Florida Medicaid expansion delayed to 2028 as new ballot-restriction law takes effect

A campaign to expand Medicaid in Florida is delaying its push to get the issue on the ballot until 2028, citing a new state law that tightens how constitutional amendments can be advanced. Florida Decides Healthcare had been working to qualify the measure for the 2026 ballot and is challenging the rule in federal court, with a trial slated for January. The group said HB 1205, signed by Republican Gov. Ron DeSantis earlier this year, “changed the ballot initiative rules mid-campaign” in a way that “deliberately undermined” the group's effort to gather enough signatures to qualify for 2026.

HB 1205, which DeSantis signed in May, imposes new limits on how many petitions Florida voters can collect for a constitutional amendment and carries penalties for violations, potentially including felonies. The measure also bars non-U.S. citizens and non-Florida residents from gathering signatures for ballot initiatives. Representatives for DeSantis did not immediately respond to requests for comment. Lawmakers argue the restrictions are needed to reform a process they contend has been tainted by fraud.

The campaign’s leadership has framed the law as politically motivated. Mitch Emerson, executive director of Florida Decides Healthcare, said, “HB 1205 wasn’t about transparency, it was sabotage aimed directly at citizen-led ballot initiatives. This law may have delayed us until 2028, but it will not stop us.” The federal case against the law remains active, with a trial set for January as the group pursues voter signatures for a 2028 initiative.

Across the country, proponents and opponents alike have tracked a surge in bills aimed at restricting ballot access. The Fairness Project, which supports ballot initiatives in multiple states, noted nearly 150 bills were introduced this year in about 15 states—roughly double the number seen two years earlier—reflecting a broader debate over how to balance safeguarding elections with preserving direct democracy. Voting-rights advocates say the trend undercuts the premise of direct democracy even as some lawmakers insist the reforms curb fraud. In Florida, voters previously backed amendments to protect abortion rights and to legalize recreational marijuana, but those initiatives fell short of the 60% threshold required for passage.

Analysts say the timing of HB 1205’s enactment appears intertwined with the 2026 ballot push and the Legislature’s broader interest in tightening control over citizen-led initiatives. Supporters contend the law addresses longstanding concerns about fraud and signature manipulation, while opponents argue it effectively interrupts the ability of Florida residents to place issues on the ballot through citizen initiative. For Florida Decides Healthcare, the focus remains on building support for a 2028 vote, and the group says it will continue pursuing the legal challenge while coordinating signature-gathering efforts within the new rules.