Florida's Amendment 3 set to cut $323 million in local health funding

Florida voters decide on Nov. 3 whether to approve Amendment 3, a measure that would reduce property tax revenue for local health systems by an estimated $323 million in the first few years. The Florida Policy Institute, a nonpartisan research group, calculated this loss based on current state financial reports. The cut would affect 28 hospital districts and health systems across the state that rely on local taxes to serve residents without insurance.

Frank Isele, executive director of the Indian River County Hospital District, said his agency would lose about one-third of its tax funding. He estimated the reduction would result in approximately 10,000 fewer people receiving medical visits, counseling, and prenatal care. The district currently serves about 27,000 residents, or one in six county inhabitants, using property taxes to pay for services ranging from Meals on Wheels to child dental care.

State economists project the amendment will cut local property tax revenue by $4.9 billion in its first year, rising to $11.8 billion by 2031. The measure raises the homestead exemption for non-school taxes from $50,000 to $150,000 in 2027 and $250,000 in 2028. It also lowers the annual cap on assessment increases for non-primary residences from 10% to 5% and requires new residents to wait five years for the full exemption. Gov. Ron DeSantis called the measure a necessary correction, while critics argue it ignores the impact on local services.

The financial hit varies by county. Four hospital districts in Indian River, Baker, Lake, and Volusia counties rely on property taxes for 95% or more of their revenue. The Indian River district alone faces a projected loss of $8.9 million over three years. Larger systems like North Broward, which receives only 12% of its revenue from property taxes, face a higher absolute loss of $100 million but have more diversified funding sources. Sarasota Memorial expects to lose $36 million over two years, a sum equal to its planned cancer center expansion.

Heather Miranda, CEO of Treasure Coast Community Health, said her organization receives 14% of its funding from the Indian River district. She noted that the health center runs on thin margins and lacks large programs to cut. Rakeem Ford, board chair of the West Volusia Hospital Authority, said his board faces a choice between raising taxes or removing services like dialysis and cancer treatment, which cost $4.5 million annually. He described the budget balancing options as unpalatable for both taxpayers and patients.

The cuts land on a state with a fragmented safety net. Florida has not expanded Medicaid, and enhanced federal insurance subsidies expired at the end of last year. In 2024, roughly 572,000 low-income working-age Floridians had no health insurance, according to U.S. Census Bureau estimates. Erica Monet Li, a health policy analyst at the Florida Policy Institute, said the amendment hits people in coverage gaps hardest. She noted that Florida’s system lacks a unified structure, with 41 counties relying on general budgets for indigent care, a resource the amendment also shrinks.