This is part 3 of an investigative series about money and influence in high-stakes health policy decisions, and how the Broward Hospital Bill, which never received a referendum, became a battleground for unsung interests.
In the first article in this series, The Florida Daily examined how private polling and merger-based questions shaped early public perceptions of House Bill 1047 and Senate Bill 1122. Part 2 describes how the Tallahassee-based 501(c)(4), its vendors, and political operatives conveyed these messages through “Taxpayer”-branded campaigns.
In this third series, we trace the steps the visible and invisible power centers took together to prevent Broward’s public hospitals from getting new tools to work together.
To most Broward residents, the fight over HB 1047/SB 1122 looked like a clash between a public hospital district and a group of “taxpayers” warning of a secret merger. What the mailers and talking points didn’t reveal were a host of off-stage actors, including competitors of major private hospitals, well-connected lobbyists and private advocacy groups, working on the same bill from Tallahassee to corporate boardrooms.
Broward’s campaign to block public hospitals from getting new tools to collaborate told voters it was about competition and protecting taxpayers, according to mailers, poll language and online ads from a group called Taxpayers for Medical Accountability. The organization is described in the fine print as a Tallahassee-based 501(c)(4) “Florida’s Future First Project.” The organization has not disclosed what companies or individuals may benefit if the campaign is successful, and the organization’s public filings do not list donors.
According to the bill text and bill summary, House Bill 1047 and its Senate bill, SB 1122, would have allowed Broward Health and Memorial Healthcare System to work more closely together on services, contracts, and strategic planning under state oversight while remaining independent public hospital districts with their own boards, budgets, and Sunshine Act obligations.
Supporters, including HB 1047’s sponsor, Rep. Hilary Cassell, and Shane Stram, president and CEO of Broward Health and interim CEO of Memorial Healthcare System, said in interviews and press releases that the measure would allow the 11 public hospitals to maintain transparency and oversight while coordinating services, avoiding costly duplication and negotiating more effectively in a market dominated by large private companies. It also notes that similar cooperative frameworks have been enacted in more than 20 states to provide information to public authorities. Safety net systems clarify the rules for cooperation in the absence of constant legal uncertainty.
Critics branded the bill a “backdoor merger” and warned of less competition, higher prices and less accountability if the two taxpayer-funded systems functioned like a single network. These issues appeared in poll scripts, editorials, form letters, mailers and social media ads sent to Broward voters this winter.
National giant with local interests
HCA Healthcare, based in Nashville, Tennessee, is a dominant force in American healthcare. The company, a publicly traded company listed on the New York Stock Exchange under the ticker symbol HCA, operates about 190 hospitals across the United States and expects 2026 revenue to be in the range of about $76 billion to $80 billion, according to its latest earnings release. HCA Florida Healthcare, a division of HCA, is the state’s largest network of hospitals and related care facilities with more than 650 locations throughout the state. In South Florida, HCA’s East Florida division includes four hospitals and multiple free-standing emergency departments in Broward County, with plans to add an ER, making it an important foothold in one of Florida’s most competitive health care markets.
When lawmakers pushed an early version of a proposed partnership with Broward in 2025, HCA publicly opposed the plan, deploying lobbyists and other advocates to warn it would make it less competitive. The bill stalled in Tallahassee after the company and other critics raised concerns, the Florida Bulldog and South Florida Sun Sentinel reported.
When the Florida Legislature took up HB 1047 and SB 1122 this year, HCA again registered lobbyists for the measures and continued to engage in public debate, disclosure of the state’s lobbying activities, and media coverage of the Legislature.
HCA continued to publicly raise concerns about competition and accountability. Charles Gressle, president of the company’s East Florida division, warned in a statement to the South Florida Sun Sentinel that “this proposal would reduce competition, avoid accountability, limit patient choice, and have serious long-term impacts on the quality, cost, and accessibility of care,” and argued that “mergers” involving public hospital districts should go before voters.
The language echoes arguments used by other opponents of HB 1047, who called the bill a “backdoor merger” that could concentrate power into a single public system and lock taxpayers out of major decisions.
The army of lobbyists then and now
In 2025, when lawmakers first discussed broad cooperation powers for Broward’s public hospital district, the South Florida Sun Sentinel reported that, based on the Legislature’s own lobbying database, HCA had a “formidable lobbying force” in Tallahassee, with just under 20 people from seven lobbying and law firms registered to represent the company on the proposal. The article noted that Broward Health & Memorial has 15 lobbyists across multiple companies, even though it cannot make corporate political contributions like private companies.
Although the momentum for 2026 looks a little smaller on paper, it is still strong. Florida House lobbyist registration records for HB 1047/SB 1122 show Broward Health & Memorial has seven lobbyists registered with three lobbying firms, HCA Healthcare has seven lobbyists registered with three companies, and one lobbyist is registered with Cleveland Clinic in Florida and Baptist Health in South Florida.
On the public hospital side, Broward Health and Memorial Healthcare System hired GrayRobinson, Ronald L. Book and Capital City Consulting to sue for cooperation authority.
David M. Christian, a registered lobbyist for the Cleveland Clinic Florida Health System nonprofit corporation, and South Florida Baptist Health Greenberg Traurig indicated that both expanding systems are closely tracking how much cooperation Broward’s public district is likely to receive.
At least seven lobbyists working on the HCA legislation included a firm called The Mayernick Group. Rubin Turnbull & Associates; First reported by the Florida Daily, Lewis Longman & Walker was previously represented by Natalie Kato, who currently plays a key role in Florida Future First/Taxpayer Medical Accountability.
Taken together, these registrations suggest that the nation’s largest for-profit hospital chains view Broward’s public system and the new legal tools they may receive as a matter of important strategic interest.
From visible lobbying to invisible “taxpayers”
While state lobbying records reveal which hospital systems are pressuring lawmakers, a parallel campaign targeting Broward voters is far more opaque. A message urging residents to “vote no on HB 1047” is branded “Taxpayer Responsibility for Healthcare.” A review of the group’s website, Facebook page, text messages and direct mailings shows the group repeatedly denounces HB 1047 as a “backroom deal” and “power grab” that reduces transparency and competitiveness, but never mentions HCA or other private health care providers by name.
Florida’s Future First is not required to disclose its donors under its 501(c)(4) regulations, and the company’s limited public filings do not list its donors. A Florida Daily search of Florida’s online campaign finance database and available federal tax records did not identify any direct contributions to Florida Future First from designated hospital corporations or other health care companies, leaving the Broward campaign’s financial backers effectively anonymous.
What is clear is that they are parallel lines. Major hospital systems, including HCA, have lined up lobbyists in Tallahassee to publicly discuss competition. In another campaign, an anonymous “Taxpayer” brand campaign uses similar themes and sings the same song sheet to rally voters against HB 1047/SB 1122 without disclosing who is paying for the message.
This law has been repealed for now, but until someone pulls back the curtain on who funded that “taxpayer” chorus, Broward residents will be left guessing which private interests carried this bill.
