Posted On: August 2, 2019

Smaller, less wealthy counties in Florida are worried that the expansion of Medicaid access to low-income childless families could force them to raise their property taxes.

In July, Small County Coalition of Florida lobbyist Chris Doolin wrote Amy Baker (the state’s chief economist) an email stating that it would be “important to identify” which counties are at or near a tax cap, which would restrict the amount of revenue that can be obtained by counties through property taxes.

The Agency for Health Care Administration calculates how much each county must contribute to the overall cost of the program, which is shared by the federal government. In the fiscal year of 2019 through 2020, Florida counties will provide $302 million to the $29 billion health care program. The expansion of Medicaid is of pressing concern for the 29 fiscally constrained counties, which are rural counties in North Florida and the south-central portion of the state because they do not produce a lot of money from property taxes.

“It is true that they share in part of the costs of the Medicaid system. And if you grow the Medicaid population by this newly eligible expansion group, then that does have a feedback … It’s not one-to-one, but that does increase the cost pressure on governments.” Baker reported to The News Service of Florida. 

However, Baker also suggests that the expansion might not be a bad idea for small counties:

“If new enrollees are concentrated more in the larger counties, or more than normal in the larger counties in the state, it’s possible you could have a very small county that could even end up better off.”

The constitutional amendment would force the state to expand Medicaid access to low-income childless adults as allowable under the health care law, known as Obamacare.

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