TALLAHASSEE, Fla. -- It's been two years since the onset of Medicaid expansion, and a new report says it's paying off for states that have helped close their "coverage gaps" with economic benefits for health-care systems and the people they serve. But Florida is missing out.

More than a half-million Floridians can't afford marketplace health insurance but don't qualify for Medicaid. The research pointed to a ripple effect on the stability of the state's health-care delivery system.

Florida House Minority Leader Mark Pafford, D-West Palm Beach, chief executive of Florida Community Health Action Information Network (CHAIN), blamed the Legislature's failure to act for Florida hospitals having to cut staff and reduce services.

"I'm talking about the providers dealing with people who need health insurance, who are in poverty many times, who are working full-time jobs," he said, "and so that economic impact to those hospitals is really unjust."

According to the report from the Georgetown University Center for Children and Families, hospitals and clinics in Medicaid expansion states report opening new facilities, buying new equipment and hiring staff. To date, 31 states and the District of Columbia have chosen to expand Medicaid. Report co-author Jack Hoadley, a research professor at the Georgetown center, said states that have expanded Medicaid have seen major reductions in the amount of uncompensated care delivered by safety-net institutions, signifcant drops in the number of uninsured residents and budget savings for hospitals and community health centers.

"This is the kind of ripple effect," Hoadley said. "It's not just the patient now comes in and gets a service, or now comes in and is able to pay for the service as opposed to receiving charity care, but the dollars that are saved -- or the dollars that are brought in to these institutions -- really are used in ways that really fundamentally change the way care is delivered."

Pafford said he finds it ironic that Gov. Rick Scott has taken such a strong stand against Medicaid expansion but is asking the federal government for more money to help prevent and monitor the spread of the Zika virus in Florida.

"So, at a time where the state's ability to respond should be at its greatest," Pafford said, "he turned his back on Medicaid expansion, which was the delivery of those dollars to react to Zika."

Opponents of expanding Medicaid often claim it will place a higher financial burden on state budgets, but the report found fiscal benefits for many expansion states -- from $25 million in savings in Kentucky to $100 million in Washington state.

The report is online at ccf.georgetown.edu.


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Indiana lawmakers introduced a third property tax plan this week, aiming to protect local governments from funding cuts while offering minimal relief to homeowners.

The proposal, led by state Rep. Jeff Thompson, R-Lizton, would change how property taxes are calculated, including phasing out certain homestead deductions and shifting local income tax authority.

"When you raise the rate, pocketbook lost some money," he said. "You lower the rate; pocketbook gains some money - that's the right system. It won't be always smooth, but the alternative is where we're at right now, and we can continue on down the path and we'll have the same results."

Thompson's plan joins competing proposals from Gov. Mike Braun and Senate Republicans. Braun's plan, which was central to his campaign, would significantly cut property taxes but at the expense of local government funding. The Senate version proposes smaller cuts to both homeowner taxes and local budgets.

David Ober, vice president for taxation and public finance at the Indiana Chamber of Commerce, told lawmakers that changes to the business personal property tax rate were "a bit of a double-edged sword."

"It eliminates the aggregate floor," he said. "It doesn't eliminate individual pool floors. A lot of businesses' personal property is sitting at that floor - at that 30% - but if you eliminate that 30% floor, it's not like it goes down to zero."

Despite the differences, all three plans would shift tax burdens between property classes.

Critics argued that reducing business taxes could place more financial pressure on homeowners. The Ways and Means Committee is also considering separate legislation to gradually lower the state income tax rate if revenue growth meets specific targets.


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In a significant development for family caregivers across America, AARP is spearheading initiatives at both federal and state levels to provide tax relief for those caring for loved ones. The organization is championing the Credit for Caring Act, which proposes a $5,000 federal tax credit, while also pursuing similar legislation at the state level in Ohio.

Jenny Carlson, AARP Ohio state director, said it's a comprehensive approach to supporting the 48 million Americans who serve as family caregivers.

"We're doubling down on this initiative! We feel strongly that it's going to work on the national level. We are turning our attention to the state law, working towards (a) swift package so that family caregivers could take advantage of it for their 2026 returns," she explained.

Carlson added that Ohio is home to approximately 1.5 million family caregivers, providing an estimated $21 billion worth of unpaid care each year. She added they struggle to balance caregiving with full-time jobs, often sacrificing income and retirement savings. The proposed tax credit has received bipartisan support.

AARP has been vocal in its support for Rep. Mike Carey, R-OH, who is sponsoring the legislation in Congress. Carlson emphasized the importance of enabling caregivers to continue working while supporting their loved ones.

"It's called the Credit for Caring Act, which would provide eligible working caregivers a tax credit to help offset the costs of care that they offer. It would allow them to continue to work while caring for a loved one through illness, disability and aging in place," Carlson said.

A recent AARP backed survey found that 84% of voters across party lines support a tax credit for family caregivers. However, some experts caution that while tax relief is helpful, broader policies-such as increased Medicaid coverage for home care may be necessary to fully address the challenges caregivers face. The bill's future now rests with Congress.

Dozens of local leaders from California are in the nation's capital this week, joining about 2,800 colleagues from around the country at the National League of Cities' Congressional City Conference.

The group met with White House officials Tuesday and is set to see Sen. Alex Padilla, D-Calif., today.

David Sander, a council member and former mayor in the city of Rancho Cordova and immediate past president of the league, said local leaders want to find out how the "DOGE" cuts could impact their cities' bottom lines.

"Because there are so many changes potentially underway, we're really focused on certainty and stability," Sander explained. "Because it's hard in local government, where everything has to work, and we're held accountable."

Local officials are concerned the budget bill being prepped in Congress could eliminate the tax-free status cities now get on their municipal bonds, financing priorities like roads and schools. And in the upcoming transportation bill, local leaders want to continue the previous Trump administration practice of sending funds directly to municipalities, rather than routing them through the state.

Sanders pointed out the briefing on immigration covered the many legal issues surrounding cities' policies on cooperation with federal Immigration and Customs Enforcement.

"There's an awful lot in the hands of the courts right now," Sanders observed. "Trying to understand the role of a federal detainer versus a federal warrant, versus a local warrant; trying to understand the legalities around all those and what cities can or can't do."

California is home to multiple so-called sanctuary cities, including Berkeley, Fremont, Oakland, Los Angeles, San Francisco, Santa Ana and Watsonville. The conference wraps up today.


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