Statewide Health Care Coverage

Florida Senate
-
2026

SB 348

By
Senator Smith

17-00061-26 2026348__
1 A bill to be entitled
2 An act relating to statewide health care coverage;
3 defining terms; establishing the Task Force on
4 Universal Health Care for a specified purpose;
5 requiring the Office of Program Policy Analysis and
6 Government Accountability (OPPAGA) to provide staff
7 support to the task force; directing all agencies of
8 state government to assist the task force, including
9 furnishing information and advice deemed necessary by
10 the task force; providing for the membership,
11 meetings, and funding of the task force; requiring the
12 task force to establish an advisory committee for a
13 specified purpose; providing for the membership of the
14 advisory committee; authorizing the task force to
15 establish additional advisory and technical
16 committees; specifying duties of the task force;
17 requiring the task force to consider specified values
18 and parameters in developing certain recommendations;
19 requiring the task force to make findings and
20 recommendations for the design of the Health Care for
21 All Florida Plan and for the Health Care for All
22 Florida Board to administer the plan; specifying
23 requirements for the design of the plan; specifying
24 requirements for the plan and factors the task force
25 must include in its recommendations; requiring the
26 task force to engage in a public process to solicit
27 public input on certain elements of the plan;
28 specifying requirements for such process; specifying
29 requirements for the report of the task force’s
30 findings and recommendations; requiring that task
31 force members be appointed by a specified date;
32 requiring OPPAGA to begin preparing a work plan for
33 the task force by a specified date; requiring the task
34 force to submit a report of its findings and
35 recommendations to the Governor and the Legislature by
36 a specified date; requiring the Agency for Health Care
37 Administration to develop a plan for a Medicaid buy-in
38 program or a public health care option for certain
39 residents of this state; specifying requirements for
40 the plan; requiring the agency to report its plan to
41 the Governor and the Legislature by a specified date;
42 providing for the future repeal of specified
43 provisions; providing an appropriation; providing an
44 effective date.
45
46 Be It Enacted by the Legislature of the State of Florida:
47
48 Section 1.
Task Force on Universal Health Care for

49
Florida.—

50
(1)

DEFINITIONS.—As used in this section, the term:

51
(a)

“Group practice” means a single legal entity composed

52
of individual providers organized as a partnership, professional

53
corporation, limited liability company, foundation, nonprofit

54
corporation, or faculty practice plan or a similar association

55
in which:

56
1.

Each individual provider uses office space, facilities,

57
equipment, and personnel shared with other individual providers

58
to deliver medical care, consultation, diagnosis, treatment, or

59
other services that the provider routinely delivers in the

60
provider’s practice;

61
2.

Substantially all of the services delivered by the

62
individual providers are delivered on behalf of the group

63
practice and billed as services provided by the group practice;

64
3.

Substantially all of the payments to the group practice

65
are to reimburse the cost of services provided by the individual

66
providers in the group practice;

67
4.

The overhead expenses of, and the income from, the group

68
practice are shared among the individual providers in the group

69
practice in accordance with methods agreed to by the individual

70
providers who are members of the group practice; and

71
5.

There is a unified business model with consolidated

72
billing, accounting, and financial reporting and a centralized

73
decisionmaking body that represents the individual providers who

74
are members of the group practice.

75
(b)

“Individual provider” means a health care practitioner

76
who is licensed, certified, or registered in this state or who

77
is licensed, certified, or registered to provide care in another

78
state or country.

79
(c)

“Institutional provider” means a single legal entity

80
that is:

81
1.

A health care facility, such as a hospital;

82
2.

A comprehensive outpatient rehabilitation facility;

83
3.

A home health agency; or

84
4.

A hospice program.

85
(d)

“Provider” means an individual provider, an

86
institutional provider, or a group practice.

87
(e)

“Single-payor health care financing system” means a

88
universal system used by the state for paying the cost of health

89
care services or goods in which:

90
1.

Institutional providers are paid directly for health

91
care services or goods by the state or are paid by an

92
administrator that does not bear risk in its contracts with the

93
state;

94
2.

Group practices are paid directly for health care

95
services or goods by the state or are paid by an administrator

96
that does not bear risk in its contracts with the state, by the

97
employer of the group practice, or by an institutional provider;

98
and

99
3.

Individual providers are paid directly for health care

100
services or goods by the state, by their employers, by an

101
administrator that does not bear risk in its contracts with the

102
state, by an institutional provider, or by a group practice.

103
(2)

ESTABLISHMENT OF THE TASK FORCE ON UNIVERSAL HEALTH

104
CARE; PURPOSE; AGENCY COOPERATION.—The Task Force on Universal

105
Health Care is established to recommend the design of the Health

106
Care for All Florida Plan, a universal health care system

107
administered by the Health Care for All Florida Board which is

108
equitable, affordable, and comprehensive; provides high-quality

109
health care; and is publicly funded and available to every

110
individual residing in this state. The Office of Program Policy

111
Analysis and Government Accountability (OPPAGA) shall provide

112
staff support to the task force. All agencies of state

113
government are directed to assist the task force in the

114
performance of its duties and, to the extent permitted by laws

115
relating to confidentiality, to furnish information and advice

116
deemed necessary by the task force to perform its duties.

117
(3)

MEMBERSHIP; MEETINGS; FUNDING; ADVISORY COMMITTEES.—

118
(a)

The task force shall be composed of the following 20

119
members:

120
1.

Two members of the Senate, one from the majority party

121
and one from the minority party, appointed by the President of

122
the Senate.

123
2.

Two members of the House of Representatives, one from

124
the majority party and one from the minority party, appointed by

125
the Speaker of the House of Representatives.

126
3.

Thirteen members appointed by the Governor, each of whom

127
must reside in this state and:

128
a.

Represent to the greatest extent practicable:

129
(I)

Diverse social identities, including, but not limited

130
to,
identities based on
geography, race, ethnicity, sex, gender

131
nonconformance, sexual orientation, economic status, disability,

132
or health status; and

133
(II)

Diverse areas of expertise, based on knowledge and

134
personal
experience, including, but not limited to, patient

135
advocacy, receipt of medical assistance, management of a

136
business that offers health insurance to its employees, public

137
health, organized labor, provision of health care, or owning a

138
small business;

139
b.

Represent, at a minimum, the following areas of

140
expertise acquired by education, vocation, or personal

141
experience:

142
(I)

Rural health;

143
(II)

Quality assurance and health care accountability;

144
(III)

Fiscal management and change management;

145
(IV)

Social services;

146
(V)

Public health services;

147
(VI)

Medical and surgical services;

148
(VII)

Alternative therapy services;

149
(VIII)

Services for persons with disabilities; and

150
(IX)

Nursing services;

151
c.

Include at least eight members who are representatives

152
of labor unions representing employees who work in the health

153
care field in this state;

154
d.

Include at least one member who is a representative of a

155
Florida legal aid organization helping health care patients;

156
e.

Include at least one member who has produced at least

157
three economic analyses of the economic benefits of single-payor

158
programs on the state level. This member need not be a resident

159
of this state in order to serve on the task force; and

160
f.

Include at least one member who has an active license to

161
practice social work in this state.

162
4.

The State Surgeon General or his or her designee, who is

163
a nonvoting member.

164
5.

The Secretary of Business and Professional Regulation or

165
his or her designee, who is a nonvoting member.

166
6.

A member of the Florida Association of Counties,

167
selected by the association, who is a nonvoting member.

168
(b)

In making the appointments under subparagraph (a)3.,

169
the Governor shall ensure that there is no disproportionate

170
influence by any individual, organization, government, industry,

171
business, or profession in any decisionmaking by the task force

172
and no actual or potential conflicts of interest.

173
(c)

The task force shall elect one of its members to serve

174
as chair and one to serve as vice chair.

175
(d)

If there is a vacancy
on the task force
for any cause,

176
the appointing authority
must
make an appointment to fill the

177
vacancy, which appointment becomes effective

immediately.

178
(e)

Members of the Legislature appointed to the task force

179
are nonvoting members of the task force and may act in an

180
advisory capacity only.

181
(f)

A majority of the voting members of the task force

182
constitutes a quorum for the transaction of business.

183
(g)

Official action by the task force requires the approval

184
of a majority of the voting members of the task force.

185
(h)

The task force shall meet at times and places specified

186
by the call of the chair or by a majority of the voting members

187
of the task force.

188
(i)

Members of the task force are not entitled to

189
compensation but are entitled to receive per diem and travel

190
expenses as provided in s. 112.061, Florida Statutes.

191
(j)

The task force may apply for public or private grants

192
from nonprofit organizations for the costs of research.

193
(k)1.

The task force shall establish an advisory committee

194
to provide input from a consumer perspective and, to the

195
greatest extent practicable, from the diverse social identities

196
described in sub-sub-subparagraph (a)3.a.(I).

197
2.

Members of the advisory committee must have the

198
following qualifications
,
such that at least one member:

199
a.

Has experience in seeking or receiving health care in

200
this state to address one or more serious medical conditions or

201
disabilities.

202
b.

Is enrolled in health insurance offered by the state

203
group insurance program or represents public employees.

204
c.

Is enrolled in employer-sponsored health insurance,

205
group health insurance, or a self-insured health plan offered by

206
an employer.

207
d.

Is enrolled in commercial insurance purchased without

208
any employer contribution.

209
e.

Receives medical assistance.

210
f.

Is enrolled in Medicare.

211
g.

Is a parent or guardian of a child enrolled in the

212
Children’s Health Insurance Program.

213
h.

Is enrolled in the Federal Employee
s
Health Benefits

214
Program.

215
i.

Is enrolled in
the federal
TRICARE
program
.

216
j.

Receives care from the United States Department of

217
Veterans Affairs Veterans Health Administration.

218
k.

Receives care from the Indian Health Service.

219
(l)

The task force may establish additional advisory or

220
technical committees that the task force considers necessary.

221
The committees may be continuing or temporary. The task force

222
shall determine the representation, membership, terms, and

223
organization of the committees and shall appoint the members of

224
the committees.

225
(m)

Members of advisory or technical committees are not

226
entitled to compensation but

may, in the discretion of the task

227
force, be reimbursed for per diem and travel expenses as

228
provided in s. 112.061, Florida Statutes.

229
(4)

DUTIES; VALUES; P
ARAMETER
S.—

230
(a)

The task force shall produce findings and

231
recommendations for
the
Health Care for All Florida Plan
,
a

232
well-functioning, single-payor health care financing system that

233
is responsive to the needs and expectations of the residents of

234
this state by:

235
1.

Improving the health status of individuals, families,

236
and communities;

237
2.

Defending against threats to the health of the residents

238
of this state;

239
3.

Protecting individuals from the financial consequences

240
of ill health;

241
4.

Providing equitable access to person-centered care;

242
5.

Removing cost as a barrier to accessing health care;

243
6.

Removing any financial incentive for a health care

244
practitioner to provide care to one patient over another;

245
7.

Making it possible for individuals to participate in

246
decisions affecting their health and the health
care
system;

247
8.

Establishing measurable health care goals and guidelines

248
that align with other state and federal health standards; and

249
9.

Promoting continuous quality improvement and fostering

250
interorganizational collaboration.

251
(b)

The task force, in developing its recommendations for

252
the Health Care for All Florida Plan, shall consider, at a

253
minimum, all of the following values:

254
1.

Health care, as a fundamental element of a just society,

255
should
be secured for all individuals on an equitable basis by

256
public means, similar to public education, public safety, and

257
other public infrastructure.

258
2.

Access to a distribution of health care resources and

259
services should be available according to each individual’s

260
needs and location within
this
state. Race, color, national

261
origin, age, disability, wealth, income, citizenship status,

262
primary language use, genetic conditions, previous or existing

263
medical conditions, religion, or sex, including sex

264
stereotyping, gender identity, sexual orientation, and pregnancy

265
and related medical conditions, such as termination of

266
pregnancy,
should
not create any barriers to health care or

267
disparities in health outcomes due to access to care.

268
3.

The components of the system must be accountable and

269
fully transparent to the public with regard to information,

270
decisionmaking, and management through meaningful public

271
participation in decisions affecting people’s health care.

272
4.

Funding for the Health Care for All Florida Plan is a

273
public trust, and any savings or excess revenue
should
be

274
returned to that public trust.

275
(c)

The task force, in developing its recommendations for

276
the Health Care for All Florida Plan, shall consider, at a

277
minimum, all of the following
parameters
:

278
1.

A participant in the plan may choose any individual

279
provider who is licensed, certified, or registered in this state

280
or any group practice.

281
2.

The plan may not discriminate against any individual

282
provider who is licensed, certified, or registered in this state

283
to provide services covered by the plan and who is acting within

284
the provider’s scope of practice.

285
3.

A participant and the participant’s provider shall,

286
within the scope of services covered within each category of

287
care and within the plan’s parameters for standards of care and

288
requirements for prior authorization, determine whether a

289
treatment is medically necessary or medically appropriate for

290
that participant.

291
4.

The plan
must
cover services from birth to death, based

292
on evidence-based decisions as determined by the Health Care for

293
All Florida Board.

294
(5)

SCOPE OF DESIGN FOR THE HEALTH CARE FOR ALL FLORIDA

295
PLAN.—

296
(a)

The task force shall make findings and recommendations

297
for the design of the Health Care for All Florida Plan and the

298
Health Care for All Florida Board, which shall administer the

299
plan. The task force shall submit a report of its findings and

300
recommendations to the Governor, the President of the Senate,

301
and the Speaker of the House of Representatives as specified in

302
subsection (6). The task force’s recommendations must be

303
succinct statements and include actions and timelines, the

304
degree of consensus among the task force members, and the

305
priority of each recommendation, based on urgency and

306
importance. The task force may defer any recommendations to be

307
determined by the board.

308
(b)

The design of the Health Care for All Florida Plan

309
recommended by the task force must:

310
1.

Adhere to the values and
parameter
s described in

311
paragraphs (4)(b) and (c);

312
2.

Be a single-payor health care financing system;

313
3.

Ensure that individuals who receive services from the

314
United States Department of Veterans Affairs Veterans Health

315
Administration or the Indian Health Service may be enrolled in

316
the plan while continuing to receive those services;

317
4.

Require o
btain
ing
a waiver of federal requirements that

318
pose barriers
to, or adopt other approaches,

enabling equitable

319
and uniform inclusion of all residents such that
a resident of

320
this state who has other coverage that is not subject to state

321
regulation
may
enroll in the plan without jeopardizing

322
eligibility for the other coverage if the person moves out of

323
this state; and

324
5.

Preserve the coverage of the health services currently

325
required by Medicare, Medicaid, the Children’s Health Insurance

326
Program, the Patient Protection and Affordable Care Act, Pub. L.

327
No. 111-148, as amended by the Health Care and Education

328
Reconciliation Act of 2010, Pub. L. No. 111-152, Florida’s

329
medical assistance program
for the needy
, and any other state or

330
federal program.

331
(c)

The plan must allow participation by any individual

332
who:

333
1.

Resides in this state;

334
2.

Is a nonresident who works full time in this state and

335
contributes to the plan; or

336
3.

Is a nonresident who is a dependent of an individual

337
described in subparagraph 1. or subparagraph 2.

338
339
The task force’s recommendations must address issues related to

340
the provision of services to nonresidents who receive services

341
in this state and to plan participants who receive services

342
outside
of
this state.

343
(d)

Providers shall be paid under the plan as follows or

344
through an alternative method that is similarly equitable and

345
cost-effective:

346
1.

Individual providers licensed in this state shall be

347
paid:

348
a.

On a fee-for-services basis;

349
b.

As employees of institutional providers or members of

350
group practices that are reimbursed with global budgets; or

351
c.

As individual providers in group practices that receive

352
capitation payments for providing outpatient services as

353
permitted by subparagraph 4.

354
2.

Institutional providers shall be paid with global

355
budgets that include separate capital budgets, determined

356
through regional planning, and operational budgets.

357
3.

Budgets
must
be determined for individual hospitals and

358
not for entities that own multiple hospitals, clinics, or other

359
providers of health care services or goods.

360
4.

A group practice may be reimbursed with capitation

361
payments if the group practice:

362
a.

Primarily uses individual providers in the group

363
practice to deliver care in the group practice’s facilities;

364
b.

Does not use capitation payments to reimburse the cost

365
of hospital services; and

366
c.

Does not offer financial incentives to individual

367
providers in the group practice based on the use of services.

368
(e)

In designing the plan, the task force shall:

369
1.

Develop cost estimates for the plan, including, but not

370
limited to, cost estimates for:

371
a.

The approach recommended for achieving the result

372
described in subparagraph (b)4.; and

373
b.

The payment method designed by the task force under

374
paragraph (d);

375
2.

Consider how the plan will impact the structure of

376
existing state and local boards and commissions, counties,

377
cities, and special districts, as well as the
Federal

378
Government, other states, and Indian tribes;

379
3.

Investigate other states’ attempts at providing

380
universal coverage and using single-payor health care financing

381
systems, including the outcomes of those attempts; and

382
4.

Consider
the work by existing health care professional

383
boards and commissions
and
incorporate important aspects of
such

384
work into recommendations for the plan.

385
(f)

In developing recommendations for long-term care

386
services and support for the plan under subparagraph (i)16., the

387
task force shall convene an advisory committee that includes:

388
1.

Persons with disabilities who receive long-term services

389
and support;

390
2.

Older adults who receive long-term services and support;

391
3.

Individuals representing persons with disabilities and

392
older adults;

393
4.

Members of groups that represent the diversity,

394
including by gender, race, and economic status, of individuals

395
who have disabilities;

396
5.

Providers of long-term services and support, including

397
in-home care providers who are represented by organized labor,

398
and family attendants and caregivers who provide long-term

399
services and support; and

400
6.

Academics and researchers in relevant fields of study.

401
402
Notwithstanding subparagraph (i)16., the task force may explore

403
the effects of excluding long-term care services from the plan,

404
including, but not limited to, the social, financial, and

405
administrative costs.

406
(g)

The task force’s recommendations for the duties of the

407
board and the details of the plan must ensure
that
, by

408
considering the following factors, patients are empowered to

409
protect their health, their rights, and their privacy:

410
1.

The patient’s a
ccess to patient advocates who are

411
responsible to the patient and maintain patient confidentiality

412
and whose responsibilities include, but are not limited to,

413
addressing concerns about providers and helping patients

414
navigate the process of obtaining medical care;

415
2.

The patient’s a
ccess to culturally and linguistically

416
appropriate care and service;

417
3.

The patient’s ability to obtain needed care when a

418
treating provider is unable or unwilling to provide the care;

419
4.

The patient’s ability to receive paid assistance to

420
complete forms or perform other administrative functions to

421
qualify for disability benefits, family medical leave, or other

422
income support; and

423
5.

The patient’s access to and control of medical records,

424
including:

425
a.

Empowering
the
patient to control access to
his or her

426
medical records and obtain independent second opinions, unless

427
there are clear medical reasons not to do so;

428
b.

Requiring that a patient or the patient’s designee be

429
provided a complete copy of the patient’s health records

430
promptly after every interaction or visit with a provider;

431
c.

Ensuring that the copy of the health records provided to

432
a patient includes all data used in the care of that patient;

433
and

434
d.

Requiring that the patient or the patient’s designee

435
provide approval before any forwarding of the patient’s data to,

436
or access of the patient’s data by, family members, caregivers,

437
or other providers or researchers.

438
(h)

In developing recommendations for the plan, the task

439
force shall engage in a public process to solicit public input

440
on the elements of the plan described in paragraphs (b), (i),

441
(j), and (k). The public process must:

442
1.

Ensure input from individuals in rural and underserved

443
communities and from individuals in communities that experience

444
health care disparities;

445
2.

Solicit public comments statewide while providing to the

446
public evidence-based information developed by the task force

447
about the health care costs of a single-payor health care

448
financing system, including the cost estimates developed under

449
paragraph (e), as compared to the current system; and

450
3.

Solicit the perspectives of:

451
a.

Individuals throughout the range of communities that

452
experience health care disparities;

453
b.

A range of businesses, based on industry and employer

454
size;

455
c.

Individuals whose insurance coverage represents a range

456
of current insurance types and individuals who are uninsured or

457
underinsured; and

458
d.

Individuals with a range of health care needs, including

459
individuals needing disability services and long-term care

460
services who have experienced the financial and social effects

461
of policies requiring them to exhaust a large portion of their

462
resources before qualifying for long-term care services paid for

463
by the medical assistance program
for the needy
.

464
(i)

With respect to
the
administration of the plan, the

465
report
required under paragraph (a)
must include, but need not

466
be limited to, all of the following:

467
1.

The governance and leadership of the board,

468
specifically:

469
a.

The composition and representation of the membership of

470
the board, appointed or otherwise selected using an open and

471
equitable selection process;

472
b.

The statutory authority the board will need
in order
to

473
establish policies, guidelines, mandates, incentives, and

474
enforcement
mechanisms
to develop a highly effective and

475
responsive single-payor health care financing system;

476
c.

The ethical standards and their enforcement for members

477
of the board such that there are the most rigorous protections

478
from
and prohibitions
against
actual or perceived economic

479
conflicts of interest; and

480
d.

The steps for ensuring that there is no disproportionate

481
influence by any individual, organization, government, industry,

482
business, or profession in any decisionmaking by the board;

483
2.

A list of federal and state laws
and
rules, state

484
contracts or agreements,
and
court actions or decisions that may

485
facilitate, constrain, or prevent implementation of the plan and

486
an explanation of how the
y
may facilitate or constrain or

487
prevent implementation;

488
3.

The plan’s economic sustainability, operational

489
efficiency, and cost control measures that include, but are not

490
limited to, the following:

491
a.

A financial governance system supported by relevant

492
legislation, financial audit, and public expenditure reviews and

493
clear operational rules to ensure efficient use of public funds;

494
and

495
b.

Cost control features
,
such as multistate purchasing;

496
4.

Features of the plan that are necessary to continue to

497
receive federal funding that is currently available to the state

498
and estimates of the amount of the federal funding
which
will be

499
available;

500
5.

Fiduciary requirements for the revenue generated to fund

501
the plan, including, but not limited to, the following:

502
a.

A dedicated fund, separate and distinct from the General

503
Revenue Fund, which is held in trust for the residents of this

504
state;

505
b.

Restrictions to be authorized by the board on the use of

506
the trust fund;

507
c.

A process for creating a reserve fund by retaining

508
moneys in the trust fund if, over the course of a year, revenue

509
exceeds costs; and

510
d.

Required accounting methods that eliminate the potential

511
for misuse of public funds, detect inaccuracies in provider

512
reimbursement, and use the most rigorous
,
generally accepted

513
accounting principles, including annual external audits and

514
audits at the time of each transition in the board’s executive

515
management;

516
6.

Requirements for the purchase of reinsurance;

517
7.

Any necessary b
onding authority;

518
8.

The board’s role in workforce recruitment, retention,

519
and development;

520
9.

A process for the board to develop statewide goals
and

521
objectives and ongoing review;

522
10.

The appropriate relationship between the board and

523
regional or local authorities regarding oversight of health

524
activities, health care systems, and providers to promote

525
community health reinvestment, equity, and accountability;

526
11.

Criteria to guide the board in determining which health

527
care services are necessary for the maintenance of health, the

528
prevention of health problems, the treatment or rehabilitation

529
of health conditions, and the provision of long-term and respite

530
care. Criteria may include, but are not limited to, the

531
following:

532
a.

Whether the services are cost-effective and based on

533
evidence from multiple sources;

534
b.

Whether the services are currently covered by the health

535
benefit plans offered by the state group insurance program;

536
c.

Whether the services are designated as effective by the

537
United States Preventive Services Task Force, the United States

538
Centers for Disease Control and Prevention’s Advisory Committee

539
on Immunization Practices, the
federal
Health Resources and

540
Services Administration’s Bright Futures Program, or the

541
National Academy of Medicine’
s Committee on Preventive Services

542
for Women; and

543
d.

Whether the evidence on the effectiveness of services

544
comes from peer-reviewed medical literature, existing

545
assessments and recommendations from state and federal boards

546
and commissions, and other peer-reviewed sources;

547
12.

A process to track and resolve complaints, grievances,

548
and appeals, including establishing an Office of the Patient

549
Advocate;

550
13.

Options for transition planning, including an impact

551
analysis on existing health
care
systems, providers, and patient

552
relationships;

553
14.

Options for incorporating cost containment measures,

554
such as prior approval and prior authorization requirements, and

555
the effect of such measures on equitable access to quality

556
diagnosis and care;

557
15
.

The methods for reimbursing providers for the cost of

558
care as described in paragraph (d) and recommendations regarding

559
the appropriate reimbursement for the cost of services provided

560
to plan participants when they are traveling outside this state;

561
and

562
16.

Recommendations for long-term care services and support

563
that are tailored to each individual’s needs based on an

564
assessment. The services and support may include, but need not

565
be limited to:

566
a.

Long-term nursing services provided by an institutional

567
provider or in a community-based setting;

568
b.

A broad spectrum of long-term services and support,

569
including home and community-based settings or other

570
noninstitutional settings;

571
c.

Services that meet the physical, mental, and social

572
needs of individuals while allowing them maximum possible

573
autonomy and maximum civic, social, and economic participation;

574
d.

Long-term services and support that are not based on the

575
individual’s type of disability, level of disability, service

576
needs, or age;

577
e.

Services provided in the least restrictive setting

578
appropriate to the individual’s needs;

579
f.

Services provided in a manner that allows persons with

580
disabilities to maintain their independence, self-determination,

581
and dignity;

582
g.

Services and support that are of equal quality and

583
accessibility in every geographic region of this state; and

584
h.

Services and support that give the individual the

585
opportunity to direct the services.

586
(j)

The task force’s report must include:

587
1.

The waivers of federal laws or other federal approval

588
that will be necessary to enable a person who is a resident of

589
this state and who has other coverage that is not subject to

590
state regulation to enroll in the plan without jeopardizing

591
eligibility for the other coverage if the person moves out of

592
this state;

593
2.

Estimates of the savings and expenditure increases under

594
the plan, relative to the current health care system, including,

595
but not limited to:

596
a.

Savings from eliminating waste in the current system and

597
from administrative simplification, fraud reduction, monopsony

598
power, simplification of electronic documentation, and other

599
factors that the task force identifies;

600
b.

Savings from eliminating the cost of insurance that

601
currently provides medical benefits that would be provided

602
through the plan; and

603
c.

Increased costs due to providing better health care to

604
more individuals than under the current health care system;

605
3.

Estimates of the expected health care expenditures under

606
the plan, compared to the current health care system, reported

607
in categories similar to the National Health Expenditure

608
Accounts compiled by the Centers for Medicare and Medicaid

609
Services, including, but not limited to:

610
a.

Personal health care expenditures;

611
b.

Health consumption expenditures; and

612
c.

State health expenditures;

613
4.

Estimates of how much of the expenditures on the plan

614
will be made from moneys currently spent on health care in this

615
state from both state and federal sources and redirected or

616
used, in an equitable and comprehensive manner, to the plan;

617
5.

Estimates of the amount, if any, of additional state

618
revenue that will be required;

619
6.

Results of the task force’s evaluation of the impact on

620
individuals, communities, and the state if the current level of

621
health care spending continues without implementing the plan,

622
using existing reports and analys
e
s where available; and

623
7.

A description of how the Health Care for All Florida

624
Board or another entity may enhance:

625
a.

Access to comprehensive, high-quality, patient-centered,

626
patient-empowered, equitable, and publicly funded health care

627
for all individuals;

628
b.

Financially sustainable and cost-effective health care

629
for the benefit of businesses, families, individuals, and state

630
and local governments;

631
c.

Regional and community-based systems integrated with

632
community programs to contribute to the health of individuals

633
and communities;

634
d.

Regional planning for cost-effective, reasonable capital

635
expenditures that promote regional equity;

636
e.

Funding for the modernization of public health, as an

637
integral component of cost efficiency in an integrated health

638
care system; and

639
f.

An ongoing and deepening collaboration with Indian

640
tribes and other organizations providing health care
which
will

641
not be under the authority of the board.

642
(k)1.

The task force’s findings and recommendations

643
regarding revenue for the plan, including redirecting existing

644
health care moneys under subparagraph (j)4., must be ranked

645
according to explicit criteria, including the degree to which an

646
individual, class of individuals, or organization would

647
experience an increase or decrease in the direct or indirect

648
financial burden or whether they would experience no change.

649
Revenue options may include, but are not limited to, the

650
following:

651
a.

The redirection of current public agency expenditures;

652
b.

An employer payroll tax based on progressive principles

653
that protect small businesses and that tend to preserve or

654
enhance federal tax
benefits
for Florida employers that pay the

655
costs of their employees’ health care; and

656
c.

A dedicated revenue stream based on progressive taxes

657
that do not impose a burden on individuals who would otherwise

658
qualify for medical assistance.

659
2.

The task force may explore the effect of means-tested

660
copayments or deductibles, including, but not limited to, the

661
effect of increased administrative complexity and the resulting

662
costs that cause patients to delay getting necessary care,

663
resulting in more severe consequences for their health.

664
(l)

The task force’s recommendations must ensure:

665
1.

Public access to state, regional, and local reports and

666
forecasts of revenue expenditures;

667
2.

That the reports and forecasts are accurate, timely, of

668
sufficient detail, and presented in a way that is understandable

669
to the public to inform policymaking and the allocation or

670
reallocation of public resources; and

671
3.

That the information can be used to evaluate programs

672
and policies, while protecting patient confidentiality.

673
(6)

TASK FORCE TIMELINE.—

674
(a)

Members of the task force must be appointed by May 31,

675
202
7
.

676
(b)

By September 30, 202
7
, OPPAGA shall begin preparing a

677
work plan for the task force.

678
(c)

The task force shall submit a report containing its

679
findings and recommendations for the design of the Health Care

680
for All Florida Plan and the Health Care for All Florida Board

681
to the Governor, the President of the Senate, and the Speaker of

682
the House of Representatives by the first day of the 202
8

683
regular session of the Legislature.

684
(7)

PLAN FOR A MEDICAID BUY-IN PROGRAM OR A PUBLIC OPTION.—

685
(a)

The Agency for Health Care Administration shall develop

686
a plan for a Medicaid
b
uy-
i
n program or a public option to

687
provide an affordable health care option to all Florida

688
residents, with the primary focus being Florida residents who do

689
not have access to health care. To the extent feasible, the plan

690
must:

691
1.

Have no net cost to the state;

692
2.

Provide a comprehensive package of benefits that are, at

693
a minimum, equivalent to the benefits offered by qualified plans

694
offered through the
federal
health insurance exchange;

695
3.

Impose no more than minimal cost sharing, deductibles,

696
or copayments;

697
4.

Take into account the impact on the distribution of risk

698
in the health insurance market;

699
5.

Encourage the use of premium tax credits available under

700
s
.
36B of the Internal Revenue Code and other subsidies

701
available under federal law;

702
6.

Maximize the receipt of federal funds to support the

703
costs of the program or option;

704
7.

Use the coordinated care organization health care

705
delivery model; and

706
8.

Use the coordinated care organization provider networks

707
to the extent possible without destabilizing the networks.

708
(b)

By May 1, 202
7
, the agency shall report to the

709
Governor, the President of the Senate, and the Speaker of the

710
House of Representatives the plan developed in accordance with

711
paragraph (a), including:

712
1.

A discussion of potential eligibility requirements for

713
the Medicaid
b
uy-
i
n program or public option, as well as the

714
implications of limiting or not limiting eligibility in various

715
ways;

716
2.

Options for Medicaid
b
uy-
i
n programs or public options

717
targeted to specific populations, including, but not limited to:

718
a.

Residents with household incomes above 400 percent and

719
below 600 percent of the federal poverty guidelines who are

720
unable to afford health insurance offered by their employers;

721
b.

Residents who regularly cycle through enrolling and

722
disenrolling in medical assistance and employer-sponsored health

723
insurance; or

724
c.

Other groups that face significant barriers to accessing

725
affordable, quality health care;

726
3.

Recommendations for legislative changes necessary to

727
implement the plan; and

728
4.

Any federal approval that will be required to implement

729
the plan, such as demonstration projects under s. 1115 of the

730
Social Security Act, a state plan amendment, or a waiver for

731
state innovation under 42 U.S.C. s. 18052.

732
(8)

REPEAL.—
This section is repealed on January 2, 202
9
.

733 Section 2.
F
or the
2026-2027 fiscal year, the nonrecurring

734
sum of
$1,174,816
is appropriated

from the General Revenue Fund

735
to the
Agency for Health Care Administration

for the purpose of

736
implementing this act
.

737 Section 3. This act shall take effect upon becoming a law.