, events and mail pieces. One of those mail pieces reminded voters there’s an election.
The two opponents had few opportunities for head-to-head debate. TheLeague of Women Voters of Citrus County conducted a SD 11 forum on Zoom in late October, when the two candidates clashed over the state’s direction.
Marwah said DeSantis and Republicans are “playing games” in their attempts to redraw congressional district boundaries.
“No need to go through this expense,” he said. “It will really ruin decades of progress in civil rights. We should honor the rule of law that we agreed on that it’ll be done every 10 years. I’m not sure why the game is being played at this point.”
Massullo said congressional districts should reflect population shifts.
“The people of our state deserve to be adequately represented based on population,” he said. “I personally do not believe we should use race as a means to justify particular areas. I’m one that believes we should be blind to race, blind to creed, blind to sex, in everything that we do, particularly looking at population.”
Senate District 11 covers all of Citrus, Hernando and Sumter counties, plus a portion of northern Pasco County. It is safely Republican — Ingoglia won 69% of the vote there in November, and Donald Trump carried the district by the same margin in 2024.
Miles Davis is taking his Florida-focused organizing playbook to the national stage.
Davis, Policy Director at PRISM Florida and Director of Advocacy and Communications at SAVE, has been selected to present a workshop at the 2026 Creating Change Conference, the largest annual LGBTQ advocacy and movement-building convention.
It’s a major nod to his rising role in Florida’s LGBTQ policy landscape.
The National LGBTQ Task Force, which organizes the conference, announced that Davis will present his session, “School Board Organizing 101.” His proposal rose to the top of more than 550 submissions competing for roughly 140 slots, a press note said, making this year’s conference one of the most competitive program cycles in the event’s history.
His workshop will be scheduled during the Jan. 21-24 gathering in Washington, D.C.
Davis said his selection caps a strong year for PRISM Florida, where he helped shepherd the organization’s first-ever bill (HB 331) into the Legislature. The measure, sponsored by Tampa Democratic Rep. Dianne Hart, would restore local oversight over reproductive health and HIV/AIDS instruction, undoing changes enacted under a 2023 expansion to Florida’s “Parental Rights in Education” law, dubbed “Don’t Say Gay” by critics.
Davis’ workshop draws directly from that work and aims to train LGBTQ youth, families and advocates in how local boards operate, how public comment can shape decisions and how communities can mobilize around issues like book access, inclusive classrooms and student safety.
“School boards are where the real battles over student safety, book access, and inclusive classrooms are happening,” Davis said. “I’m honored to bring this training to Creating Change and help our community build the skills to show up, speak out, and win — especially as PRISM advances legislation like HB 331 that returns power to our local communities.”
Davis’ profile has grown in recent years, during which he jumped from working on the campaigns and legislative teams of lawmakers like Hart and Miami Gardens Democratic Sen. Shevrin Jones to working in key roles for organizations like America Votes, PRISM and SAVE.
The National LGBTQ Task Force, founded in 1973, is one of the nation’s oldest LGBTQ advocacy organizations. It focuses on advancing civil rights through federal policy work, grassroots engagement and leadership development.
Its Creating Change Conference draws thousands for four days of training and strategy-building yearly, a press note said.