FORT LAUDERDALE, Fla. — Almost inevitably, Floridians will feel the harsh impact if the new Trump administration’s proposed cuts to federal spending on health care come to fruition.

Everyone who relies on lower drug costs, gets treated at a public hospital or community health center, taps into the marketplace for health insurance or uses government insurance to cover childbirth or primary care could be affected by potential cuts in federal spending on health care.

“There are so many things in jeopardy that will affect the health of people in our state,” said Rep. Lois Frankel, D-Fla., whose district spans from West Palm Beach to Boca Raton. “We are talking about every kind of health care you can think of.”

The new administration wants to cut federal spending by trillions of dollars, and government-assisted health care programs are among their first targets. The cuts likely will trickle down to people living in Florida who rely on these programs. The state has more than 4 million people enrolled in Medicaid health insurance for low-income adults and children. In addition, Florida leads the country in terms of the number of people enrolled in health insurance under the Affordable Care Act. Both programs are being eyed for cost savings, as are grants for medical research and community health. There is also concern that Congress will roll back the Inflation Reduction Act or laws that address lowering drug prices for seniors on Medicare.

“Floridians need to pay attention,” said Florida Rep. Maxwell Frost, a Democrat whose district is in central Florida. “They should be on high alert and speak out.”

Some fearful Floridians did speak out at recent news briefings:

—Jeffrey Schultz, father of a 41-year-old Fort Lauderdale woman who has battled multiple cancers for decades, worried about a halt to medical research.

—Reverend Latifah Griffin of North Palm Beach, who adopted a boy with special needs, fretted over taking care of her son should he lose access to Medicaid.

—Virginia, a disabled senior in North Florida, agonized over losing her home health aide should the government cut access to her federal health insurance.

Frankel said the health care impact could be greater than most Floridians realize.

“You’re talking about the possible loss of access to critical healthcare services, prescriptions, routine check-ups, mental health support,” Frankel said. “And don’t forget about seniors in nursing homes.”

Along with individuals, Florida health systems and community clinics are bracing for the potential of a spike in people without insurance coverage and loss of funding for all types of health services and prevention programs.

Community health would suffer

“We are being positive and hopeful,” said Christopher Irizarry, CEO of Foundcare, which runs eight federally funded community health center locations in Palm Beach County. “Nothing is certain right now.”

On Jan. 28 the Trump administration ordered a pause on federal payments for grants and other programs, causing widespread confusion over what would be affected. Irizarry and leaders of community health centers nationwide subsist largely on federal dollars, and couldn’t access funding through the Health and Human Services Department payment system on Tuesday. However, the administration rescinded its call for a pause on Wednesday in the face of legal challenges and widespread outrage.

“It’s chaotic out there,” Frankel said. “The providers are in a panic. Consumers may not fully realize yet what could happen.”

Florida has 47 federally funded community clinics like FoundCare that provide primary care services to underserved populations. These centers depend on federal grants for one-quarter or more of their budgets. Irizarry said any cuts to funding would have significant consequences on much-needed access to services including pediatric and dental care.

“We practice preventative health care rather than reactive. We are keeping people out of the emergency room,” he said. “The last thing an organization like ours needs is a disruption to a revenue source.”

Frost said Florida already has an inequity in who can get good health care and he doesn’t want to see that deepen by actions taken in D.C. He plans to push back on proposed cuts to Medicaid or programs that fund community health.

“Community health centers serve as a safety net for underserved populations,” he said. “These are people who have nowhere else to go for health care. They can’t go to a clinic in CVS or other places where people with insurance end up going for care.”

Hospitals are watching closely

As the battle plays out in Congress, hospital leaders say they are adopting a “wait-and-see” approach, carefully monitoring any changes to Medicaid spending. Medicaid is the primary source of financing for states to provide health coverage and long-term care for low-income residents. In Florida, the federal government pays 65% and the state pays 35% of Medicaid financing. About 4.5 million people in Florida receive health insurance through Medicaid, according to the state Agency for Health Care Administration.

One proposal from Republican congressional leaders is to eliminate supplemental Medicaid funding, which is extra money given to health care providers in addition to their base Medicaid payments. Hospitals say that elimination would hit hard.

“It would be devastating if that went away, not just for Tampa General, but for most hospitals in Florida,” Steve Harris, senior vice president of payor and government affairs at Tampa General Hospital, told Modern Healthcare.

Another proposal would cut funds by switching how states are paid for Medicaid costs — instead of being based on actual costs incurred, the states would be paid a fixed amount per enrollee.

“That could result in a calculation that could be bad for seniors and Florida’s Medicaid program overall,” said Erica Monet Li, a policy analyst at Florida Policy Institute. “We would be locked into a state funding rate that won’t account for the growth in our senior and aging population.”

Eventually, all Floridians would pay the price, she explained. “All these cuts are designed to shift the costs to individual states, and the states would have to make up for the funding loss in other ways.”

Alison Yager, executive director at Florida Health Justice Project, said If Florida were to lose Medicaid funding, lawmakers would have to make hard choices. “Are they going to cut services, cut eligibility, cut reimbursement to providers, reshape the benefits package?”

What she doesn’t want to see happen is anything that would interfere with care for children. Florida has a higher percentage of children enrolled in Medicaid than other states.

“It’s vitally important for kids to have ongoing access to health care,” Yager said. “Floridians are already struggling to take care of their children and elders, and those with chronic conditions. We cannot afford to lose this lifeline.”

Lawmakers in Congress are also considering policy changes that could significantly reduce access or increase costs for people who get health insurance through the Affordable Care Act’s open marketplace. In Florida, 4.6 million people, including those self-employed, signed up for the federal program in 2024.

Justin Senior, chief executive officer for the Safety Net Hospital Alliance of Florida, said his organization represents 14 Florida hospital systems legally required to serve all populations regardless of their insurance status.

“We are keeping our ear to the group to understand how cuts would affect us,” Senior said. “Some cuts would miss us entirely and others would affect us more. The devil here is in the details, and it is difficult right now to assess the impact.”

Shane Strum, CEO of Broward Health and interim CEO of Memorial Healthcare System, said he is not worried yet.

“There are a lot of conversations about cuts, and this happens all the time,” he said. “Any time there’s a new administration or new leadership in different agencies, there is talk about cuts. Hopefully, we’ll have a thoughtful approach moving forward, but right now, we are sticking to our daily plan and waiting to see what happens.”

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