The Brevard County Board of County Commissioners on July 3 voted 5-0 to adopt a rate resolution imposing non‑ad valorem special assessments on the county's listed private and nonprofit hospitals so the state can use the assessments to access federal Medicaid matching funds.

County staff and hospital representatives said the vote is time-sensitive because pending legislation — referred to in the meeting as the "big beautiful bill" — would freeze provider assessment rates if it becomes law, preventing counties from raising the assessment rate later.

Jill (county staff) introduced the agenda item, saying the request "is at the request of the affected hospitals" and that the assessments would apply only to the providers listed in the assessment rule attached to the agenda. Jill said, "This is not an assessment or a tax on any residential or business property in the county." She added the program is a federally approved mechanism that "allows the state to access federal Medicaid funds for managed care expenditures, and that offsets the hospital's Medicaid shortfalls."

Rachel Rexford, a representative of Adelanto Healthcare Ventures who said her firm represents the hospitals, told commissioners the measure had to be adopted immediately because of language in the pending legislation. "So basically, once the big beautiful bill goes into effect, the rates right now that the county can assess the hospital ... will be frozen indefinitely," Rexford said, adding that Florida's current statewide assessment rate is about 3.5 percent and that, under federal law, the assessment could be as high as 6 percent.

Commissioner Altman urged support, placing the action in the context of the state's long debate over Medicaid financing. "I can think of nothing more important. Saving taxpayer dollars, providing health care for our citizens just don't get more critical than that," Altman said.

During public comment, Sandra Sullivan of South Patrick Shores asked for more transparency about the timing and effects of the assessment and raised concerns about projected federal Medicaid funding cuts. Sullivan asked, "What does this do? What’s the real story here?" and said she wanted clarification that the measure would not expand federal taxes. Jill and Rexford responded to procedural and timing questions, telling members of the public the county had planned to consider the item at its July 8 meeting but convened the special meeting because the legislation advanced faster than anticipated.

After discussion the board voted. Commissioner Goodson moved the measure; Commissioner Altman seconded. The clerk recorded roll call votes of Yes from Commissioner Delaney, Vice Chair Goodson, Commissioner Atkinson, Commissioner Altman and Chair Feltner; the motion passed 5-0.

The board also scheduled an executive session after the meeting and staff offered to provide additional background materials and data to members of the public and commissioners who requested more information. No ordinance or countywide property tax was imposed; the resolution applies only to the hospitals listed in the assessment rule attached to the agenda.