← Florida's state agencies, by the numbers
Agency for Health Care Administration
Spending excluding construction grew 83.8% between FY2019 and FY2026 against a population-and-inflation baseline of 45.1%, above the baseline. FY2026 spending excluding construction: $49.27B.
Snapshot
Between FY2019 and FY2026, Florida's population grew 11.9% and prices in the South region (CPI-U) rose 29.7%. Together they account for 45.1% growth in any figure that kept pace with the state. That is the baseline every figure below is compared to. “At the baseline” figures are what each amount would be if it had grown at exactly that rate since FY2019; “cumulative” sums the yearly difference between the actual figure and that path. They describe the arithmetic, not what the agency could or should have done. “Spending excluding construction” is the amount spent in every appropriation category except fixed capital outlay (construction and land, which is appropriated in one year, spent over several and recorded against the year appropriated) and transfers to a state trust fund or the General Revenue Fund (dollars that appear again as spending when drawn from the receiving fund). Each is shown separately where it occurs.
Fiscal years are named by the year they end in: FY2026 is July 1, 2025 to June 30, 2026. “Spending” is the amount disbursed as recorded on Transparency Florida; the “operating budget” is the year's appropriations as amended during the year.
Spending against the baseline
Health Care Administration spending excluding construction rose from $26.80B in FY2019 to $49.27B in FY2026, 83.8%. The population-and-inflation baseline was 45.1%: at that rate the FY2026 figure would be $38.89B, so FY2026 is $10.38B above the baseline. Over the seven years FY2020–FY2026, spending excluding construction ran a cumulative $23.57B above the baseline path.
Actual spending excluding construction as recorded on Transparency Florida; the dashed line is the FY2019 figure grown by population and inflation.
Each bar is the year's actual minus the FY2019 figure grown by population and inflation to that year. The cumulative figure in the snapshot is the sum of these bars from FY2020.
| Fiscal year ($ billions) | Spending excluding construction | At the FY2019 baseline | Above (+) / below (−) | Fixed capital outlay (recorded against the year) | Spending, all categories | Operating budget | Budget not drawn in year |
|---|---|---|---|---|---|---|---|
| FY2015 | 23.32 | — | — | 0.00 | 23.32 | 23.32 | 0.00 |
| FY2016 | 23.99 | — | — | 0.00 | 23.99 | 24.78 | 0.79 |
| FY2017 | 25.99 | — | — | 0.00 | 25.99 | 26.27 | 0.28 |
| FY2018 | 26.17 | — | — | 0.00 | 26.17 | 27.23 | 1.06 |
| FY2019 | 26.80 | 26.80 | 0.00 | 0.00 | 26.80 | 27.84 | 1.03 |
| FY2020 | 27.54 | 27.56 | −0.02 | 0.00 | 27.54 | 28.72 | 1.19 |
| FY2021 | 30.19 | 28.70 | 1.49 | 0.00 | 30.19 | 30.93 | 0.74 |
| FY2022 | 34.71 | 31.43 | 3.28 | 0.00 | 34.71 | 35.24 | 0.53 |
| FY2023 | 38.15 | 34.09 | 4.06 | 0.00 | 38.15 | 38.81 | 0.66 |
| FY2024 | 38.77 | 35.90 | 2.87 | 0.00 | 38.77 | 39.67 | 0.90 |
| FY2025 | 38.84 | 37.33 | 1.51 | 0.00 | 38.84 | 39.48 | 0.63 |
| FY2026 | 49.27 | 38.89 | 10.38 | 0.00 | 49.27 | 50.23 | 0.97 |
| FY2027 (in progress; spending to date) | — | — | — | — | 14.44 | 44.48 | — |
FY2027 is the year in progress: its operating budget is shown and its spending to date is not compared with any baseline. “Budget not drawn in year” is the operating budget minus spending; reversions have already been taken out of the operating budget, so the gap is authority still being spent in later years or never drawn — the observations say which categories it sits in.
Where the money comes from
Of the FY2026 operating budget (all categories, construction included), 25% was General Revenue, 12% state trust funds and an estimated 63% federal money. Spending excluding construction from state funds (General Revenue and state trust funds; General Revenue from the ledger, the trust-fund part by the fund rule) grew 77.3% between FY2019 and FY2026, above the baseline; from federal money it grew 87.9%, from $16.55B to $31.09B (the ledger pages give the General Revenue and trust-fund dollars exactly; the federal share of trust funds is estimated).
Spending by fund from the ledger pages (General Revenue and trust-fund disbursements exact); the federal share of each trust fund is the Legislature's classification of that fund, or the agency's own budget request for mixed funds.
| Operating budget by fund type ($ billions) | General Revenue | State trust funds (est.) | Federal (est.) | Total |
|---|---|---|---|---|
| FY2019 | 6.30 | 4.14 | 17.39 | 27.84 |
| FY2020 | 6.48 | 4.10 | 18.14 | 28.72 |
| FY2021 | 6.06 | 4.18 | 20.69 | 30.93 |
| FY2022 | 6.73 | 4.75 | 23.76 | 35.24 |
| FY2023 | 7.64 | 5.15 | 26.01 | 38.81 |
| FY2024 | 9.67 | 4.76 | 25.24 | 39.67 |
| FY2025 | 9.79 | 5.38 | 24.30 | 39.48 |
| FY2026 | 12.58 | 6.02 | 31.63 | 50.23 |
| FY2027 (in progress) | 13.91 | 4.22 | 26.35 | 44.48 |
General Revenue is the state's general tax money. Trust funds hold money dedicated by law to a purpose; some are state money (licence fees, the lottery's education transfer, documentary stamp taxes), others carry federal grants. The split of trust funds into state and federal is an estimate: the Legislature's own classification of each fund (Fiscal Analysis in Brief) decides when a fund is essentially one or the other, and the agency's budget request gives the split for mixed funds. The about page gives the rule in full.
Where it goes
By budget entity
A budget entity is the unit the Legislature appropriates to inside an agency — a program, an institution, a division. Figures are spending excluding construction, the same basis as the rest of the page. Entities with spending in any of the years shown, largest in FY2026 first; an entity that rounds to zero in every column is left out. ↔ marks an entity whose change coincided with an opposite move in another entity the same year.
| Budget entity, spending ($ billions) | FY2019 | FY2022 | FY2024 | FY2026 | FY2019–FY2026 | At baseline, FY2026 | Above baseline |
|---|---|---|---|---|---|---|---|
| Medicaid Services to Individuals | 19.46 | 26.67 | 28.81 | 36.52 | +87.6% | 28.24 | 8.28 |
| Medicaid Long Term Care | 6.48 | 7.33 | 9.04 | 11.37 | +75.3% | 9.41 | 1.96 |
| Children's Special Health Care | 0.55 | 0.37 | 0.49 | 0.88 | +58.5% | 0.80 | 0.07 |
| Executive Direction and Support Services | 0.19 | 0.26 | 0.33 | 0.38 | +101.0% | 0.28 | 0.11 |
| Health Care Regulation | 0.07 | 0.06 | 0.06 | 0.08 | +20.4% | 0.10 | −0.02 |
| Administration and Support | 0.04 | 0.03 | 0.03 | 0.04 | −9.8% | 0.06 | −0.02 |
By appropriation category
Spending by category from the public “Amount Spent by category” pages, largest in FY2026 first; categories with no spending in any year shown are left out. Categories are the state's: salaries and benefits, expenses, special categories (contracted services and most program payments), aid to local governments, fixed capital outlay (construction), and so on.
| Appropriation category, spending ($ billions) | FY2019 | FY2022 | FY2024 | FY2026 | FY2019–FY2026 | Above baseline |
|---|---|---|---|---|---|---|
| Special categories | 26.68 | 34.60 | 38.64 | 49.10 | +84.0% | 10.38 |
| Salaries and benefits | 0.10 | 0.09 | 0.11 | 0.13 | +39.8% | −0.01 |
| Expenses | 0.02 | 0.02 | 0.02 | 0.02 | +16.9% | 0.00 |
| Continuing appropriations | — | — | — | 0.01 | — | — |
| Other personal services | 0.00 | 0.00 | 0.00 | 0.01 | +42.9% | 0.00 |
| Data processing services | 0.00 | 0.00 | 0.00 | 0.00 | +11.7% | 0.00 |
| Operating capital outlay | 0.00 | 0.00 | 0.00 | 0.00 | −84.5% | 0.00 |
Special categories, by name
| Special categories, operating budget ($ billions, largest in FY2026) | FY2019 | FY2022 | FY2024 | FY2026 | FY2019–FY2026 |
|---|---|---|---|---|---|
| Prepaid Health Plans | 12.73 | 16.35 | 15.80 | 20.51 | +61.2% |
| Prepaid Health Plan/Long Term Care | 4.62 | 5.04 | 6.15 | 7.99 | +73.0% |
| Prepaid Health Plan - Hospital Directed Payment Program | — | 1.76 | 3.04 | 6.40 | — |
| Supplemental Medical Insurance | 1.85 | 2.29 | 2.47 | 2.84 | +53.5% |
| Home and Community Based Services | 1.14 | 1.39 | 1.95 | 2.20 | +94.1% |
| Low Income Pool | 1.46 | 1.45 | 1.39 | 2.17 | +48.3% |
| Indirect Medical Education | — | 0.51 | 1.16 | 1.22 | — |
| Medicare Part D Payment | 0.61 | 0.72 | 1.06 | 1.08 | +77.1% |
| Hospital Inpatient Services | 0.92 | 0.84 | 0.69 | 0.61 | −34.1% |
| Other Fee for Service | 0.55 | 0.60 | 0.55 | 0.60 | +8.2% |
| Intermediate Care Facilities/Developmentally Disabled Community | 0.27 | 0.27 | 0.47 | 0.53 | +100.4% |
| Graduate Medical Education | 0.23 | 0.28 | 0.42 | 0.51 | +117.0% |
| Children's Medical Services Network | 0.15 | 0.18 | 0.18 | 0.40 | +163.2% |
| Grants and AIDS - Florida Healthy Kids Corporation | 0.27 | 0.25 | 0.21 | 0.36 | +32.6% |
| Nursing Home Care | 0.31 | 0.16 | 0.21 | 0.31 | −1.3% |
Positions
Established positions went from 1,530 in FY2019 to 1,548 in FY2026 (+1.2%), against population growth of 11.9%; that is 0.65 positions per 10,000 residents in FY2026, from 0.72 in FY2019.
Established positions are those set up in the state's personnel system on the day the summary was taken; filled positions have someone in them.
| Positions (State Positions summary) | Authorized | Established | Filled | Vacant | Per 10,000 residents (established) |
|---|---|---|---|---|---|
| FY2015 | 1,644 | 1,611 | 1,412 | 199 | 0.8 |
| FY2016 | 1,563 | 1,545 | 1,374 | 171 | 0.8 |
| FY2017 | 1,546 | 1,540 | 1,392 | 148 | 0.8 |
| FY2018 | 1,534 | 1,518 | 1,380 | 138 | 0.7 |
| FY2019 | 1,536 | 1,530 | 1,375 | 154 | 0.7 |
| FY2020 | 1,524 | 1,511 | 1,347 | 164 | 0.7 |
| FY2021 | 1,530 | 1,530 | 1,292 | 237 | 0.7 |
| FY2022 | 1,530 | 1,530 | 1,216 | 313 | 0.7 |
| FY2023 | 1,540 | 1,540 | 1,230 | 309 | 0.7 |
| FY2024 | 1,544 | 1,544 | 1,276 | 268 | 0.7 |
| FY2025 | 1,636 | 1,636 | 1,374 | 262 | 0.7 |
| FY2026 | 1,550 | 1,548 | 1,404 | 144 | 0.7 |
Among the agencies
Among the 31 agencies compared on the same years, Health Care Administration ranks #7 of 31 on spending excluding construction growth above the baseline in percentage points, #1 of 31 (the highest) on cumulative dollars above the baseline path, #1 of 31 (the highest) on spending excluding construction per resident in FY2026, and #17 of 31 on growth in established positions relative to population growth.
Key observations
What the numbers support. Descriptive, not prescriptive. Single-year changes in a budget entity are listed when the entity rose 25% or more or fell 30% or more in a year, by at least $10 million or 2% of the agency's spending excluding construction, whichever is larger; the three largest by dollars are printed.
- Health Care Administration spending excluding construction rose from $26.80B in FY2019 to $49.27B in FY2026, 83.8%. The population-and-inflation baseline was 45.1%: at that rate the FY2026 figure would be $38.89B, so FY2026 is $10.38B above the baseline. Over the seven years FY2020–FY2026, spending excluding construction ran a cumulative $23.57B above the baseline path.
- Per resident, spending excluding construction went from $1,265 in FY2019 to $2,078 in FY2026, which is $1,602 in FY2019 dollars.
- Split at the pandemic years: FY2019–FY2022 spending excluding construction grew 29.5% against a 17.3% baseline, and FY2022–FY2026 it grew 41.9% against 23.7%.
- Of the FY2026 operating budget (all categories, construction included), 25% was General Revenue, 12% state trust funds and an estimated 63% federal money. Spending excluding construction from state funds (General Revenue and state trust funds; General Revenue from the ledger, the trust-fund part by the fund rule) grew 77.3% between FY2019 and FY2026, above the baseline; from federal money it grew 87.9%, from $16.55B to $31.09B (the ledger pages give the General Revenue and trust-fund dollars exactly; the federal share of trust funds is estimated).
- The budget entity with the most spending above the baseline was Medicaid Services to Individuals: $19.46B in FY2019 to $36.52B in FY2026 (+87.6%, against a 45.1% baseline).
- Established positions went from 1,530 in FY2019 to 1,548 in FY2026 (+1.2%), against population growth of 11.9%; that is 0.65 positions per 10,000 residents in FY2026, from 0.72 in FY2019.
- In FY2026 the operating budget was $50.23B and spending $49.27B; the $965M difference (2%) is budget authority not drawn within the year: $671M in special categories, $294M in continuing appropriations (authority carried from an earlier year). Amounts that reverted at year-end are already out of the operating budget shown.
- The Legislature's enacted appropriation for the Agency for Health Care Administration (the General Appropriations Act and other appropriation bills, net of vetoes) and the operating budget these pages use differed most in FY2025: $35.17B enacted, $39.48B operating budget after budget amendments during the year and year-end reversions — $4.30B more. By fund, the operating budget was +$5.80B against the enacted figure in trust funds (where money received during the year — federal grants and disaster money among it — is added by budget amendment) and −$1.49B in General Revenue. The two differed by 10% or more in two of the seven years FY2019–FY2025 that the site's Ten-Year History covers.
- Among the 31 agencies compared, Health Care Administration ranks #7 of 31 on spending excluding construction growth above the baseline (percentage points, FY2019–FY2026) and #1 of 31 (the highest) on cumulative dollars above the baseline path.
- Spending in Medicaid Services to Individuals went from $28.10B in FY2025 to $36.52B in FY2026 (+30.0%). In that year an estimated 62% of the entity's budget was federal money.
Questions this raises
Questions an agency or legislative staff member could answer. The records show the change; they do not show the reason.
- What drove Medicaid Services to Individuals spending from $19.46B to $36.52B between FY2019 and FY2026?
- What drove Medicaid Services to Individuals spending from $28.10B to $36.52B in FY2026? An estimated 62% of that entity's budget was federal money that year.
- What drove established positions from 1,530 to 1,548 between FY2019 and FY2026, against population growth of 11.9%?
Sources and method
- Transparency Florida — Agency for Health Care Administration: operating budget and amount spent by budget entity, FY2026 (the same page for each year FY2015–FY2027) — Executive Office of the Governor, from the state's accounting system (FLAIR) and appropriations system (LAS/PBS)
- Transparency Florida — Agency for Health Care Administration: budget analyst view, with the budget-entity detail pages (appropriations by category and fund) — same source
- Transparency Florida — State Positions summary, each year — same source
- Transparency Florida — Ten-Year History of Appropriations, Agency for Health Care Administration (enacted appropriations by program, operations and fixed capital outlay, FY2016–FY2025) — same source
- Florida Fiscal Portal — Agency for Health Care Administration, Legislative Budget Request, Exhibit D-3A (used for the state / federal split of trust funds) — Executive Office of the Governor, Office of Policy and Budget
- Florida Demographic Estimating Conference, June 22, 2026 — Florida resident population, April 1 of each year — Office of Economic and Demographic Research
- CPI-U, All Items, South region (BLS series CUUR0300SA0), via FRED; July–June fiscal-year averages
Figures are amounts spent and operating budgets as recorded on Transparency Florida, the Governor's budget and spending site, for each fiscal year; positions from the same site's State Positions summary. The baseline multiplies the FY2019 figure by population growth (EDR's April 1 estimates, the one published series, no splice) and by the change in the CPI-U for the South region (July–June averages). This is an analysis of public records; it is not an examination of any agency's books, and it makes no recommendation. Method and limits: About this study. Feedback is welcome by email at [email protected].