Hillsborough County weighs using $531 million Health Care Plan reserve to expand services or cut surtax

Hillsborough County officials presented commissioners with options Thursday for a large and growing reserve in the county's Health Care Plan, urging deliberation before any changes. Kevin Wagner, director of the county's Health Care Services Department, told the Board of County Commissioners the plan is projected to hold about $531,000,000 at the end of fiscal 2025 and laid out scenarios to use or reduce that reserve.

Wagner said the plan, created in 1991 under "ordinance 91 19" and shaped by state statute cited in the presentation, remains a payer-of-last-resort for county residents who lack other coverage and is designed to divert medically needy people from costly emergency-room care into primary care. He told commissioners the county currently budgets about $129,000,000 for medical services and about $38,000,000 for administration within the plan.

To "soften the landing" for the large balance, Wagner presented a spend-down "Scenario 1" that would fund expansions and provider requests: up to $12,000,000…