Amendment 3 to Cut Hospital District Funding by $323 Million

Florida’s public hospital districts face a potential loss of $323 million in the first few years of Amendment 3, according to the Florida Policy Institute. The amendment, which voters will consider on Nov. 3, raises the homestead exemption for non-school property taxes from $50,000 to $150,000 in 2027. State economists project local property tax revenue will drop by $4.9 billion in the first year, growing to $11.8 billion by 2031.

Eleven of the state's 28 hospital districts rely on property taxes for the bulk of their budgets. Frank Isele, executive director of the Indian River County Hospital District, estimates his district will lose about a third of its tax revenue. He predicts this reduction will mean approximately 10,000 fewer people receive services. The district currently covers 230,000 medical visits, counseling sessions, and prenatal checkups for roughly 27,000 residents, about one in six county inhabitants.

The impact varies by district structure. Four districts in Indian River, Baker, Lake, and Volusia counties derive 95% or more of their revenue from property taxes. None of these four operate hospitals directly; they fund other facilities to care for low-income residents. In contrast, districts that run large hospital systems are more insulated. North Broward Hospital District would lose an estimated $100 million over three years, but property taxes constitute only 12% of its revenue. Sarasota Memorial Health Care System collected $103 million in property taxes in fiscal 2025, representing just 4% of its $2.3 billion total revenue.

Kevin Cooper, a board member for the Sarasota Memorial Health Care System, noted that his district projects a $36 million loss over two years. This amount nearly matches the cost of a recently approved cancer center expansion in Venice. He stated that geographic and service capacity expansions will likely face delays. In Indian River County, Heather Miranda, CEO of Treasure Coast Community Health, reported that the district provides 14% of her organization's funding. She warned that waitlists could form, forcing patients with worsening conditions into emergency rooms.

Rakeem Ford, board chair of the West Volusia Hospital Authority, said his board will review its largest line items, including $4.5 million annually for specialty care such as dialysis and cancer treatment. He identified only two options for balancing the budget: increasing taxes or removing services. The amendment leaves health care funding unprotected, unlike public safety and schools. Scott Darius of Florida Voices for Health described the situation as creating chaos across counties, as each district decides independently what to prioritize.

The cuts coincide with other coverage losses. Florida is one of 10 states that have not expanded Medicaid. Enhanced federal marketplace subsidies expired at the end of 2025, causing Florida enrollment to fall by more than 440,000. In 2024, about 572,000 low-income working-age Floridians had no health insurance. Erica Monet Li, a health policy analyst at the Florida Policy Institute, said the amendment will hit those in coverage gaps hardest. These individuals often work in service, retail, or construction and earn too much for Medicaid but too little for private insurance.