Florida Budget Proposals in Brief (FY 2025-26): Tax and Revenue
Introduction
The Legislature is at a standstill, with two seemingly competing visions for the future of taxes in Florida. On the one hand, the House of Representatives advanced House Bill (HB) 7033 with various changes to the state’s general sales tax, as well as changes to local tourist development taxes. On the other hand, the Senate’s omnibus tax bill, Senate Bill 7034, resembles previous tax packages since it includes a slew of sales tax holidays; however, the legislation also offers permanent tax exemptions for consumers. The House’s tax package would cost Floridians nearly $5.5 billion, whereas the Senate’s plan would cost almost $2.1 billion. The size and scope of these proposals would impact the state’s ability to invest in programs and services; Consequently, the chambers’ disagreement also extends to their respective budget recommendations. The House’s budget proposal for FY 2025-26 (HB 5001) totals $113 billion, while the Senate’s budget totals $117.4 billion (Senate Bill 2500).[1],[2]
Due to the differences between the House and Senate, lawmakers will adjourn on May 2 — the last day of Florida’s 2025 regular session — without having passed the final budget. The goal of this brief is to highlight key general sales tax provisions in the tax packages that are at the heart of ongoing disputes and negotiations.
When it Comes to Tax Cuts, Context Matters
According to the Institute on Taxation and Economic Policy (ITEP), Florida has the most regressive tax code in the nation, as the 20 percent of Florida taxpayers with the lowest income bear an effective state and local tax rate that is nearly five times that of the top 1 percent of households.[3] This is a result of a state government that relies on consumption taxes for over 75 percent of its general revenue.[4]
Tax reform is long overdue, to ease the tax burden of over 4 million households currently struggling to make ends meet,[5] and to balance the state budget so that Floridians have recurring (or permanent) access to programs and services that improve their quality of life and help those who need it the most. At the same time, any attempt to reform Florida’s tax code cannot ignore the realities of the current moment:
- Florida law requires policymakers to pass a balanced budget annually. This means that any tax reduction must be balanced with budget cuts, higher taxes, or a combination of both.
- The federal government currently finances roughly 32 percent of Florida’s budget.[6] In light of ongoing uncertainty about the scope of federal budget cuts, especially for basic needs programs and Medicaid, any state-level reduction could become more costly if policymakers are put in a position where they must decide whether to let millions of Floridians lose access to essential services due to federal budget slashing.
- The state government could be facing a deficit of nearly $3 billion -$7 billion by FY 2027-28.[7] According to the latest Long-Range Financial Outlook, if policymakers continue spending as they have over the past three fiscal years, spending will inevitably surpass revenue collections, leading to substantial budget cuts.
- Nearly eight out of 10 flexible spending dollars come from consumption taxes, which are sensitive to economic disruptions.[8] While there is uncertainty about the chances of a widespread economic recession, a downturn would disrupt sales tax revenue, making it difficult to balance the state budget.
While Floridians need tax reform, they deserve good quality public services as well. Without a plan to raise revenue — whether it is to prevent a multibillion-dollar deficit, safeguard access to service due to drastic federal changes, or prepare for a recession — significant tax cuts will offer little relief and prevent lawmakers from tackling ongoing budget challenges.
In terms of urgent budget challenges: nearly 50 percent of households in Florida cannot afford necessities like housing, child care, food, transportation, and health care.[9] Three-quarters of Florida prisons lack A/C;[10] over 2.5 million Floridians are without health coverage;[11] and thousands of homebound adults and individuals with disabilities are stuck on long waitlists for home- and community-based care.[12] Yet, state and local funding for public services has trailed behind most of the country, as 44 other states and D.C. invest more on a per capita basis.[13]
While Floridians need tax reform, they deserve good quality public services as well. Without a plan to raise revenue — whether it is to prevent a multibillion-dollar deficit, safeguard access to service due to drastic federal changes, or prepare for a recession — significant tax cuts will offer little relief and prevent lawmakers from tackling ongoing budget challenges.
Neither the House nor the Senate raise revenue to pay for proposed tax cuts in their respective tax packages (HB 7033 and SB 7034). Consequently, since both bills include permanent changes, Floridians will pay for “relief” at the expense of other area of the state budget on a recurring basis.
Permanent Sales Tax Policy Changes
The flagship policy in the House’s tax plan (HB 7033) is a 0.75 percentage-point reduction to the state’s 6 percent general sales tax, intended to offer about $5 billion in annual savings to consumers.[14] Moreover, HB 7033 includes a 0.75 percentage-point reduction to the sales tax businesses pay on commercial leases, plus several other sales tax cuts (electricity, new mobile homes, coin-operated amusement machines, and select vending machines).[15] The Senate’s tax package (SB 7034) includes a permanent sales tax exemption on clothing and shoes with a sales price of $75 or less per item, which, per the state’s Revenue Estimating Conference, will cost between $963 million to $1.1 billion annually.[16] (See Table 1.)
Although these proposals aim to provide tax relief, HB 7033’s permanent, one-size-fits-all sales tax reduction, like SB 7034’s clothing and shoes sales tax exemption, will benefit all consumers, including tourists and wealthy residents.
Temporary Sales Tax Policy Changes
Since 2000,[17] policymakers have opted for temporary, ineffective solutions like sales tax holidays,[18] while permanently collecting more sales taxes on online purchases to lower taxes for businesses.[19] Due to the House’s push for a general sales tax reduction, HB 7033 does not include one-time sales tax holidays. In contrast, SB 7034 includes five different holidays with an estimated combined one-time cost of $315 million in FY 2025-26. (See Table 2.)
Sales tax holidays are poorly targeted and too temporary to offer meaningful relief. Specifically:
- These holidays primarily shift the timing of purchases rather than increase overall economic activity.[20]
- Wealthier households gain more from sales tax holidays, while lower-income families often cannot take advantage due to limited disposable income.[21]
- Out-of-state tourists and shoppers from neighboring states can take advantage of the holidays, diluting benefits meant for residents.[22]
- These tax-free periods deliver less fairness compared to targeted policies like state-level Earned Income Tax Credits.[23],[24]
- State and local governments lose critical tax revenue needed for public services.
- Retailers and tax agencies face added complexity and costs to comply with and manage temporary tax suspensions.
The Opportunity Costs of Not Raising Revenue
Combined Reporting: A $2.4 Billion Omission
To date, the proposed tax packages do not include any revenue raisers, meaning that tax relief would come at the expense of programs and services. The Florida House rejected an amendment to include combined reporting in its tax package, which would have raised $2.4 billion annually. [25],[26]
According to ITEP, under combined reporting, the incomes and losses of all entities linked to a corporation (those under common ownership) are consolidated into a single taxable entity. This approach is widely considered the most significant corporate tax reform available to state lawmakers because it eliminates the benefit of shifting profits to subsidiaries in lower-tax jurisdictions.[27] With combined reporting, the income is instead brought back into the taxable base. If any part of the corporation has a sufficient connection (nexus) to a state, that state can calculate and apportion a share of the corporation’s total income for taxation purposes.[28]
Combined reporting would only impact a small percentage of businesses — specifically, the largest and wealthiest multi-state and multi-national corporations in Florida who use loopholes to lower their corporate income tax (CIT) bill. By voting to exclude combined reporting from its tax package, the House offers no way to pay for its $5.5 billion tax proposal, and instead looks to recurring budget cuts. Likewise, the Senate offers no way to raise revenue, leaving budget cuts as the only option on the table.
Working Floridians Tax Rebate: A Way to Offer Common-Sense Tax Relief For Floridians Who Need It the Most
As noted, not only do the Florida House and Senate fail to include options to raise revenue to avoid budget cuts — they also choose one-size-fits-all sales tax reductions (whether it is a rate change or a new exemption) instead of more targeted policies. Consequently, portions of the chambers’ multibillion-dollar tax relief will go to wealthy residents, tourists, and businesses who are already receiving state subsidies.[29] Although the tax packages may help Floridians who are struggling to afford the basics — a questionable outcome considering possible public program and service cuts — it will also benefit individuals who are already well-resourced.
Under legislation creating the Working Floridians Tax Rebate (WFTR) program, HB 1331 and SB 1158, nearly 100 percent of the benefit (just over $1 billion) would have gone to families earning less than 75,000 annually. This program would offer lawmakers a way to target Florida families and households struggling the most by boosting their Earned Income Tax Credits (EITCs).[30]
What’s Next in the Budget Process?
While it is still unclear what will be included in the final tax package, lawmakers have indicated their intent to make changes to Florida’s sales tax code.[31] Regardless of their preferred policy, so far, neither chamber has seriously considered raising revenue to pay for relief. Ultimately, when the dust settles and lawmakers come to an agreement, it is likely that Floridians will pay for tax relief with an underfunded budget.
Notes
[1] Florida House of Representatives, HB 5001 - General Appropriation Act, April 2, 2025, https://housedocs.myfloridahouse.gov/Sections/Bills/billsdetail.aspx?BillId=82443.
[2] The Florida Senate, SB 2500: Appropriations, April 3, 2025, https://www.flsenate.gov/Session/Bill/2025/2500/?Tab=BillText.
[3] Carl Davis et al., Who Pays? A Distributional Analysis of the Tax systems in All 50 States (7th ed.), Institute on Taxation and Economic Policy (ITEP), January 2024, https://itep.org/whopays-7th-edition/?mc_cid=c39eb2e005&mc_eid=6cb16947ac.
[4] The Florida Legislature, Fiscal Analysis in Brief: 2024 Legislative Session, EDR, August 2024, https://edr.state.fl.us/Content/revenues/reports/fiscal-analysis-in-brief/FiscalAnalysisinBrief2024.pdf.
[5] United Way of Florida, ALICE in the Crosscurrents: 2024 Update on Financial Hardship in Florida, May 2024, https://www.uwof.org/sites/uwof/files/2024-ALICE-Update-FL-FINAL.pdf.
[6] The Florida Legislature, Fiscal Analysis in Brief: 2024 Legislative Session, EDR, August 2024.
[7] The Senate Committee on Appropriations, The House Appropriations Committee, and The Legislative Office of Economic and Demographic Research, State of Florida: Long-Range Financial Outlook - Fiscal Years 2025-26 Through 2027-28, EDR, September 6, 2024, https://edr.state.fl.us/Content/long-range-financial-outlook/3-Year-Plan_Fall-2024_2026-2028.pdf.
[8] The Florida Legislature, Fiscal Analysis in Brief: 2024 Legislative Session, EDR, August 2024.
[9] United Way of Florida, ALICE in the Crosscurrents: 2024 Update on Financial Hardship in Florida, May 2024.
[10] Siena Duncan, “‘Cooking Someone to Death’: Southern States Resist Calls to Add Air Conditioning to Prisons,” Politico, June 5, 2024, https://www.politico.com/news/2024/06/05/prison-heat-air-conditioning-00160676#:~:text=The%20end%20result:%20The%20vast%20majority%20of%20facilities%20remain%20without.
[11] Florida Department of Health, “Population Uninsured (Aged 0-64 Years) (Census ACS),” FLHealthCharts, April 17, 2025, https://www.flhealthcharts.gov/ChartsDashboards/rdPage.aspx?rdReport=NonVitalIndNoGrpCounts.Dataviewer&cid=8733.
[12] Florida Council on Aging, “Department of Elder Affairs - Waitlist/Priority List for Services,” February 2025, https://fcoa.starchapter.com/images/waitlistreport_02252025__002_.pdf.
[13] U.S. Census Bureau, Annual Survey of State and Local Government Finances, 1977-2020. Compiled by the Urban-Brookings Tax Policy Center, “State and Local General Expenditures, Per Capita,” July 10, 2023, https://taxpolicycenter.org/statistics/state-and-local-general-expenditures-capita.
[14] Daniel Perez (Speaker), “Florida House Proposes Largest Tax Cut in State History,” Florida House of Representatives, March 26, 2025, https://flhouse.gov/api/document/house?listName=Press%20Releases&itemId=915
[15] Revenue Estimating Impact Conference, “Sales Tax Rate Reductions,” EDR, April 4, 2025, https://edr.state.fl.us/Content/conferences/revenueimpact/archives/2025/_pdf/page249-264.pdf.
[16] Revenue Estimating Impact Conference, “Clothing and Shoes Sales Tax Exemption – Permanent,” EDR, April 18, 2025, https://edr.state.fl.us/Content/conferences/revenueimpact/archives/2025/_pdf/page326-331.pdf.
[17] Esteban Leonardo Santis, “Sales Tax Holidays Provide Little Relief to Floridians,” Florida Policy Institute, May 4, 2021, https://www.floridapolicy.org/posts/sales-tax-holidays-provide-little-relief-to-floridians.
[18] Marco Guzman, Sales Tax Holidays: An Ineffective Alternative to Real Sales Tax Reform, ITEP, August 2, 2023, https://itep.org/sales-tax-holiday-2023-ineffective-alternative-to-real-sales-tax-reform/.
[19] In 2021, policymakers passed Chapter 2021-2 (https://laws.flrules.org/files/Ch_2021-002.pdf) to require sales taxes on all online purchases with the revenue being earmarked to lower businesses taxes.
[20] Joseph Johns and Benjamin Patrick, “Sales Tax Holidays by State, 2024,” Tax Foundation, July 23, 2024, https://taxfoundation.org/data/all/state/sales-tax-holidays-2024/
[21] Marco Guzman, “Sales Tax Holidays: An Ineffective Alternative to Real Sales Tax Reform,” ITEP, August 2, 2023, https://itep.org/sales-tax-holiday-2023-ineffective-alternative-to-real-sales-tax-reform/
[22] Marco Guzman, “Sales Tax Holidays: An Ineffective Alternative to Real Sales Tax Reform,” ITEP, August 2, 2023.
[23] Marco Guzman, “Sales Tax Holidays: An Ineffective Alternative to Real Sales Tax Reform,” ITEP, August 2, 2023.
[24] Samantha Waxman and Iris Hinh, “States Can Enact or Expand Child Tax Credits and Earned Income Tax Credits to Build Equitable, Inclusive Communities and Economies,” CBPP, March 3, 2023, https://www.cbpp.org/research/state-budget-and-tax/states-can-enact-or-expand-child-tax-credits-and-earned-income-tax.
[25] House Amendment 604289 (Eskamani), “Amendment to Bill No. CS/HB 7033 (2025),” April 23, 2025, https://static-s3.lobbytools.com/bills/2025/pdf/7033C1604289.pdf.
[26] Carl Davis, Matthew Gardner, and Michael Mazerov, “A Revenue Analysis of Worldwide Combined Reporting in the States,” ITEP, February 20, 2025, https://itep.org/worldwide-combined-reporting-state-corporate-taxes/
[27] Michael Mazerov, “Policy Brief: States Can Fight Corporate Tax Avoidance by Requiring Worldwide Combined Reporting,” CBPP, March 29, 2024, https://www.cbpp.org/research/state-budget-and-tax/states-can-fight-corporate-tax-avoidance-by-requiring-worldwide.
[28] Currently, the Florida Department of Revenue imposes a corporate income tax (CIT) on corporations doing business in the state. However, the state exempts: (1) the first $50,000 of net income, (2) Limited Liability Companies (LLCs), and (3) S Corporations or pass-through businesses that have no more than 100 shareholders and whose profits flow through to shareholders’ income. Since Florida does not have a personal income tax, these profits are not taxed in the state. As a result, most businesses in Florida do not pay CITs. Even among the businesses that are not exempt, only 1 out of 10 owes a CIT. See Esteban Leonardo Santis, “3 Reasons Why Florida Lawmakers Should Fix the Corporate Income Tax,” October 4, 2021, Florida Policy Institute, https://www.floridapolicy.org/posts/3-reasons-why-florida-lawmakers-should-fix-the-corporate-income-tax.
[29]. According to estimates from the 2024 Tax Handbook, in FY 2025-26, Florida will spend $3.5 billion in subsidies (e.g., corporate income tax exemptions, credits, and refunds) for corporations. As the Tax Handbook specifies, this is in addition to $2.1 billion the state forfeits by not taxing S-Corporations and LLCs (see previous footnote). See Office of Economic and Demographic Research, Florida Tax Handbook 2024, EDR, October 2024, page 32, https://edr.state.fl.us/content/revenues/reports/tax-handbook/.
[30] For more information, see https://workingfloridiansrebate.org/.
[31] Relatedly, outside the Legislature, Governor DeSantis has urged legislators to focus on property tax relief by announcing his idea to offer $1,000 rebates to homeowners of homesteaded properties as part of his “long-term goal of eliminating property taxes through a constitutional amendment.” Like the House’s plan, the Governor’s rebate proposal would provide $5 billion in relief. The Governor has also advocated for a new round of sales tax holidays, similar to those found in the Senate’s tax package.
Re-employment Assistance (RA)
Department of Children and Families (DCF) Multi-Program Policies
Supplemental Nutrition Assistance Program (SNAP)
Medicaid
Child Nutrition Programs
Temporary Assistance for Needy Families (TANF)
Re-employment Assistance (RA)
American Rescue Plan Act Changes. The American Rescue Plan Act of 2021 extended PEUC and PUA benefits through the week ending September 6, 2021. It also increased the maximum duration of PEUC benefits ($300 a week) to 53 weeks and the maximum duration of PUA to 79 weeks. Although PEUC and PUA did not end until September 6, 2021, Florida withdrew from the Federal Pandemic Unemployment Compensation Program (FPUC) effective June 26, 2021. FPUC provided persons who were out of work due to COVID-19 with an additional $300 a week in unemployment insurance.
Reemployment Assistance weeks reverted to 12 effective January 1, 2022. DEO determines the maximum number of weeks available to RA claimants based on a statutory formula that looks at the average unemployment rate for the most recent third calendar year quarter (i.e., July, August, and September). Based on the downturn in unemployment, the maximum number of weeks for RA reverted to 12 effective January 1, 2022.
RA work-search and work registration requirements reinstated on May 30, 2021. Persons filing an application for RA benefits beginning March 15, 2020, are not required to complete work registration in Employ Florida through May 29, 2021. In addition, work search requirements for individuals requesting benefits for the weeks beginning March 15, 2020, were also reinstated on May 30, 2021.
RA biweekly reporting requirements reinstated. Although previously waived, biweekly reporting was reinstated effective May 10, 2020. DEO’s guide to claiming weeks is here.
Mobile app deployed. DEO has deployed a mobile app for RA applications.
DEO announces extended benefits. DEO announced implementation of Extended Benefits (EB).
Resources and guidance. For a list of resources and guidance from the United States Department of Labor on unemployment insurance and COVID-19, go here.
For DEO’s “Reemployment Assistance Frequently Asked Questions and Additional Resources,” updated 12/30/2020, go here.
For DEO’s latest claims data, go here.
Department of Children and Families (DCF) Multi-Program Policies
DCF opens offices. DCF has reopened its brick-and-mortar storefronts, which were previously closed due to coronavirus.
DCF adds call center numbers. DCF has added a call center number for Monday through Friday, from 7 a.m. to 6 p.m. Call center numbers now include 850-300-4323, 866-762-2237, or TTY 1-800-955-8771.
Certification periods extended by 6 months only through August 2020. Certification periods for cash, food and medical assistance were extended by 6 months for individuals and families scheduled to recertify in April through August 2020. FNS’ approval of the SNAP extension for August is here. However, effective September 1, 2020, SNAP, TANF and Medicaid recertifications have been reinstated, although DCF says that no one will lose Medicaid due to recertification.
DCF allows phone interviews. Phone interviews are now being used for TANF cash and SNAP food assistance.
Mandatory work requirements suspended only through May 2021. Under a directive from Governor DeSantis to waive work requirements for safety net programs, DCF waived work requirements for individuals participating in the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) through May 2021. To do this, DCF explains that it partnered with the Department of Economic Opportunity to apply “good cause” statewide for TANF and SNAP recipients who would otherwise be subject to participation in mandatory work requirements as a condition of receiving those benefits. Through May 2021, persons who were sanctioned in the past due to work requirements will be able to reapply and participate in SNAP or TANF again.
Work requirements were reinstated effective June 1, 2021.
Supplemental Nutrition Assistance Program (SNAP)
Emergency allotments (EA) ended. DCF automatically supplemented SNAP allotments of current recipients up to the maximum for a household’s size for July 2021. However, EA was discontinued beginning August 1, 2021.
The SNAP benefits increase by 15 percent ended in October 2021. Floridians who participate in SNAP to put food on the table will receive a temporary 15 percent supplement to SNAP under COVID relief passed by Congress and extended by the American Rescue Plan Act through September 2021.
FNS permanently increases SNAP through revamp of the Thrifty Food Plan. Effective October 2021, FNS has mandated a permanent increase to SNAP through a revamp of the Thrifty Food Plan. DCF says that the increase amounts to about 6% for Floridians.
Time limits suspended. SNAP time limits are suspended during the COVID-19 public health emergency. No one in Florida should be barred from SNAP due to time limits, even if they exhausted their time limit in the past.
Florida granted waiver to allow families to purchase groceries online. DCF has been granted a federal waiver to permit the State of Florida to launch a pilot project statewide effective April 21, 2020, that allows families to purchase groceries online with their Electronic Benefit Transfer (EBT) card instead of going into stores.
- At present, participating retailers are Walmart, Amazon, Aldi, BJ’s Wholesale Club, and Publix. DCF cautions, however, that EBT cards cannot be used for delivery fees.
- For more information, see DCF’s questions and answers about online purchasing with SNAP.
Medicaid
No Medicaid terminations from March 2020 through the end of the federal public health emergency. The national public health emergency has existed since January 27, 2020 and has been renewed by the Secretary of the U.S. Department of Health & Human Services in 90-day increments since that time. The most recent renewal is effective January 16, 2022.
On March 31, 2020, AHCA alerted providers and DCF posted on the ACCESS website that:
- No Medicaid recipient will lose Medicaid eligibility during the COVID-19 public health emergency (unless the individual is no longer a state resident or request voluntary termination); under the newly enacted Families First Coronavirus Response Act, a state is prohibited from ending coverage for recipients enrolled as of March 18th for the duration of the public health emergency if the state opts to obtain an enhanced federal Medicaid match.
- AHCA is working to notify recipients who may have received a termination notice in the month of March that their benefits will be reinstated.
- An FAQ released by federal CMS provides some examples of Medicaid eligibility groups protected under these "no termination" requirements including: former foster care youth aging out when they turn 26; youth aging out of children's eligibility when they turn 19; individuals who become ineligible for SSI; individuals no longer qualifying for Qualified Medicare Benefits (QMB). In a May 5, 2020 update, CMS states that this “no termination” requirement also applies to medically needy individuals determined eligible during the public health emergency even if they do not continue to meet their monthly share of cost in subsequent months. This protection extends through the last day of the month the public health emergency ends.
- On October 28, 2020, federal CMS issued a new interim final rule weakening the continuous coverage, “no termination” requirement. In states like Florida that have opted to cover full benefits for lawfully residing children in the first 5 years after entry into the United States, once they turn 18, states are now required to limit their coverage to emergency services. In addition, states are now permitted to reduce optional benefits such as dental coverage or increase cost-sharing such as requiring nursing home residents to contribute more to their costs of care. But in Florida this type of change would require the Legislature to amend state Medicaid law.
Redetermination/recertification times are reinstated. As of October 1, 2020 AHCA's website is alerting recipients that the Department of Children and Families is now mailing letters for case reviews to check if a household is still eligible for Medicaid and/or Medically Needy. AHCA is urging people receiving these letters to take steps now to re-apply. But note, Medicaid coverage will not end during the COVID-19 Public Health Emergency. In January 2021 DCF conducted one-year “automated renewals” for people whose sole income is social security and SSI and are enrolled in an SSI-related Medicaid program (e.g., MEDS/AD, Medically Needy and Medicare Savings Programs). People getting VA income were not included in the automated renewal.
Extended application time. Effective with applications filed in February 2020, the time for submitting documentation required to process an application is extended for 120 days from the date of the application and eligibility will still be effective the first day of the month the application was received. Effective July 1, 2021, this policy has been rescinded. Medicaid applications submitted on or after July 1, 2021 may be denied on the 30th day after application or the day after verification information is due. Applications filed prior to July 1, will be allowed 120 days to provide requested verification to establish Medicaid eligibility.
Exclusion of additional unemployment payments in determining eligibility. The $600/week of additional unemployment insurance payments under the CARES Act will not be counted as income in determining Medicaid eligibility. (However, these payments will be counted as income in determining marketplace subsidy calculations.)
Coverage of Medicaid services during the state of emergency
- Coverage of all medically necessary services to COVID-19 testing and treatment.
- Waiver of limits on services that must be exceeded to maintain the health and safety of recipients diagnosed with COVID-19 or when necessary to maintain a recipient safely in their home
- Waiver of prior authorization requirements for hospital, physician, advanced practice registered nursing, physician assistant, home health services and durable medical equipment and supplies. As of June 19, 2020, AHCA reinstated prior authorization requirements for all of these services.
- Waiver of copayments for all services
- Waiver of limits on early prescription refills, except for controlled substances
- Coverage of a 90-day supply of maintenance prescriptions when available at the pharmacy
- Reimbursement of out-of-state providers providing medically necessary services to Florida Medicaid beneficiaries. As of July 1, 2021, the availability of provider “provisional enrollment” for in-state and out-of-state providers will end.
- 120 day extension of time to request fair hearings. As of July 1, 2021, the extended timeframe ends and the standard timeframes available to recipients to submit an appeal or request a hearing will be reinstated.
- Delay of fair hearings only in those instances when the recipient is continuing to receive services pending the outcome of the hearing
COVID-19 Vaccines for Medicaid Enrollees. In an executive order published March 16, 2021 Governor DeSantis revised the vaccine distribution plan, which applies to the general public including Medicaid enrollees, to lower the age requirement to 40 effective March 29, 2021 and then effective April 5, 2021 all Floridians are eligible to receive any COVID-19 vaccination approved by the Food and Drug Administration.
Medicaid enrollees eligible to receive the vaccine may visit myvaccine.fl.gov to find a location distributing the vaccine and to schedule an appointment.
On March 12, 2021, AHCA published instructions for Medicaid enrollees on how to obtain Medicaid transportation once they have scheduled an appointment for a vaccine. AHCA states: "Florida Medicaid will take you to get the COVID-19 vaccine at no cost. All you need to do is set up a time to get your vaccine. Next, let your Medicaid plan know you need a ride and they will take care of the rest. If you are not enrolled in a plan, call the Medicaid Helpline at 1-877-254-1055 to find out the name and phone number for a transportation service."
The state has also recently launched a new email system to help bring COVID-19 vaccines to homebound seniors. Seniors will be able to sign up to have the vaccine come to them by emailing a request to HomeboundVaccine@em.myflorida.com.
AHCA has posted Medicaid Alerts and FAQs providing more detail on Medicaid service changes in response to COVID-19. They address a wide range of topics including, but not limited to: telemedicine guidance for medical, behavioral health, and early intervention services providers; long-term care provider network flexibilities allowing more types of providers to deliver specified long term care services; and continuity of care for adult day care center enrollees during the time these centers are closed.
AHCA is loosening coverage restrictions for behavioral health services. Effective May 5, 2020, all prior authorization requirements for mental health or substance use disorder treatment are waived and service limitations (frequency and duration) are lifted. For behavioral analysis services, current authorizations will be extended through an "administrative approval process" which does not require providers to reassess beneficiaries currently getting services. Effective July 1, 2021 service limits will be reinstated for behavioral health services and effective July 15, 2021 Medicaid prior authorization requirements will be reinstated for behavioral health services.
Per a May 29, 2020 provider alert, during the state of emergency AHCA will be reimbursing providers for telemedicine well-child visits provided to children older than 24 months through age 20. Providers are directed to actively work to schedule follow-up in-person visits to administer immunizations and other physical components of the exam which cannot be accomplished through telemedicine.
Coverage of home and community-based waiver services (HCBS) - In response to the public emergency, Florida obtained approval from the federal government to make changes in HCBS waiver programs, including the Long Term Care and Developmental Disabilities programs. The changes are effective retroactively from January 27, 2020 to January 26, 2021. Details can be found here. They include, but are not limited to:
- permitting virtual evaluations, assessments and care planning meetings in lieu of face to face meetings and use of electronic signatures;
- lifting service limits in order to address health and welfare issues of enrollees;
- adjusting service prior authorization requirements;
- temporarily expanding the settings where services can be provided;
- allowing payments for support services provided to enrollees in hospital or short- term institutional settings; and
- prohibiting visitors in certain residential settings to minimize the spread of infection.
Note on COVID-19 testing, treatment, and vaccines for the uninsured. Florida has not opted to receive 100 percent federal Medicaid funding for COVID-19 testing of people without health insurance. Under the 2021 American Rescue Plan Act this option has been expanded to cover COVID-19 treatment and vaccines for the uninsured as well. Since the state has not taken up this option Floridians must look to an uneven patchwork of free testing, treatment, and vaccine resources scattered around the state. AHCA advises that uninsured people may receive free testing from their county health department or a federally qualified health center and that “many communities provide testing for free for individuals who do not have insurance. Please [click here] to find a test site in your area. Uninsured individuals should ask before the test whether testing is free of charge." There are no state agency instructions on where uninsured people can receive free treatment. However, more information on possible sources for free treatment is available here.
Residency proof no longer required at some vaccine sites, “paving the way for migrants.” - On April 29, 2021 Surgeon General Rivkees issued a new public health advisory specifying that COVID-19 vaccines are available to “a Florida resident” or someone “who is present in Florida for the purpose of providing goods or services for the benefits of residents and visitors of the State of Florida.” This new policy applies to all state-run and federally supported vaccination sites. It rescinds an advisory issued in January that had restricted vaccinations to people who could show proof of Florida residency
2021 unemployment compensation claimants can access free or reduced cost health insurance through the ACA marketplace. The Affordable Care Act (ACA) Marketplace was re-opened in February 2021 to give people who need health insurance a new “special enrollment" opportunity to get covered. The 2021 American Rescue Plan eliminated or vastly reduced premiums for many people with low or moderate incomes.
Starting July 1, 2021, people who received or have been approved for unemployment compensation for any week beginning in 2021 can access free or reduced cost comprehensive health insurance plans through the ACA marketplace. This benefit is available regardless of someone's current income. To get this benefit, people must enroll in the marketplace no later than August 15, 2021. For help with enrollment, contact Covering Florida at 877-813-9115.
Child Nutrition Programs
School children in distance learning still eligible for free or reduced cost meals. Students in distance learning for 2020-21 can still receive school meals through the National School Lunch Program if they are eligible. The student or parent/guardian may pick up meals at the school but should contact their school for more information.
For a list of current child nutrition program waivers for Florida from USDA, go here.
Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
Congress allows increased fruit and vegetable benefits. At present, WIC provides $9 for children and $11 for women monthly for fruits and vegetables. The American Rescue Plan Act makes funding available for a four-month increase in the benefit of up to $35 monthly, if a state chooses to do so.
DOH attains waiver allowing remote issuance: Department of Health (DOH) obtained a waiver of the requirement that participants pick up their EBT cards in person at recertification or during nutritional education appointments.
WIC participants allowed to substitute certain food. Under a waiver from USDA, WIC participants in Florida are allowed to substitute milk of any available fat content and whole wheat or whole grain bread in package sizes up to 24 oz. when 16 oz. packages are unavailable.
USDA waived physical presence requirements: Although the scope and logistics are unclear at this time, USDA has given DOH permission to waive the requirement that persons be physically present at each certification or recertification determination in order to determine eligibility under the program through May 31, 2020.
USDA extends certification periods through May 31, 2020, for some participants.
For a list of current WIC waivers for Florida from USDA, go here.
Temporary Assistance for Needy Families (TANF)
HHS provides guidance. HHS has issued guidance on the flexibilities in TANF to respond to COVID-19.
