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Medicaid $15 Minimum Wage Advocacy Toolkit

During the 2022 Florida Legislative Session, state legislators increased the minimum wage for Medicaid direct care workers to $15 per hour, which took effect on October 1, 2022. The state's actuarial services vendor, Milliman, estimated the impact a $15 minimum wage for direct care workers would have on costs for health care providers. The legislature used this study to allocate funds for Medicaid reimbursement rate increases in order to cover the $15 minimum wage.

However, based on feedback from the Medicaid home health provider community, the updated Medicaid fee-for-service fee schedules and increased reimbursement rates from the Statewide Medicaid Managed Care (SMMC) health plans are insufficient to cover the new minimum wage.

As part of its public policy efforts, HCAF will seek an additional increase in Medicaid reimbursement when legislators convene for the next legislative session on March 7, 2023. Until then, Medicaid providers are invited to attend a legislative delegation meeting to express their concerns to their elected officials.

A legislative delegation consists of members of the Florida Senate and House of Representatives who represent all or part of a county. Delegations hold public meetings prior to the annual legislative session in order to allow the public to express their views and request assistance on state policy issues. These public meetings assist the delegation in formulating its legislative priorities.

The schedule of upcoming meetings can be found below. Meetings will be added as they are scheduled and periodically announced through email action alerts.

If you are able to attend a meeting in your community, follow these simple steps:

  1. Follow the instructions for requesting to address the delegation, which will usually require you to request to be placed on the meeting agenda.
  2. Use our talking points (below) to craft your message. Keep it brief — 3-5 minutes is ideal.
  3. Please download and bring enough fact sheets to ensure that each legislator receives a copy.

If you attend a meeting, we would appreciate hearing how your comments were received in order to continue developing a successful advocacy strategy. For feedback or questions, please contact Kyle Simon, Director of Government Affairs and Communications, at

If you cannot attend a delegation meeting or if there is not one scheduled in your county, you can still send your legislator an email or schedule a meeting with them through their local office. Please visit the Legislative Action Center to look up and contact your state elected officials.

Talking Points

  • Share your experiences and challenges with the implementation of the $15 minimum wage, which took effect on October 1, 2022. In addition, it is important to provide information regarding how some plans delayed contract amendments — which were not required until January 1, 2023 — leading to higher payroll expenses without an increase in reimbursement.
  • The state increased Medicaid fee-for-service rates increased by 3.3% for Home Health Services and Private Duty Nursing Services, and 15.45% for Personal Care Services due to the appropriation in the 2022-23 budget. Without taking into account increased taxes, benefits, and other business costs, the $15 minimum wage represents a 29.3% increase in wages for employers.
  • According to the Florida Department of Economic Opportunity, the average direct care worker in Florida earned $11.60 per hour prior to the Medicaid minimum wage increase. The sweeping minimum wage increase has had the unintended consequence of some home health agencies being forced to discharge patients, and others opting out of serving those on Medicaid. Here is an article from October 2022 that illustrates this point.
  • The state is expected to save $745 million in fiscal savings annually by prioritizing the provision of care in the home rather than in a nursing home, according to a report from Florida TaxWatch released in 2022.
  • Policymakers should continue investing annually in Medicaid home- and community-based services (HCBS) if they wish to ensure that cost-effective in-home care is available (rather than facility-based care). It is inevitable that the state minimum wage will increase until it reaches $15 in 2026, which will further compound the challenges that the $15 mandate presents.

Upcoming Events

The schedule of upcoming meetings can be found below. Meetings will be added as they are scheduled and periodically announced through email action alerts. Please note that some meetings may require the submission of a request form to address the delegation. In the event that the deadline for submitting a request has passed but you wish to speak at the meeting, please contact the delegation office or your elected officials to make a special request. You can find contact information for your elected officials by visiting the Legislative Action Center.

If you are unable to load the calendar, please click here for a PDF listing of upcoming meetings provided by the Florida League of Cities.