Primaries Will Decide Who Decides: Where Florida Governor Candidates Stand on Medicaid

Florida’s 2026 Primary Election is Tuesday, August 18. Early voting and vote by mail are already part of the election process, and voters across the state will soon help determine which candidates move forward to November.

At SurfMed, we do not tell anyone how to vote or which candidate to support. We do, however, encourage everyone in Florida’s healthcare community to participate in the election process, learn about the candidates, and understand where they stand on issues that could affect the patients and communities we serve.

Medicaid is one of those issues.

Florida’s next governor will play an important role in shaping the state’s healthcare priorities. The candidates have different philosophies about Medicaid, healthcare spending, eligibility, and the role state government should play in expanding access to care.

Here is a brief look at several of the gubernatorial candidates and their positions.

Byron Donalds

Republican Congressman Byron Donalds has generally favored a more limited federal role in healthcare and has supported changes designed to give states greater control over government healthcare programs.

His approach to Medicaid has included support for policies such as work requirements and tighter controls on government assistance, while his broader healthcare philosophy emphasizes market based approaches and greater individual control over healthcare decisions.

For voters concerned about Medicaid, the central question surrounding Donalds is how greater state control and tighter eligibility and spending policies would affect access to services for Florida beneficiaries.

Paul Renner

Former Florida House Speaker Paul Renner has been direct in his opposition to traditional Medicaid expansion.

Renner has argued that Medicaid resources should remain focused on populations he describes as the truly needy, including children, seniors, and people with disabilities. During the current campaign, he has reiterated that he would oppose expanding Medicaid eligibility to additional adults.

At the same time, Renner has supported expanding Florida KidCare eligibility. As House Speaker, he made increasing access to subsidized children's health coverage a priority, and the Legislature ultimately approved an expansion of the program.

Jay Collins

Lieutenant Governor Jay Collins is running in the Republican primary after serving in the Florida Senate and joining Governor Ron DeSantis’ administration.

Collins has generally aligned himself with the current administration’s conservative approach to healthcare policy rather than advocating for traditional Medicaid expansion. His broader healthcare record has emphasized alternatives intended to improve access, competition, affordability, and patient choice.

For Medicaid stakeholders, Collins is a candidate whose healthcare proposals should continue to be watched as the campaign develops.

James Fishback

Republican candidate James Fishback has built much of his campaign around affordability, reducing the cost of living, and limiting government bureaucracy. His published platform also emphasizes healthcare for veterans and what he describes as health freedom.

Unlike some of the other candidates, Fishback’s published campaign platform does not currently provide a detailed proposal specifically addressing the future structure or expansion of Florida Medicaid.

That distinction is important. When a candidate has not released a detailed Medicaid plan, voters should be careful not to assume a position that has not been clearly stated.

David Jolly

Democratic candidate David Jolly takes a substantially different approach.

Jolly supports expanding Medicaid in Florida to provide healthcare coverage to more low income residents. His campaign has presented Medicaid expansion as part of a broader healthcare and affordability agenda and has argued that expansion could help patients while also supporting hospitals, including rural healthcare facilities.

Jolly is a former Republican congressman who is now running for governor as a Democrat, making healthcare one of several areas where his current platform differs from positions traditionally associated with his former party.

Learn Before You Vote

These summaries are not endorsements, nor are they intended to tell anyone which healthcare philosophy is right for Florida.

They are a starting point.

Whether you are a case manager, healthcare provider, caregiver, patient, family member, or simply a Florida voter, ask questions.

Will a candidate protect current Medicaid beneficiaries? Do they support expanding eligibility or limiting it? How would they control Medicaid spending? What would their policies mean for seniors, children, people with disabilities, caregivers, providers, and Florida families?

Most importantly, go directly to the candidates, review their platforms, and ask them to explain their positions.

The primary will decide who advances to the general election, and ultimately those elections will determine who is sitting at the table when decisions about Florida Medicaid are made.

At SurfMed, our message is simple: be informed, be engaged, and participate.