Grand Jury Finds DeSantis Misused $10M in Medicaid Funds

Grand Jury Issues Formal Finding on Medicaid Spending

The grand jury report released Thursday found that the Florida Agency for Health Care Administration improperly allocated Medicaid funds to produce and distribute television and digital ads opposing Amendment 3. The ads ran statewide in October 2025. They warned viewers that cannabis legalization would harm children and increase traffic fatalities. AHCA classified the campaign as public health education, but the grand jury rejected that designation as inconsistent with Medicaid statutory guidelines.

The $10 million expenditure represented approximately 0.03 percent of Florida's annual Medicaid budget. The grand jury didn't recommend criminal charges but referred its findings to the Florida Legislature for potential policy reforms.

Timeline and Scale of the Anti-Amendment 3 Campaign

AHCA launched the ad campaign on October 1, 2025, three weeks before the November 5 election. The agency purchased airtime on broadcast television in Miami, Tampa, Orlando, and Jacksonville, and ran pre-roll video ads on YouTube and Facebook. Internal AHCA emails cited in the grand jury report show that communications staff coordinated messaging themes with the governor's office.

Amendment 3 ultimately received 55.8 percent of the vote. It fell short of the 60 percent threshold required for constitutional amendments in Florida. The DeSantis administration spent an estimated $50 million in total state funds opposing the measure, including separate campaigns funded by the Department of Transportation and the Department of Children and Families.

Legal Standard for Medicaid Fund Use

Federal Medicaid statute restricts fund use to direct medical services, administrative costs, and health education programs that meet CMS guidelines. The grand jury found that the anti-Amendment 3 ads didn't qualify as health education under those guidelines because they advocated a specific electoral outcome rather than providing neutral information about cannabis health effects.

The report cited a 2019 CMS advisory letter that prohibits states from using Medicaid dollars for lobbying or campaign activities. Florida's AHCA didn't seek a waiver or formal opinion from CMS before launching the campaign.

Governor's Office Response and Legislative Implications

A spokesperson for Governor DeSantis said Thursday that the administration believes the ads were lawful public health messaging and that the grand jury overstepped its authority. The spokesperson didn't address whether the governor's office would cooperate with any legislative inquiry. DeSantis hasn't commented publicly on the report.

State Senator Lori Berman, a Democrat who chairs the Senate Health Policy Committee, said she'll introduce legislation in the 2027 session to tighten restrictions on state agency spending during election cycles. Republican leadership in the Florida House hasn't indicated whether it'll pursue the grand jury's recommendations.

Implications for Future Ballot Measures

This finding constrains how Florida governors can deploy state resources against citizen-led ballot initiatives. The grand jury didn't rule on whether the other $40 million in anti-Amendment 3 spending violated any statutes, but the report's logic applies equally to DOT and DCF campaigns that also ran during the election window.

Florida voters will likely see cannabis legalization on the ballot again in 2028. Smart & Safe Florida, the coalition that sponsored Amendment 3, has already filed preliminary paperwork for a revised measure. For full background on this story, see the CannIntel topic hub on Florida Amendment 3 Campaign.