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Drug companies threaten Florida’s health care safety net

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Taxpayers, get ready for another round of bailouts.

However, unlike Wall Street executives who begged Uncle Sam to cover their risky bets, cash-strapped nonprofit rural health care providers have not gambled away their resources.

Quite the contrary, they have done nothing irresponsible. The best part is that the bailout is not a fait accompli. And state lawmakers do not have to stand by and wait for a federal solution. The Florida Legislature and Governor DeSantis are not powerless. The simplest way to protect providers, and by extension, medically underserved Floridians, is by codifying the process by which eligible providers attain critical savings under the 340B Drug Pricing Program.

If drug makers get their way, they will shred Florida’s health care safety net. Their new scheme involves converting the current 340B payment model from upfront savings on drug purchases to rebates on the backend of transactions. The problem is that nonprofit health care providers rely on these critical savings to offset losses from delivering high-quality care that often receives below-cost reimbursements.

Here is what drug companies want: Delay.

The plan is to reimburse providers at an indeterminate future date, on their own terms, making every 340B claim subject to dispute and protracted payment. Drug companies understand that many rural providers operate on shoestring budgets. If they can slow-walk how covered entities attain 340B savings, providers face resource deficits they cannot overcome.

What if drug makers deny every initial rebate claim, extending the lifecycle of payments months down the road? The clinical outcomes of millions of rural Americans depend on their providers, often the sole provider they can access, receiving upfront 340B savings to keep their doors open.

In August, the Trump administration released guidance for a rebate model pilot program that displeased providers and the pharmaceutical manufacturers. Providers worry that savings from rebates will not be distributed to them in a timely manner. Drug makers fret that instead of a universal change, the administration opted for what they view as a half measure, and only for a subset of prescription drugs.

And here is where Florida’s Legislature has a role to play. The pilot program limits rebate conversion to the 10 drugs selected for the Medicare Drug Price Negotiation Program, an initiative in the Inflation Reduction Act. Florida has the authority to pass legislation shielding prescriptions paid for by private payers and the state Medicaid fund, limiting rebate conversion in 340B to only those drugs selected for negotiation in federally funded Medicare. Such legislation would not interfere with federal prerogatives, as states have the authority to control the dispensing of prescription drugs within their borders when they or private actors are the payors.

Florida should act now to preempt drug companies that seek to convert all 340B savings, regardless of the payor, into rebates. If state lawmakers remain idle, expect foreseeable consequences.

Since 2010, 89 rural hospitals have closed, including five in Florida. Another 65 underwent “converted closures,” defined by reducing or eliminating services, changing locations and/or closing facilities. According to a 2025 analysis from the Center for Healthcare Quality and Payment Reform, 760 rural hospitals are at risk of closing, with 40% facing immediate risk. In Florida, nine rural hospitals (41%) are at risk of closure, with two hospitals facing imminent peril.

Recognize that the current financial reality would have occurred even with the critical savings enabled by the 340 B program. The fundamental changes to the 340B program sought by drug companies would cause catastrophic harm to health care in rural America.

Gov. Ron DeSantis signed landmark pharmacy benefit reform legislation into law in 2023. The Prescription Drug Reform Act loosened the stranglehold PBMs had over the state’s prescription drug supply chain. State lawmakers, however, have yet to protect 340B providers from drug companies bent on limiting the number of prescriptions available at discounted prices.

Florida is one of five states where contract pharmacy protection legislation died in its Legislature in 2025. HB 1527 would have prohibited drug manufacturers from taking actions that interfere with how 340B providers acquire drugs and PBMs from discriminatory reimbursements to said providers.

Florida should not leave its rural 340B providers to the whims of national politics. Federal solutions take too long to materialize, if they happen at all. The attorney general should file suit against any drug company that attempts to expand rebate conversion beyond the parameters of the pilot program. Lawmakers should reintroduce HB 1527 with the added provision that prohibits drug companies from expanding their rebate scheme.

Drug companies are undertaking a multi-pronged effort to dismantle 340B. The Legislature has the power to protect rural nonprofit providers. The time to act is now.

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John Arcano is the senior manager of policy and government affairs at AIDS Healthcare Foundation.



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Debra Tendrich turns ‘pain into policy’ with sweeping anti-domestic violence proposal

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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 2928 said 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 Fund praised 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.”



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Ash Marwah, Ralph Massullo battle for SD 11 Special Election

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Even Ash Marwah knows the odds do him no favors.

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.

The Florida LGBTQ+ Democratic Caucus is endorsing Marwah.

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. The League 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.



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Miles Davis tapped to lead School Board organizing workshop at national LGBTQ conference

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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.



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