Deal Between the Trump Administration and the State of Florida
In Progress

Policy Summary

President Donald Trump’s Administration is negotiating an agreement with the State of Florida to reinstate federal funding for the low-income pool to $1.5 billion annually. This pool helps reimburse hospitals for the costs accumulated by low-income, uninsured patients. The funds go to covering the hospital costs of emergency room visits for uninsured people, providing medical charity care, hospitals absorbing bad debt, and hospitals making up any additional differences between the costs incurred and the payments made. It is a temporary strategy and does not provide healthcare coverage. During the Obama administration, the pool was reduced to about $608 million. The Obama administration withheld these federal funds to encourage states to expand Medicaid under the Affordable Care Act. If the deal goes through and Florida receives federal funding for low-income pools, it is expected to cut state Medicaid spending by roughly $650 million. LEARN MORE


Despite the 75% of Americans that think the President and his administration should do what they can to make the ACA work, this deal with Florida sabotages the ACA’s key tool in encouraging states to expand Medicaid. The agreement would essentially subsidize Florida for not expanding Medicaid and encourage other states to do the same or roll back expansion. Other states such as Kansas, Tennessee, and Texas could be a future target for this type of deal as they have also resisted Medicaid expansion and have low-income pools. The Obama administration defunded the low-income pools to encourage people to get insured under the ACA. Now, uninsured people have federal funding for their care through these low-income pools and have less incentive to get insurance. After his own failed healthcare act, Trump said the best thing to do is “let Obamacare explode.” Deals like the one in Florida undermine the ACA and facilitate a healthcare failure. LEARN MORE

Engagement Resources

  • Contact Your State Officials – Voice your opinion on the matter to the people who make these important decisions! Learn more about what some GOP Governors are doing to keep Medicaid expansion and get in touch with them.
  • Kaiser Family Foundation Tracking Poll – Learn more about the future direction of the ACA, Medicaid, and healthcare in America and see how Americans feel about these changes.

This brief was compiled by Ann Furbush. If you have comments or want to add the name of your organization to this brief please contact



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