On Friday, May 29, 2026, Florida lawmakers approved a $114.5 billion state budget (House Bill 5001) for Fiscal Year 2026-27, concluding an extended budget negotiation process during a special legislative session. The budget now heads to Governor Ron DeSantis, who retains line-item veto authority before it takes effect on July 1, 2026.

For home care providers, the budget reflects continued investment in Medicaid, aging services, community-based care, and disability services, while also funding several initiatives that may indirectly affect patient access, workforce development, and care coordination.

The following provides a high-level overview of budget items most relevant to Florida’s home care provider community. For a more comprehensive analysis of health care policy and budget outcomes from the 2026 Legislative Session, click here to download a report prepared by Continental Strategy, HCAF’s contract lobbying and governmental affairs firm.

High-Level Budget Overview

The state’s Health and Human Services budget totals $49.2 billion, representing approximately 43% of the overall state budget. Funding is distributed across six major agencies, with the vast majority flowing through the Agency for Health Care Administration (AHCA) and Florida’s Medicaid program.

Key health and human services appropriations include:

• $38.0 billion for the Agency for Health Care Administration (AHCA)
• $4.8 billion for the Department of Children and Families (DCF)
• $4.1 billion for the Department of Health (DOH)
• $1.3 billion for the Agency for Persons with Disabilities (APD)
• $513 million for the Department of Elder Affairs (DOEA)

Key Budget Items Impacting Care-at-Home Providers

While the budget does not include a major stand-alone home health initiative, several appropriations are relevant to home health, private duty, personal care, and hospice providers, as well as organizations serving older adults and individuals with disabilities.

Medicaid Provider Rate Increases – $205.9 Million

The most significant item for many providers is $205.9 million for Medicaid provider rate increases administered through AHCA. The budget includes rate increases for Prescribed Pediatric Extended Care (PPEC) services, orthotic and prosthetic durable medical equipment and related services, and providers participating in the Home and Community-Based Services iBudget Florida waiver program. Collectively, these investments represent one of the largest direct provider funding initiatives included in the health care budget and reflect the Legislature’s continued commitment to supporting Medicaid providers serving some of Florida’s most vulnerable populations.

PACE Expansion – $38.4 Million

The budget includes $38.4 million for expansion of the Program of All-Inclusive Care for the Elderly (PACE). PACE programs rely heavily on home- and community-based services, including skilled nursing, personal care, therapy, care coordination, and in-home supports.

Expansion of PACE may create additional contracting and referral opportunities for home care providers serving older adults.

Rural Health Transformation Program – $209.9 Million

Lawmakers appropriated $209.9 million for the Rural Health Transformation Program. While much of this funding is expected to support hospitals and rural health infrastructure, strengthening rural health delivery systems could improve access to home-based care services in rural and underserved communities.

Department of Elder Affairs Programs – $513.4 Million Total

The Department of Elder Affairs budget includes continued support for programs that help older Floridians remain at home and avoid institutional placement. Notable investments include:

• $4 million expansion of the Community Care for the Elderly (CCE) program
• $3.5 million expansion of the Home Care for the Elderly (HCE) program
• $3 million expansion of the Alzheimer’s Disease Initiative for respite care services to support individuals on waiting lists statewide

These programs often serve populations that rely on in-home care, respite, and community-based supports.

Agency for Persons with Disabilities – $1.3 Billion Total

The budget includes several investments that may affect providers serving individuals with developmental disabilities, including:

• $22.8 million for iBudget provider rate increases
• $35.1 million for the iConnect system
• $10 million for pre-enrollment to waiver services

Home care providers serving individuals enrolled in Medicaid waiver programs should monitor implementation of these initiatives, particularly the provider rate adjustments.

Florida Healthy Kids Stabilization – $27.8 Million

The Legislature appropriated $27.8 million for Florida Healthy Kids premium stabilization. While not directly tied to home care reimbursement, maintaining pediatric coverage stability can support access to medically necessary services for children with complex needs.

Graduate Medical Education and Workforce Development – $13.5 Million

The budget includes $13.5 million for Graduate Medical Education. Although focused on physician training, continued workforce investments remain important as Florida faces persistent shortages across the health care continuum, including home health nursing and direct care positions.

Budget Outlook

While lawmakers successfully balanced the FY 2026-27 budget, state economists continue to project fiscal challenges in future years.

State economists project an initial budget shortfall of approximately $1.5 billion in FY 2027-28, with the shortfall growing to approximately $6.6 billion if current spending trends continue.

The primary drivers of these projected deficits include rising Medicaid expenditures associated with health care inflation and Florida’s growing aging population, increased education funding obligations, school choice program costs, and higher expenses associated with state employee benefits and government operations.

As a result, legislative leaders have increasingly emphasized fiscal restraint, recurring budget reductions, and maintaining healthy reserve balances to help address projected future deficits.

While these projections may make future Medicaid investments more difficult to secure, HCAF will continue making the case that home- and community-based services represent a high-value investment that improves outcomes while allowing Floridians to receive care in the lowest-cost, patient-preferred setting. That includes advocating for increased Medicaid reimbursement rates, as many current rates remain low and outdated, limiting providers’ ability to recruit and retain caregivers and threatening access to care amid growing demand for home-based services.

Key Takeaways

The FY 2026-27 budget largely reflects Florida’s continued emphasis on Medicaid program stability, home- and community-based services, aging services, disability supports, behavioral health infrastructure, and rural health access.

For home care providers, the most significant appropriations include $205.9 million in Medicaid provider rate increases, $38.4 million for PACE expansion, expanded funding for CCE and HCE services, and $22.8 million in iBudget provider rate increases.

Notably absent from the final budget, however, was the Governor’s proposed $7.1 million Medicaid Private Duty Nursing (PDN) rate increase, which was included in Governor DeSantis’ recommended budget released at the outset of the 2026 Legislative Session. The proposal was intended to help address severe nursing workforce shortages and improve access to medically necessary in-home nursing services for medically fragile children and other Medicaid recipients.

HCAF and providers have consistently identified inadequate reimbursement as one of the primary barriers to recruiting and retaining nurses needed to serve high-acuity Medicaid patients in their homes. While the final budget includes meaningful investments in other areas of Medicaid and long-term care, the omission of the proposed PDN rate increase represents a missed opportunity to strengthen Florida’s home-based care infrastructure and improve access to medically necessary services.

HCAF’s annual Legislative Session Report will be released soon and will provide a comprehensive review of legislation that passed and failed during the 2026 Session, along with a final analysis of the state budget following Governor DeSantis’ review and any line-item vetoes.

HCAF will continue monitoring the Governor’s budget actions and subsequent agency implementation plans and will keep members informed of developments affecting Florida’s home care provider community.

Advocacy in Action — and What Comes Next

With the 2026 elections approaching and the 2027 Legislative Session beginning in March, HCAF is already preparing for the next round of advocacy efforts. Key priorities will include Medicaid reimbursement improvements, workforce development initiatives, regulatory modernization, and policies that strengthen access to high-quality care in the home.

Achieving meaningful policy change requires more than advocacy during the 60-day legislative session. The groundwork is laid months and often years in advance through candidate engagement, relationship-building, and ongoing education of elected officials about the challenges and opportunities facing Florida’s home care provider community.

The Home Care Political Action Committee (PAC) is one of the most effective tools available to support those efforts. Contributions help ensure that home care providers have a seat at the table, that policymakers understand the value of care delivered in the home, and that HCAF can build relationships with candidates and elected officials who are willing to champion policies that strengthen access to care and support the provider community.

As the 2027 Legislative Session approaches, continued investment in the PAC will be essential to maintaining and expanding home care’s influence in Tallahassee. Every contribution helps amplify the voice of Florida’s home care providers and strengthens our ability to advance the industry’s priorities when critical decisions are being made.

Click here to contribute to the PAC today.