The reconciliation bill passed by the U.S. House of Representatives proposes deep cuts to critical health care and food assistance programs — including $1 trillion in cuts to Medicaid and the Supplemental Nutrition Assistance Program (SNAP) over the next nine years — while extending $7.7 trillion in gross tax cuts, skewed to the wealthiest households.
Below, FPI staff outlines four ways in which the reconciliation bill would impact families in this state and what Floridians should know about the proposal as it advances in Congress.
1. Floridians could see a drastic increase in health care premiums under the bill.
Florida has more people who receive their health insurance through the Affordable Care Act (ACA) Marketplace than any other state. Before the American Rescue Plan Act (ARPA), people who were enrolled in the Marketplace with household income between 100 and 400 percent of the federal poverty level (FPL) qualified for Advanced Premium Tax Credits (APTCs), which made their coverage more affordable throughout the year. Individuals could opt for the Marketplace to send a tax credit directly to their insurance company and pay less each month for their premiums. During the COVID 19 pandemic in 2021, ARPA increased these subsidized payments and included a provision that increased the income limits so that those with household income above 400 percent FPL could take advantage of these APTCs. The 2022 Inflation Reduction Act (IRA) extended these subsidies through 2025.
The House’s reconciliation bill neglects to extend enhanced ACA Marketplace premium tax credits. This would impact over 4 million Floridians who rely on these enhanced subsidies by increasing the average cost of health insurance from $588 to $1116 per year, about 90 percent. For those above the federal poverty level, such as a family of four with $126,000 in household income (403 percent FPL), premiums would increase by $9,049 annually. This would be a devastating blow to families in Florida who are already worried about the skyrocketing costs of health care.
2. The bill would extend the federal debt and disproportionately benefit wealthy households.
According to preliminary estimates from the Congressional Budget Office, the tax changes in the bill would increase the federal debt by $3.8 trillion over the 2026 to 2034 period. The House’s tax legislation extends several provisions of the 2017 Tax Cuts and Jobs Act (known to have benefited wealthy households and corporations more than those struggling to make ends meet), skewing a majority of the tax benefits toward households with the highest income.
In Florida, the House's reconciliation bill would benefit the wealthiest Floridians more so than any other group. As the Institute on Taxation and Economic Policy notes, the top 1 percent of Floridians (those with income of more than $1.1 million annually) would receive an average tax cut of $86,320 in 2026. As a share of the tax cuts, in 2026, the top 1 percent would receive 25 percent of the total tax cuts. In comparison, the 60 percent of Floridians who make between $0 and $77,600 would see an average benefit of $80 to $1,540, or 12 percent of the total benefit.
In Florida, the House's reconciliation bill would benefit the wealthiest Floridians more so than any other group. As the Institute on Taxation and Economic Policy notes, the top 1 percent of Floridians (those with income of more than $1.1 million annually) would receive an average tax cut of $86,320 in 2026.
While the bill would temporarily increase the maximum child tax credit (CTC), the proposal also requires a Social Security Number (SSN) for parents and qualifying children. Currently, workers without documentation can file an income tax return by using an Individual Taxpayer Identification Number (ITIN). In 2022, undocumented immigrants contributed $19.5 billion in federal income taxes using ITINs. Under current law, parents with an ITIN can claim the CTC if they have a qualifying child who was born in the United States and is a citizen. Thus, the House’s tax proposal would deny the CTC to some American children.
3. Under the bill, Florida would lose crucial provider tax dollars — a cornerstone of Florida’s hospital and nursing home funding.
Currently, states have flexibility in how they finance their share of the cost of Medicaid. States are permitted to institute taxes and assessments on hospitals, nursing homes, and other health care providers as well as on Medicaid managed care plans. These taxes help to finance the state’s share of the Medicaid program. Florida currently imposes three types of provider taxes: hospitals, intermediate care facilities for individuals with intellectual disabilities (ICF/ID), and nursing homes. As a state that has not expanded its Medicaid program, forgoing billions in federal Medicaid funding each year, Florida relies heavily on provider tax payments to draw federal funding to make up the gap in Medicaid funding. In 2018, $2.4 billion of Florida's total Medicaid payments were financed with provider taxes and local government funds.
The House’s reconciliation bill would prohibit new provider taxes, and it would prohibit any increases in current provider taxes. Restrictions like this cause states to take harmful measures to balance budgets such as reducing eligibility, limiting benefits, or reducing already-low payment rates for health care providers. Restricting Florida’s eligibility to impose or increase these taxes would decrease the state’s ability to close the financing gap for the Medicaid program.
4. Florida could lose $1.6 billion in federal dollars for food assistance if the House’s proposed SNAP cut is enacted.
The House approved $300 billion in devastating cuts to the Supplemental Nutrition Assistance Program (SNAP). Among other cuts, the House voted to move forward with efforts to force states to pay between 5 and 25 percent of the cost of SNAP benefits that are provided to eligible households beginning in 2028. If enacted, although all states would be forced to cover at least 5 percent of the cost of SNAP benefits, states with error rates of over 10 percent, such as Florida, would be forced to pay 25 percent. Most SNAP errors are due to mistakes made by state agencies, and families who are overpaid usually are eligible for assistance.
The people who would be hit hardest by cuts to SNAP in Florida are children and seniors, who make up 41 percent and 25 percent of the state’s entire SNAP caseload, respectively; the 243,000 SNAP households containing a member who has a disability; and the 99,000 veterans in Florida who participate in the program.
Currently, the federal government pays 100 percent of the cost of monthly benefits while the state pays 50 percent of administrative costs.
Under the House’s proposal, Florida would owe $1.6 billion (or 25 percent of the cost of SNAP benefits provided to Floridians) to maintain existing benefit levels in 2028 alone. This cost shift, which would be in addition to the portion of administrative costs that states are required to pay, would come at a time when state economists are projecting a $6.9 billion deficit for Florida by that same year. Still, cost sharing of grocery benefits is only one of the many SNAP cuts passed by the House. Also included are cuts related to expansion of work requirements, increasing the share of administrative costs owed by the state, limiting updates to the Thrifty Food Plan, and denying assistance to almost all immigrants who are not lawful permanent residents, including people with refugee or asylee status and victims of domestic violence and trafficking.
The people who would be hit hardest by cuts to SNAP in Florida are children and seniors, who make up 41 percent and 25 percent of the state’s entire SNAP caseload, respectively; the 243,000 SNAP households containing a member who has a disability; and the 99,000 veterans in Florida who participate in the program. In addition, the cuts, if enacted, will hurt the 15,100 grocery stores and farmers markets participating in SNAP who will see a marked decline in purchases with SNAP.
