Governor Ron DeSantis has released his Floridians First Budget recommendations for Fiscal Year (FY) 2026–27, outlining proposed state spending priorities ahead of the upcoming legislative session. The Governor’s recommended budget totals $117.36 billion, including $53.22 billion in general revenue, and reflects continued emphasis on fiscal restraint, strong reserves, and debt reduction.

It is important to note that the Governor’s budget is a recommendation only. Under the Florida Constitution, the legislature holds the sole authority to craft, negotiate, and pass the final state budget, which will take effect on July 1, 2026.

Health Care Budget Overview

Within the health care silo, the Governor’s FY 2026–27 recommendations increase overall funding from $26.19 billion in FY 2025–26 to $26.79 billion, signaling continued investment in health care services while maintaining a broader focus on efficiency and fiscal discipline.

Key health care priorities emphasized in the Governor’s proposal include workforce capacity, long-term care services delivered in the community, and targeted Medicaid investments intended to improve access to care while avoiding higher-cost institutional settings.

Home Health & Long-Term Care Highlights

Medicaid Private Duty Nursing

The Governor’s budget recommends $7,132,057 to implement a new fee-for-service (FFS) private duty nursing (PDN) reimbursement methodology within the Medicaid program. This redesign would allow the Agency for Health Care Administration (AHCA) to adjust reimbursement rates to better reflect patient acuity and geographic challenges, particularly for medically fragile children in rural or hard-to-staff areas. The proposal is intended to help strengthen nursing capacity and improve access to PDN services where availability has been most limited.

Community Care for the Elderly Program

The budget includes $4 million to reduce the 64,859-person pre-enrollment list for the Community Care for the Elderly (CCE) program. These funds would support additional low-income seniors who are frail, functionally impaired, and at risk of out-of-home placement, helping them remain safely in their homes and communities.

Home Care for the Elderly Program

An additional $3.5 million is recommended to reduce the 20,627-person pre-enrollment list for the Home Care for the Elderly (HCE) program. This funding prioritizes frail seniors at risk of institutionalization and supports cost-effective home-based services that promote independence.

Home and Community-Based Services Waiver – Pre-Enrollment

The Governor’s proposal includes $20.18 million to enroll approximately 1,200 individuals from the Home and Community-Based Services (HCBS) waiver pre-enrollment list, focusing on individuals who meet crisis criteria and children involved in the welfare system. Expanding waiver enrollment is intended to provide timely community-based services and reduce reliance on more costly institutional care.

Looking Ahead

The legislature will begin formal budget deliberations during the 2026 session, during which lawmakers will review, revise, and negotiate funding proposals before adopting a final General Appropriations Act. HCAF will continue to closely monitor these discussions — particularly those affecting home health agencies, Medicaid providers, and community-based long-term care services — and will keep members informed as the process moves forward.

We also encourage members to join us for Home Care Day at the Capitol on February 10–11, 2026, to advocate directly for home care priorities and ensure policymakers hear from the providers and professionals delivering care in communities across Florida. Click here to learn more and register.

Additional updates and advocacy opportunities will be shared as legislative budget committees begin their work.