On April first, Florida voters in two Congressional Districts exercised an outsized influence on whether Congress would remain under Republican control. Democrats were heartened by impressive gains, but it wasn’t enough. Florida Congressional Districts 1 and 6 are Republican strongholds; voters sealed the deal preserving the Republican hold in Congress. The blush of their outsized influence may soon pale as citizens across the country experience the effects of their actions. Voters receiving Social Security, Medicare, or Medicaid nationwide could end up with voters’ remorse.

A closer look at Florida

Florida is in the top five states with citizens receiving support from Social Security alone. According to 2025 data from the Social Security Administration (SSA), it is second only to California in the number of aging residents receiving Social Security checks (158,775). On top of that, 380,209 residents collect Social Security benefits because they are blind or otherwise disabled. Finally, there are other categories, such as benefits based on the deceased, or for the spouse or child of a worker who is retired or disabled. That brings the total number of Floridians receiving some form of Social Security to 4.8 million, approximately 20% of the state’s total population.

In 2025, Florida is estimated to have 5.1 million Medicare beneficiaries, including traditional Medicare and Medicare Advantage programs. The number of Medicaid recipients in Florida totals 4.2 million residents. All three programs are facing budget cuts mandated by Congress that threaten the well-being of the elderly, disabled, and the poor. Already health advocates and local lawmakers are sounding alarm over the proposals presented so far. The federal government picks up 57% of the state’s Medicaid bill.

If Medicaid cuts go through, Florida and other states will have to either raise taxes, cut back the number of people who can enroll in the program, reduce the types of medical services offered, or significantly reduce provider rates (and many observers think Gov. Ron Desantis and his legislature will do all three). The last option, reducing provider rates, would likely cut into the number of medical professionals who care for Medicaid enrollees. Currently, Medicaid accounts for billions in revenue to Florida hospitals and nursing homes. More than 40% of Florida births and 58% of nursing home services are covered by Medicare. No matter what the option, state officials agree the proposals will open a $38 billion budget hole. Florida, which has a projected deficit of $2.8 billion for 2026–27, traditionally has not made up the difference.

“Federal cuts to Medicaid will do nothing, let’s be clear, will do nothing to lower healthcare costs or improve quality and access to care for our residents,” Alison Yager, executive director of Florida Health Justice Project told the Miami Herald.

The Georgetown Numbers

The numbers are mind-boggling. To make things even more complicated, Medicaid, Medicare, and Social Security are intertwined — which means cuts to one program can impact the others. Medicaid and Medicare provide health care security for the poor and the elderly, while Social Security is tasked with distributing earned benefits to retired citizens, as well as benefits to disabled citizens. It’s possible that a recipient receiving Social Security benefits may also need Medicaid, which could mean budget constraints in both programs cut even more into the recipient’s support.

The results could be catastrophic. Florida families are heavily invested in Medicaid funding. Georgetown University School of Public Policy broke down the numbers for seniors, adults and children. To target those figures, the following is just for the population in the 6th Congressional District of Florida, which is made up of all of or in part seven counties.

(George University School of Public Policy, undated)

Some of these percentages overlap with others. For example, a senior can be disabled and is also counted among the general population. In addition, the percentages for each county cannot be compared in real terms, since the general population in each county varies considerably. What they do show is how integrated and invested the health care of each county is tied to Medicaid.

Using Volusia County as an example, 18% of the total Medicaid coverage translates to 106,937 — more than the total population for some of the other counties. By comparison, the most involvement with Medicaid is in Dade County where Medicaid covers 58.8% of the population. The lowest percentage of involvement (12%) is in Palm Beach County where a large percentage of the state’s wealthy reside. What is most disturbing about Georgetown’s numbers is found in the category of children who receive benefits through the state’s CHIP program (Children Health Insurance Program). On average, the health of nearly half of all children in the 6th District will be negatively impacted by budget cuts.

Only real-life stories can bring the staggering numbers home. Consider, for instance, a young family of middle income with a disabled child. The child needs constant supervision including a professional care giver, an electric wheelchair, and special therapies and equipment to keep the child alive. The couple has no choice. The only way to support their child is to bring in two incomes; two jobs (and sometimes more) are the difference between bankruptcy, and homelessness, and keeping a roof over their heads, food on the table and medical care for their child.

As everyone ages, the parents become ill and infirm. The child becomes an adult still in need of expensive care. With dwindling savings and nothing in the way of a plan or resources to care for their child once they are gone, the weight of their desperation becomes enormous.

Or maybe these parents are among the lucky ones. They’ve found a non-profit that helps with housing and medical care for their adult child. They’ve also found a care facility for themselves, the cost of which they can afford because of a small inheritance and some savings. But both have remained healthy and fit in their senior years, and after ten or fifteen years, their longevity becomes a curse. Money begins to run out and there’s no family to help.

There are millions of stories just like these. Right now, Medicaid is there offering crucial support for home health care, the pricey drugs and equipment necessary to keep a child alive, and hugely expensive retirement health care. Right now, there are 700,000 Floridians whose cost of a nursing home (est. $104k and $117k a year) is paid by Medicaid. Only the very wealthy can afford long term care, and most of us, if we live long enough, will need it. Fear and worry can’t solve the problem. Nor can family members who have problems enough of their own. And as each day passes, it’s looking more and more like Medicare won’t be much help.

Under the Affordable Care Act, there is a provision that allows states to raise the level of family income to qualify. The individual states decide to adopt this plan If adopted, the federal government would pay 90% of the cost of new enrollees. Most states went for the idea; 14 states, including Florida, rejected the offer. Without the participation of those 14 states, the provision added 20 million families, children and parents to Medicaid. Had Florida accepted the plan, millions more would have Medicaid. The option is still there, but Florida’s governor and legislature are not interested. They justify this by claiming that in the future, the federal-to-state funding ratio would be reduced again to 57% and 43%, and the state would be forced to continue paying for the increased number of recipients.

Congress has yet to settle on a budget, but as each day goes by, things look bleaker for the future of those who rely on Social Security, Medicare, and Medicaid. Thanks to Republican control of Congress, it appears social programs supporting the 99% will be slashed to make way for more generous tax cuts for the 1%. It brings no comfort to hear the President say, as he did in July, that he will not cut one penny from Social Security or Medicaid. Recent history tells us we cannot rely on the President’s pronouncements about anything from budget cuts to ending the war in Ukraine, from the size of his audiences to his latest golf score.

The opinions of the author do not necessarily reflect the positions of the CPUSA.

Image:Protesters supporting “Medicare for All” hold a rally outside PhRMA headquarters April 29, 2019 in Washington, DC by Win McNamee (CC BY-NC-ND 4.0 Deed); Hospice hands by pikist.com (Creative Commons); Occupy_10_26_DSC_0050 by Michael Fleshman (Attribution-ShareAlike 2.0 Generic CC BY-SA 2.0 Deed).