Text of FL S 348 (2026)

Florida Senate - 2026 SB 348 By Senator Smith 17-00061-26 2026348__ 1 A bill to be entitled 2 An act relating to statewide health care coverage; 3 defining terms; establishing the Task Force on 4 Universal Health Care for a specified purpose; 5 requiring the Office of Program Policy Analysis and 6 Government Accountability (OPPAGA) to provide staff 7 support to the task force; directing all agencies of 8 state government to assist the task force, including 9 furnishing information and advice deemed necessary by 10 the task force; providing for the membership, 11 meetings, and funding of the task force; requiring the 12 task force to establish an advisory committee for a 13 specified purpose; providing for the membership of the 14 advisory committee; authorizing the task force to 15 establish additional advisory and technical 16 committees; specifying duties of the task force; 17 requiring the task force to consider specified values 18 and parameters in developing certain recommendations; 19 requiring the task force to make findings and 20 recommendations for the design of the Health Care for 21 All Florida Plan and for the Health Care for All 22 Florida Board to administer the plan; specifying 23 requirements for the design of the plan; specifying 24 requirements for the plan and factors the task force 25 must include in its recommendations; requiring the 26 task force to engage in a public process to solicit 27 public input on certain elements of the plan; 28 specifying requirements for such process; specifying 29 requirements for the report of the task force’s 30 findings and recommendations; requiring that task 31 force members be appointed by a specified date; 32 requiring OPPAGA to begin preparing a work plan for 33 the task force by a specified date; requiring the task 34 force to submit a report of its findings and 35 recommendations to the Governor and the Legislature by 36 a specified date; requiring the Agency for Health Care 37 Administration to develop a plan for a Medicaid buy-in 38 program or a public health care option for certain 39 residents of this state; specifying requirements for 40 the plan; requiring the agency to report its plan to 41 the Governor and the Legislature by a specified date; 42 providing for the future repeal of specified 43 provisions; providing an appropriation; providing an 44 effective date. 45 46 Be It Enacted by the Legislature of the State of Florida: 47 48 Section 1. Task Force on Universal Health Care for 49 Florida.— 50 (1) DEFINITIONS.—As used in this section, the term: 51 (a) “Group practice” means a single legal entity composed 52 of individual providers organized as a partnership, professional 53 corporation, limited liability company, foundation, nonprofit 54 corporation, or faculty practice plan or a similar association 55 in which: 56 1. Each individual provider uses office space, facilities, 57 equipment, and personnel shared with other individual providers 58 to deliver medical care, consultation, diagnosis, treatment, or 59 other services that the provider routinely delivers in the 60 provider’s practice; 61 2. Substantially all of the services delivered by the 62 individual providers are delivered on behalf of the group 63 practice and billed as services provided by the group practice; 64 3. Substantially all of the payments to the group practice 65 are to reimburse the cost of services provided by the individual 66 providers in the group practice; 67 4. The overhead expenses of, and the income from, the group 68 practice are shared among the individual providers in the group 69 practice in accordance with methods agreed to by the individual 70 providers who are members of the group practice; and 71 5. There is a unified business model with consolidated 72 billing, accounting, and financial reporting and a centralized 73 decisionmaking body that represents the individual providers who 74 are members of the group practice. 75 (b) “Individual provider” means a health care practitioner 76 who is licensed, certified, or registered in this state or who 77 is licensed, certified, or registered to provide care in another 78 state or country. 79 (c) “Institutional provider” means a single legal entity 80 that is: 81 1. A health care facility, such as a hospital; 82 2. A comprehensive outpatient rehabilitation facility; 83 3. A home health agency; or 84 4. A hospice program. 85 (d) “Provider” means an individual provider, an 86 institutional provider, or a group practice. 87 (e) “Single-payor health care financing system” means a 88 universal system used by the state for paying the cost of health 89 care services or goods in which: 90 1. Institutional providers are paid directly for health 91 care services or goods by the state or are paid by an 92 administrator that does not bear risk in its contracts with the 93 state; 94 2. Group practices are paid directly for health care 95 services or goods by the state or are paid by an administrator 96 that does not bear risk in its contracts with the state, by the 97 employer of the group practice, or by an institutional provider; 98 and 99 3. Individual providers are paid directly for health care 100 services or goods by the state, by their employers, by an 101 administrator that does not bear risk in its contracts with the 102 state, by an institutional provider, or by a group practice. 103 (2) ESTABLISHMENT OF THE TASK FORCE ON UNIVERSAL HEALTH 104 CARE; PURPOSE; AGENCY COOPERATION.—The Task Force on Universal 105 Health Care is established to recommend the design of the Health 106 Care for All Florida Plan, a universal health care system 107 administered by the Health Care for All Florida Board which is 108 equitable, affordable, and comprehensive; provides high-quality 109 health care; and is publicly funded and available to every 110 individual residing in this state. The Office of Program Policy 111 Analysis and Government Accountability (OPPAGA) shall provide 112 staff support to the task force. All agencies of state 113 government are directed to assist the task force in the 114 performance of its duties and, to the extent permitted by laws 115 relating to confidentiality, to furnish information and advice 116 deemed necessary by the task force to perform its duties. 117 (3) MEMBERSHIP; MEETINGS; FUNDING; ADVISORY COMMITTEES.— 118 (a) The task force shall be composed of the following 20 119 members: 120 1. Two members of the Senate, one from the majority party 121 and one from the minority party, appointed by the President of 122 the Senate. 123 2. Two members of the House of Representatives, one from 124 the majority party and one from the minority party, appointed by 125 the Speaker of the House of Representatives. 126 3. Thirteen members appointed by the Governor, each of whom 127 must reside in this state and: 128 a. Represent to the greatest extent practicable: 129 (I) Diverse social identities, including, but not limited 130 to, identities based on geography, race, ethnicity, sex, gender 131 nonconformance, sexual orientation, economic status, disability, 132 or health status; and 133 (II) Diverse areas of expertise, based on knowledge and 134 personal experience, including, but not limited to, patient 135 advocacy, receipt of medical assistance, management of a 136 business that offers health insurance to its employees, public 137 health, organized labor, provision of health care, or owning a 138 small business; 139 b. Represent, at a minimum, the following areas of 140 expertise acquired by education, vocation, or personal 141 experience: 142 (I) Rural health; 143 (II) Quality assurance and health care accountability; 144 (III) Fiscal management and change management; 145 (IV) Social services; 146 (V) Public health services; 147 (VI) Medical and surgical services; 148 (VII) Alternative therapy services; 149 (VIII) Services for persons with disabilities; and 150 (IX) Nursing services; 151 c. Include at least eight members who are representatives 152 of labor unions representing employees who work in the health 153 care field in this state; 154 d. Include at least one member who is a representative of a 155 Florida legal aid organization helping health care patients; 156 e. Include at least one member who has produced at least 157 three economic analyses of the economic benefits of single-payor 158 programs on the state level. This member need not be a resident 159 of this state in order to serve on the task force; and 160 f. Include at least one member who has an active license to 161 practice social work in this state. 162 4. The State Surgeon General or his or her designee, who is 163 a nonvoting member. 164 5. The Secretary of Business and Professional Regulation or 165 his or her designee, who is a nonvoting member. 166 6. A member of the Florida Association of Counties, 167 selected by the association, who is a nonvoting member. 168 (b) In making the appointments under subparagraph (a)3., 169 the Governor shall ensure that there is no disproportionate 170 influence by any individual, organization, government, industry, 171 business, or profession in any decisionmaking by the task force 172 and no actual or potential conflicts of interest. 173 (c) The task force shall elect one of its members to serve 174 as chair and one to serve as vice chair. 175 (d) If there is a vacancy on the task force for any cause, 176 the appointing authority must make an appointment to fill the 177 vacancy, which appointment becomes effective immediately. 178 (e) Members of the Legislature appointed to the task force 179 are nonvoting members of the task force and may act in an 180 advisory capacity only. 181 (f) A majority of the voting members of the task force 182 constitutes a quorum for the transaction of business. 183 (g) Official action by the task force requires the approval 184 of a majority of the voting members of the task force. 185 (h) The task force shall meet at times and places specified 186 by the call of the chair or by a majority of the voting members 187 of the task force. 188 (i) Members of the task force are not entitled to 189 compensation but are entitled to receive per diem and travel 190 expenses as provided in s. 112.061, Florida Statutes. 191 (j) The task force may apply for public or private grants 192 from nonprofit organizations for the costs of research. 193 (k)1. The task force shall establish an advisory committee 194 to provide input from a consumer perspective and, to the 195 greatest extent practicable, from the diverse social identities 196 described in sub-sub-subparagraph (a)3.a.(I). 197 2. Members of the advisory committee must have the 198 following qualifications, such that at least one member: 199 a. Has experience in seeking or receiving health care in 200 this state to address one or more serious medical conditions or 201 disabilities. 202 b. Is enrolled in health insurance offered by the state 203 group insurance program or represents public employees. 204 c. Is enrolled in employer-sponsored health insurance, 205 group health insurance, or a self-insured health plan offered by 206 an employer. 207 d. Is enrolled in commercial insurance purchased without 208 any employer contribution. 209 e. Receives medical assistance. 210 f. Is enrolled in Medicare. 211 g. Is a parent or guardian of a child enrolled in the 212 Children’s Health Insurance Program. 213 h. Is enrolled in the Federal Employees Health Benefits 214 Program. 215 i. Is enrolled in the federal TRICARE program. 216 j. Receives care from the United States Department of 217 Veterans Affairs Veterans Health Administration. 218 k. Receives care from the Indian Health Service. 219 (l) The task force may establish additional advisory or 220 technical committees that the task force considers necessary. 221 The committees may be continuing or temporary. The task force 222 shall determine the representation, membership, terms, and 223 organization of the committees and shall appoint the members of 224 the committees. 225 (m) Members of advisory or technical committees are not 226 entitled to compensation but may, in the discretion of the task 227 force, be reimbursed for per diem and travel expenses as 228 provided in s. 112.061, Florida Statutes. 229 (4) DUTIES; VALUES; PARAMETERS.— 230 (a) The task force shall produce findings and 231 recommendations for the Health Care for All Florida Plan, a 232 well-functioning, single-payor health care financing system that 233 is responsive to the needs and expectations of the residents of 234 this state by: 235 1. Improving the health status of individuals, families, 236 and communities; 237 2. Defending against threats to the health of the residents 238 of this state; 239 3. Protecting individuals from the financial consequences 240 of ill health; 241 4. Providing equitable access to person-centered care; 242 5. Removing cost as a barrier to accessing health care; 243 6. Removing any financial incentive for a health care 244 practitioner to provide care to one patient over another; 245 7. Making it possible for individuals to participate in 246 decisions affecting their health and the health care system; 247 8. Establishing measurable health care goals and guidelines 248 that align with other state and federal health standards; and 249 9. Promoting continuous quality improvement and fostering 250 interorganizational collaboration. 251 (b) The task force, in developing its recommendations for 252 the Health Care for All Florida Plan, shall consider, at a 253 minimum, all of the following values: 254 1. Health care, as a fundamental element of a just society, 255 should be secured for all individuals on an equitable basis by 256 public means, similar to public education, public safety, and 257 other public infrastructure. 258 2. Access to a distribution of health care resources and 259 services should be available according to each individual’s 260 needs and location within this state. Race, color, national 261 origin, age, disability, wealth, income, citizenship status, 262 primary language use, genetic conditions, previous or existing 263 medical conditions, religion, or sex, including sex 264 stereotyping, gender identity, sexual orientation, and pregnancy 265 and related medical conditions, such as termination of 266 pregnancy, should not create any barriers to health care or 267 disparities in health outcomes due to access to care. 268 3. The components of the system must be accountable and 269 fully transparent to the public with regard to information, 270 decisionmaking, and management through meaningful public 271 participation in decisions affecting people’s health care. 272 4. Funding for the Health Care for All Florida Plan is a 273 public trust, and any savings or excess revenue should be 274 returned to that public trust. 275 (c) The task force, in developing its recommendations for 276 the Health Care for All Florida Plan, shall consider, at a 277 minimum, all of the following parameters: 278 1. A participant in the plan may choose any individual 279 provider who is licensed, certified, or registered in this state 280 or any group practice. 281 2. The plan may not discriminate against any individual 282 provider who is licensed, certified, or registered in this state 283 to provide services covered by the plan and who is acting within 284 the provider’s scope of practice. 285 3. A participant and the participant’s provider shall, 286 within the scope of services covered within each category of 287 care and within the plan’s parameters for standards of care and 288 requirements for prior authorization, determine whether a 289 treatment is medically necessary or medically appropriate for 290 that participant. 291 4. The plan must cover services from birth to death, based 292 on evidence-based decisions as determined by the Health Care for 293 All Florida Board. 294 (5) SCOPE OF DESIGN FOR THE HEALTH CARE FOR ALL FLORIDA 295 PLAN.— 296 (a) The task force shall make findings and recommendations 297 for the design of the Health Care for All Florida Plan and the 298 Health Care for All Florida Board, which shall administer the 299 plan. The task force shall submit a report of its findings and 300 recommendations to the Governor, the President of the Senate, 301 and the Speaker of the House of Representatives as specified in 302 subsection (6). The task force’s recommendations must be 303 succinct statements and include actions and timelines, the 304 degree of consensus among the task force members, and the 305 priority of each recommendation, based on urgency and 306 importance. The task force may defer any recommendations to be 307 determined by the board. 308 (b) The design of the Health Care for All Florida Plan 309 recommended by the task force must: 310 1. Adhere to the values and parameters described in 311 paragraphs (4)(b) and (c); 312 2. Be a single-payor health care financing system; 313 3. Ensure that individuals who receive services from the 314 United States Department of Veterans Affairs Veterans Health 315 Administration or the Indian Health Service may be enrolled in 316 the plan while continuing to receive those services; 317 4. Require obtaining a waiver of federal requirements that 318 pose barriers to, or adopt other approaches, enabling equitable 319 and uniform inclusion of all residents such that a resident of 320 this state who has other coverage that is not subject to state 321 regulation may enroll in the plan without jeopardizing 322 eligibility for the other coverage if the person moves out of 323 this state; and 324 5. Preserve the coverage of the health services currently 325 required by Medicare, Medicaid, the Children’s Health Insurance 326 Program, the Patient Protection and Affordable Care Act, Pub. L. 327 No. 111-148, as amended by the Health Care and Education 328 Reconciliation Act of 2010, Pub. L. No. 111-152, Florida’s 329 medical assistance program for the needy, and any other state or 330 federal program. 331 (c) The plan must allow participation by any individual 332 who: 333 1. Resides in this state; 334 2. Is a nonresident who works full time in this state and 335 contributes to the plan; or 336 3. Is a nonresident who is a dependent of an individual 337 described in subparagraph 1. or subparagraph 2. 338 339 The task force’s recommendations must address issues related to 340 the provision of services to nonresidents who receive services 341 in this state and to plan participants who receive services 342 outside of this state. 343 (d) Providers shall be paid under the plan as follows or 344 through an alternative method that is similarly equitable and 345 cost-effective: 346 1. Individual providers licensed in this state shall be 347 paid: 348 a. On a fee-for-services basis; 349 b. As employees of institutional providers or members of 350 group practices that are reimbursed with global budgets; or 351 c. As individual providers in group practices that receive 352 capitation payments for providing outpatient services as 353 permitted by subparagraph 4. 354 2. Institutional providers shall be paid with global 355 budgets that include separate capital budgets, determined 356 through regional planning, and operational budgets. 357 3. Budgets must be determined for individual hospitals and 358 not for entities that own multiple hospitals, clinics, or other 359 providers of health care services or goods. 360 4. A group practice may be reimbursed with capitation 361 payments if the group practice: 362 a. Primarily uses individual providers in the group 363 practice to deliver care in the group practice’s facilities; 364 b. Does not use capitation payments to reimburse the cost 365 of hospital services; and 366 c. Does not offer financial incentives to individual 367 providers in the group practice based on the use of services. 368 (e) In designing the plan, the task force shall: 369 1. Develop cost estimates for the plan, including, but not 370 limited to, cost estimates for: 371 a. The approach recommended for achieving the result 372 described in subparagraph (b)4.; and 373 b. The payment method designed by the task force under 374 paragraph (d); 375 2. Consider how the plan will impact the structure of 376 existing state and local boards and commissions, counties, 377 cities, and special districts, as well as the Federal 378 Government, other states, and Indian tribes; 379 3. Investigate other states’ attempts at providing 380 universal coverage and using single-payor health care financing 381 systems, including the outcomes of those attempts; and 382 4. Consider the work by existing health care professional 383 boards and commissions and incorporate important aspects of such 384 work into recommendations for the plan. 385 (f) In developing recommendations for long-term care 386 services and support for the plan under subparagraph (i)16., the 387 task force shall convene an advisory committee that includes: 388 1. Persons with disabilities who receive long-term services 389 and support; 390 2. Older adults who receive long-term services and support; 391 3. Individuals representing persons with disabilities and 392 older adults; 393 4. Members of groups that represent the diversity, 394 including by gender, race, and economic status, of individuals 395 who have disabilities; 396 5. Providers of long-term services and support, including 397 in-home care providers who are represented by organized labor, 398 and family attendants and caregivers who provide long-term 399 services and support; and 400 6. Academics and researchers in relevant fields of study. 401 402 Notwithstanding subparagraph (i)16., the task force may explore 403 the effects of excluding long-term care services from the plan, 404 including, but not limited to, the social, financial, and 405 administrative costs. 406 (g) The task force’s recommendations for the duties of the 407 board and the details of the plan must ensure that, by 408 considering the following factors, patients are empowered to 409 protect their health, their rights, and their privacy: 410 1. The patient’s access to patient advocates who are 411 responsible to the patient and maintain patient confidentiality 412 and whose responsibilities include, but are not limited to, 413 addressing concerns about providers and helping patients 414 navigate the process of obtaining medical care; 415 2. The patient’s access to culturally and linguistically 416 appropriate care and service; 417 3. The patient’s ability to obtain needed care when a 418 treating provider is unable or unwilling to provide the care; 419 4. The patient’s ability to receive paid assistance to 420 complete forms or perform other administrative functions to 421 qualify for disability benefits, family medical leave, or other 422 income support; and 423 5. The patient’s access to and control of medical records, 424 including: 425 a. Empowering the patient to control access to his or her 426 medical records and obtain independent second opinions, unless 427 there are clear medical reasons not to do so; 428 b. Requiring that a patient or the patient’s designee be 429 provided a complete copy of the patient’s health records 430 promptly after every interaction or visit with a provider; 431 c. Ensuring that the copy of the health records provided to 432 a patient includes all data used in the care of that patient; 433 and 434 d. Requiring that the patient or the patient’s designee 435 provide approval before any forwarding of the patient’s data to, 436 or access of the patient’s data by, family members, caregivers, 437 or other providers or researchers. 438 (h) In developing recommendations for the plan, the task 439 force shall engage in a public process to solicit public input 440 on the elements of the plan described in paragraphs (b), (i), 441 (j), and (k). The public process must: 442 1. Ensure input from individuals in rural and underserved 443 communities and from individuals in communities that experience 444 health care disparities; 445 2. Solicit public comments statewide while providing to the 446 public evidence-based information developed by the task force 447 about the health care costs of a single-payor health care 448 financing system, including the cost estimates developed under 449 paragraph (e), as compared to the current system; and 450 3. Solicit the perspectives of: 451 a. Individuals throughout the range of communities that 452 experience health care disparities; 453 b. A range of businesses, based on industry and employer 454 size; 455 c. Individuals whose insurance coverage represents a range 456 of current insurance types and individuals who are uninsured or 457 underinsured; and 458 d. Individuals with a range of health care needs, including 459 individuals needing disability services and long-term care 460 services who have experienced the financial and social effects 461 of policies requiring them to exhaust a large portion of their 462 resources before qualifying for long-term care services paid for 463 by the medical assistance program for the needy. 464 (i) With respect to the administration of the plan, the 465 report required under paragraph (a) must include, but need not 466 be limited to, all of the following: 467 1. The governance and leadership of the board, 468 specifically: 469 a. The composition and representation of the membership of 470 the board, appointed or otherwise selected using an open and 471 equitable selection process; 472 b. The statutory authority the board will need in order to 473 establish policies, guidelines, mandates, incentives, and 474 enforcement mechanisms to develop a highly effective and 475 responsive single-payor health care financing system; 476 c. The ethical standards and their enforcement for members 477 of the board such that there are the most rigorous protections 478 from and prohibitions against actual or perceived economic 479 conflicts of interest; and 480 d. The steps for ensuring that there is no disproportionate 481 influence by any individual, organization, government, industry, 482 business, or profession in any decisionmaking by the board; 483 2. A list of federal and state laws and rules, state 484 contracts or agreements, and court actions or decisions that may 485 facilitate, constrain, or prevent implementation of the plan and 486 an explanation of how they may facilitate or constrain or 487 prevent implementation; 488 3. The plan’s economic sustainability, operational 489 efficiency, and cost control measures that include, but are not 490 limited to, the following: 491 a. A financial governance system supported by relevant 492 legislation, financial audit, and public expenditure reviews and 493 clear operational rules to ensure efficient use of public funds; 494 and 495 b. Cost control features, such as multistate purchasing; 496 4. Features of the plan that are necessary to continue to 497 receive federal funding that is currently available to the state 498 and estimates of the amount of the federal funding which will be 499 available; 500 5. Fiduciary requirements for the revenue generated to fund 501 the plan, including, but not limited to, the following: 502 a. A dedicated fund, separate and distinct from the General 503 Revenue Fund, which is held in trust for the residents of this 504 state; 505 b. Restrictions to be authorized by the board on the use of 506 the trust fund; 507 c. A process for creating a reserve fund by retaining 508 moneys in the trust fund if, over the course of a year, revenue 509 exceeds costs; and 510 d. Required accounting methods that eliminate the potential 511 for misuse of public funds, detect inaccuracies in provider 512 reimbursement, and use the most rigorous, generally accepted 513 accounting principles, including annual external audits and 514 audits at the time of each transition in the board’s executive 515 management; 516 6. Requirements for the purchase of reinsurance; 517 7. Any necessary bonding authority; 518 8. The board’s role in workforce recruitment, retention, 519 and development; 520 9. A process for the board to develop statewide goals and 521 objectives and ongoing review; 522 10. The appropriate relationship between the board and 523 regional or local authorities regarding oversight of health 524 activities, health care systems, and providers to promote 525 community health reinvestment, equity, and accountability; 526 11. Criteria to guide the board in determining which health 527 care services are necessary for the maintenance of health, the 528 prevention of health problems, the treatment or rehabilitation 529 of health conditions, and the provision of long-term and respite 530 care. Criteria may include, but are not limited to, the 531 following: 532 a. Whether the services are cost-effective and based on 533 evidence from multiple sources; 534 b. Whether the services are currently covered by the health 535 benefit plans offered by the state group insurance program; 536 c. Whether the services are designated as effective by the 537 United States Preventive Services Task Force, the United States 538 Centers for Disease Control and Prevention’s Advisory Committee 539 on Immunization Practices, the federal Health Resources and 540 Services Administration’s Bright Futures Program, or the 541 National Academy of Medicine’s Committee on Preventive Services 542 for Women; and 543 d. Whether the evidence on the effectiveness of services 544 comes from peer-reviewed medical literature, existing 545 assessments and recommendations from state and federal boards 546 and commissions, and other peer-reviewed sources; 547 12. A process to track and resolve complaints, grievances, 548 and appeals, including establishing an Office of the Patient 549 Advocate; 550 13. Options for transition planning, including an impact 551 analysis on existing health care systems, providers, and patient 552 relationships; 553 14. Options for incorporating cost containment measures, 554 such as prior approval and prior authorization requirements, and 555 the effect of such measures on equitable access to quality 556 diagnosis and care; 557 15. The methods for reimbursing providers for the cost of 558 care as described in paragraph (d) and recommendations regarding 559 the appropriate reimbursement for the cost of services provided 560 to plan participants when they are traveling outside this state; 561 and 562 16. Recommendations for long-term care services and support 563 that are tailored to each individual’s needs based on an 564 assessment. The services and support may include, but need not 565 be limited to: 566 a. Long-term nursing services provided by an institutional 567 provider or in a community-based setting; 568 b. A broad spectrum of long-term services and support, 569 including home and community-based settings or other 570 noninstitutional settings; 571 c. Services that meet the physical, mental, and social 572 needs of individuals while allowing them maximum possible 573 autonomy and maximum civic, social, and economic participation; 574 d. Long-term services and support that are not based on the 575 individual’s type of disability, level of disability, service 576 needs, or age; 577 e. Services provided in the least restrictive setting 578 appropriate to the individual’s needs; 579 f. Services provided in a manner that allows persons with 580 disabilities to maintain their independence, self-determination, 581 and dignity; 582 g. Services and support that are of equal quality and 583 accessibility in every geographic region of this state; and 584 h. Services and support that give the individual the 585 opportunity to direct the services. 586 (j) The task force’s report must include: 587 1. The waivers of federal laws or other federal approval 588 that will be necessary to enable a person who is a resident of 589 this state and who has other coverage that is not subject to 590 state regulation to enroll in the plan without jeopardizing 591 eligibility for the other coverage if the person moves out of 592 this state; 593 2. Estimates of the savings and expenditure increases under 594 the plan, relative to the current health care system, including, 595 but not limited to: 596 a. Savings from eliminating waste in the current system and 597 from administrative simplification, fraud reduction, monopsony 598 power, simplification of electronic documentation, and other 599 factors that the task force identifies; 600 b. Savings from eliminating the cost of insurance that 601 currently provides medical benefits that would be provided 602 through the plan; and 603 c. Increased costs due to providing better health care to 604 more individuals than under the current health care system; 605 3. Estimates of the expected health care expenditures under 606 the plan, compared to the current health care system, reported 607 in categories similar to the National Health Expenditure 608 Accounts compiled by the Centers for Medicare and Medicaid 609 Services, including, but not limited to: 610 a. Personal health care expenditures; 611 b. Health consumption expenditures; and 612 c. State health expenditures; 613 4. Estimates of how much of the expenditures on the plan 614 will be made from moneys currently spent on health care in this 615 state from both state and federal sources and redirected or 616 used, in an equitable and comprehensive manner, to the plan; 617 5. Estimates of the amount, if any, of additional state 618 revenue that will be required; 619 6. Results of the task force’s evaluation of the impact on 620 individuals, communities, and the state if the current level of 621 health care spending continues without implementing the plan, 622 using existing reports and analyses where available; and 623 7. A description of how the Health Care for All Florida 624 Board or another entity may enhance: 625 a. Access to comprehensive, high-quality, patient-centered, 626 patient-empowered, equitable, and publicly funded health care 627 for all individuals; 628 b. Financially sustainable and cost-effective health care 629 for the benefit of businesses, families, individuals, and state 630 and local governments; 631 c. Regional and community-based systems integrated with 632 community programs to contribute to the health of individuals 633 and communities; 634 d. Regional planning for cost-effective, reasonable capital 635 expenditures that promote regional equity; 636 e. Funding for the modernization of public health, as an 637 integral component of cost efficiency in an integrated health 638 care system; and 639 f. An ongoing and deepening collaboration with Indian 640 tribes and other organizations providing health care which will 641 not be under the authority of the board. 642 (k)1. The task force’s findings and recommendations 643 regarding revenue for the plan, including redirecting existing 644 health care moneys under subparagraph (j)4., must be ranked 645 according to explicit criteria, including the degree to which an 646 individual, class of individuals, or organization would 647 experience an increase or decrease in the direct or indirect 648 financial burden or whether they would experience no change. 649 Revenue options may include, but are not limited to, the 650 following: 651 a. The redirection of current public agency expenditures; 652 b. An employer payroll tax based on progressive principles 653 that protect small businesses and that tend to preserve or 654 enhance federal tax benefits for Florida employers that pay the 655 costs of their employees’ health care; and 656 c. A dedicated revenue stream based on progressive taxes 657 that do not impose a burden on individuals who would otherwise 658 qualify for medical assistance. 659 2. The task force may explore the effect of means-tested 660 copayments or deductibles, including, but not limited to, the 661 effect of increased administrative complexity and the resulting 662 costs that cause patients to delay getting necessary care, 663 resulting in more severe consequences for their health. 664 (l) The task force’s recommendations must ensure: 665 1. Public access to state, regional, and local reports and 666 forecasts of revenue expenditures; 667 2. That the reports and forecasts are accurate, timely, of 668 sufficient detail, and presented in a way that is understandable 669 to the public to inform policymaking and the allocation or 670 reallocation of public resources; and 671 3. That the information can be used to evaluate programs 672 and policies, while protecting patient confidentiality. 673 (6) TASK FORCE TIMELINE.— 674 (a) Members of the task force must be appointed by May 31, 675 2027. 676 (b) By September 30, 2027, OPPAGA shall begin preparing a 677 work plan for the task force. 678 (c) The task force shall submit a report containing its 679 findings and recommendations for the design of the Health Care 680 for All Florida Plan and the Health Care for All Florida Board 681 to the Governor, the President of the Senate, and the Speaker of 682 the House of Representatives by the first day of the 2028 683 regular session of the Legislature. 684 (7) PLAN FOR A MEDICAID BUY-IN PROGRAM OR A PUBLIC OPTION.— 685 (a) The Agency for Health Care Administration shall develop 686 a plan for a Medicaid buy-in program or a public option to 687 provide an affordable health care option to all Florida 688 residents, with the primary focus being Florida residents who do 689 not have access to health care. To the extent feasible, the plan 690 must: 691 1. Have no net cost to the state; 692 2. Provide a comprehensive package of benefits that are, at 693 a minimum, equivalent to the benefits offered by qualified plans 694 offered through the federal health insurance exchange; 695 3. Impose no more than minimal cost sharing, deductibles, 696 or copayments; 697 4. Take into account the impact on the distribution of risk 698 in the health insurance market; 699 5. Encourage the use of premium tax credits available under 700 s. 36B of the Internal Revenue Code and other subsidies 701 available under federal law; 702 6. Maximize the receipt of federal funds to support the 703 costs of the program or option; 704 7. Use the coordinated care organization health care 705 delivery model; and 706 8. Use the coordinated care organization provider networks 707 to the extent possible without destabilizing the networks. 708 (b) By May 1, 2027, the agency shall report to the 709 Governor, the President of the Senate, and the Speaker of the 710 House of Representatives the plan developed in accordance with 711 paragraph (a), including: 712 1. A discussion of potential eligibility requirements for 713 the Medicaid buy-in program or public option, as well as the 714 implications of limiting or not limiting eligibility in various 715 ways; 716 2. Options for Medicaid buy-in programs or public options 717 targeted to specific populations, including, but not limited to: 718 a. Residents with household incomes above 400 percent and 719 below 600 percent of the federal poverty guidelines who are 720 unable to afford health insurance offered by their employers; 721 b. Residents who regularly cycle through enrolling and 722 disenrolling in medical assistance and employer-sponsored health 723 insurance; or 724 c. Other groups that face significant barriers to accessing 725 affordable, quality health care; 726 3. Recommendations for legislative changes necessary to 727 implement the plan; and 728 4. Any federal approval that will be required to implement 729 the plan, such as demonstration projects under s. 1115 of the 730 Social Security Act, a state plan amendment, or a waiver for 731 state innovation under 42 U.S.C. s. 18052. 732 (8) REPEAL.—This section is repealed on January 2, 2029. 733 Section 2. For the 2026-2027 fiscal year, the nonrecurring 734 sum of $1,174,816 is appropriated from the General Revenue Fund 735 to the Agency for Health Care Administration for the purpose of 736 implementing this act. 737 Section 3. This act shall take effect upon becoming a law.