Department of Health

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. † A dagger marks a year with a data note.

Spending against the baseline

Health spending excluding construction fell from $3.82B in FY2019 to $3.65B in FY2026, −4.4%. The population-and-inflation baseline was 45.1%: at that rate the FY2026 figure would be $5.54B, so FY2026 is $1.89B below the baseline. Over the seven years FY2020–FY2026, spending excluding construction ran a cumulative $3.68B above the baseline path. (The end point and the path point different ways because earlier years ran the other way.)

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. FY2027's operating budget carries, for construction, balances from earlier years' appropriations.

Where the money comes from

Of the FY2026 operating budget (all categories, construction included), 26% was General Revenue, 33% state trust funds and an estimated 41% 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) declined 15.8% between FY2019 and FY2026, below the baseline; from federal money it grew 17.8%, from $1.29B to $1.52B (the ledger pages give the General Revenue and trust-fund dollars exactly; the federal share of trust funds is estimated).

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.

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.

Special categories, by name

Positions

Established positions went from 13,130 in FY2019 to 12,226 in FY2026 (−6.9%), against population growth of 11.9%; that is 5.2 positions per 10,000 residents in FY2026, from 6.2 in FY2019.

Among the agencies

Among the 31 agencies compared on the same years, Health ranks #31 of 31 (the lowest) on spending excluding construction growth above the baseline in percentage points, #5 of 31 on cumulative dollars above the baseline path, #5 of 31 on spending excluding construction per resident in FY2026, and #30 of 31 (the second-lowest) on growth in established positions relative to population growth.

See every agency on one page →

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.

1. Health spending excluding construction fell from $3.82B in FY2019 to $3.65B in FY2026, −4.4%. The population-and-inflation baseline was 45.1%: at that rate the FY2026 figure would be $5.54B, so FY2026 is $1.89B below the baseline. Over the seven years FY2020–FY2026, spending excluding construction ran a cumulative $3.68B above the baseline path. (The end point and the path point different ways because earlier years ran the other way.)
2. Per resident, spending excluding construction went from $180 in FY2019 to $154 in FY2026, which is $119 in FY2019 dollars.
3. Set aside from the figures above and shown separately: fixed capital outlay — construction and land, spent over several years and recorded against the year it was appropriated — was $7.2M recorded against FY2019 and $18M so far against FY2026, a year whose construction money is still being spent; transfers to state trust funds or the General Revenue Fund, which appear again as spending when drawn from the receiving fund, were $11M in FY2019 and $71M in FY2026.
4. Split at the pandemic years: FY2019–FY2022 spending excluding construction grew 33.6% against a 17.3% baseline, and FY2022–FY2026 it declined 28.5% against 23.7%.
5. Of the FY2026 operating budget (all categories, construction included), 26% was General Revenue, 33% state trust funds and an estimated 41% 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) declined 15.8% between FY2019 and FY2026, below the baseline; from federal money it grew 17.8%, from $1.29B to $1.52B (the ledger pages give the General Revenue and trust-fund dollars exactly; the federal share of trust funds is estimated).
6. The budget entity with the most spending above the baseline was Administrative Support: $59M in FY2019 to $136M in FY2026 (+131.0%, against a 45.1% baseline).
7. The budget entity furthest below the baseline was Children's Special Health Care: $1.39B in FY2019 to $191M in FY2026 (−86.2%, against the same 45.1% baseline).
8. Established positions went from 13,130 in FY2019 to 12,226 in FY2026 (−6.9%), against population growth of 11.9%; that is 5.2 positions per 10,000 residents in FY2026, from 6.2 in FY2019.
9. In FY2026 the operating budget was $4.01B and spending $3.74B; the $266M difference (7%) is budget authority not drawn within the year: $144M in special categories, $110M in continuing appropriations (authority carried from an earlier year). Amounts that reverted at year-end are already out of the operating budget shown.
10. The Legislature's enacted appropriation for the Department of Health (the General Appropriations Act and other appropriation bills, net of vetoes) and the operating budget these pages use differed most in FY2025: $4.28B enacted, $7.72B operating budget after budget amendments during the year and year-end reversions — $3.43B more. By fund, the operating budget was +$2.14B 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 +$1.29B in General Revenue. The two differed by 10% or more in seven of the seven years FY2019–FY2025 that the site's Ten-Year History covers.
11. Among the 31 agencies compared, Health ranks #31 of 31 (the lowest) on spending excluding construction growth above the baseline (percentage points, FY2019–FY2026) and #5 of 31 on cumulative dollars above the baseline path.
12. Spending in Children's Special Health Care went from $3.89B in FY2025 to $191M in FY2026 (−95.1%).
13. Spending in Children's Special Health Care went from $2.60B in FY2024 to $3.89B in FY2025 (+49.8%).
14. Spending in Disease Control and Health Protection went from $273M in FY2020 to $919M in FY2021 (+236.7%). In that year an estimated 88% 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.

1. What drove Administrative Support spending from $59M to $136M between FY2019 and FY2026?
2. What drove Children's Special Health Care spending from $2.60B to $3.89B in FY2025?
3. What drove established positions from 13,130 to 12,226 between FY2019 and FY2026, against population growth of 11.9%?

Sources and method

• Transparency Florida — Department of Health: 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 — Department of Health: 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, Department of Health (enacted appropriations by program, operations and fixed capital outlay, FY2016–FY2025) — same source
• Florida Fiscal Portal — Department of Health, 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 rob@beachsideautomation.com.