This is part 3 of an investigative series on money and influence in high‑stakes healthcare policy decisions and how a Broward hospital bill that never got a public vote became a battleground for unnamed interests.
In the first installment of this series, Florida Daily examined how an undisclosed poll and merger‑framed questions shaped early public perception of House Bill 1047 and Senate Bill 1122; in part 2, how a Tallahassee‑based 501(c)(4), its vendors, and political operatives carried those messages through a “taxpayer”‑branded campaign.
This third installment follows the trail one step further to the visible and invisible power centers whose combined efforts helped stop Broward’s public hospitals from getting new tools to collaborate.
For most Broward residents, the fight over HB 1047/SB 1122 looked like a clash between their public hospital districts and a “taxpayer” group warning of a secret merger. What the mailers and talking points did not show was the larger cast offstage – major private hospital competitors, well‑connected lobbyists, and nondisclosing advocacy groups – working the same bills from Tallahassee to corporate boardrooms.
The campaign that tried to stop Broward’s public hospitals from gaining new tools to work together told voters it was about protecting competition and taxpayers, according to mailers, polling language, and online ads from a group called Taxpayers for Healthcare Accountability, which describes itself, in fine print, as “a project of Florida’s Future First,” a Tallahassee‑based 501(c)(4). It never disclosed which businesses or individuals might stand to gain if that campaign succeeded, and the group’s public filings do not list its donors.
House Bill 1047 and its Senate companion, SB 1122, would have allowed Broward Health and Memorial Healthcare System to collaborate more closely on services, contracts, and strategic planning under state oversight while remaining separate public hospital districts with their own boards, budgets, and Sunshine‑law obligations, according to the bill text and legislative summaries.
Supporters, including HB 1047 sponsor Rep. Hillary Cassel and Shane Strum, president and CEO of Broward Health and interim CEO of Memorial Healthcare System, said in interviews and press releases that the measure would let 11 public hospitals coordinate services, avoid costly duplication, and negotiate more effectively in a market dominated by large private players, all while preserving transparency and oversight.They also note that similar collaboration frameworks have been enacted in more than 20 states, giving public and safety‑net systems clearer rules for working together without constant legal uncertainty.
Critics branded the bills a “backdoor merger,” warning of reduced competition, higher prices, and diminished accountability if two taxpayer‑funded systems could act more like a single network. Those talking points showed up in polling scripts, editorials, form letters, mailers, and social media ads that reached Broward voters this winter.
A national giant with local stakes
Nashville, Tenn.-based HCA Healthcare is a dominant force in American healthcare. A publicly traded company listed on the New York Stock Exchange under the ticker symbol HCA, it operates about 190 hospitals nationwide and has projected 2026 revenue in the range of roughly $76–$80 billion, according to its latest earnings release. HCA Florida Healthcare, a division of HCA, is the state’s largest network of hospitals and affiliated care sites, with more than 650 locations statewide. In South Florida, HCA’s East Florida division includes four hospitals and multiple freestanding emergency departments in Broward County, with an additional ER planned, giving it a significant foothold in one of Florida’s most competitive healthcare markets.
When lawmakers advanced an earlier version of a Broward collaboration proposal in 2025, HCA publicly opposed the plan, deploying lobbyists and other advocates who warned it would weaken competition; that bill stalled in Tallahassee after the company and other critics raised concerns, according to Florida Bulldog and South Florida Sun Sentinel reporting.
As Florida’s legislature took up HB 1047 and SB 1122 this year, HCA again registered lobbyists on the measures and remained engaged in public discourse, state lobbying disclosures and legislative media coverage show.
In public, HCA continued to frame its concerns around 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 weakens competition, evades accountability, and limits patient choices with serious long‑term consequences for the quality, cost, and accessibility of care,” and argued that a “merger” involving public hospital districts should go before voters.
That language echoes talking points used by other opponents of HB 1047, who described the measure as a “backdoor merger” that could concentrate power in a single public system and shut taxpayers out of big decisions.
An army of lobbyists, then and now
In 2025, when lawmakers first debated broad collaboration powers for Broward’s public hospital districts, the South Florida Sun Sentinel reportedthat HCA had “a formidable lobbying force” in Tallahassee, with just shy of two dozen individuals from seven lobbying and law firms registered to represent the company on the proposal, based on the Legislature’s own lobbying database. The same article noted that Broward Health and Memorial, which cannot make corporate political contributions like a private company, nonetheless fielded 15 lobbyists across multiple firms.
The 2026 push looks somewhat smaller on paper but still intense. Florida House lobbyistregistration records for HB 1047/SB 1122 show seven lobbyist registrations for Broward Health and Memorial across three lobbying firms, another seven lobbyists through three firms for HCA Healthcare, and single‑lobbyist entries for Cleveland Clinic Florida and Baptist Health South Florida.
On the public‑hospital side, Broward Health and Memorial Healthcare System retained GrayRobinson, Ronald L. Book, and Capital City Consulting to press their case for collaboration authority.
Cleveland Clinic Florida Health System Nonprofit Corporation registered lobbyist David M. Christian and Baptist Health South Florida registered Greenberg Traurig, signaling that both expanding systems were closely tracking how much collaboration power Broward’s public districts might receive.
At least seven lobbyists working the legislation for HCA included firms The Mayernick Group; Rubin, Turnbull & Associates; and Lewis Longman & Walker, where Natalie Kato, who now plays a key role for Florida’s Future First/Taxpayers for Healthcare Accountability, previously served as an attorney, as first reported by Florida Daily.
Taken together, those registrations suggest that the nation’s largest for‑profit hospital chain sees Broward’s public systems – and any new legal tools they might receive – as a matter of significant strategic interest.
From visible lobbying to invisible “taxpayers”
While state lobbying records make clear which hospital systems are pressuring lawmakers, the parallel campaign targeting Broward voters has been far more opaque. The messages urging residents to “oppose HB 1047” are branded as Taxpayers for Healthcare Accountability. A review of the group’s website, Facebook page, text messages, and direct mail pieces shows that it repeatedly casts HB 1047 as a “backroom deal” and “power grab” that would reduce transparency and competition but never mentions HCA or any other private healthcare player by name.
Florida’s Future First is not required to disclose its donors under 501(c)(4) rules, and the limited filings it has made public offer no list of funders. A search of Florida’s online campaign finance databases and available federal tax records by Florida Daily did not identify any direct contributions from named hospital corporations or other healthcare companies to Florida’s Future First, leaving the financial backers of the Broward campaign effectively anonymous.
What is clear is the parallel: on one track, major hospital systems, including HCA, line up lobbyists in Tallahassee and make public arguments about competition; on another, an anonymous “taxpayer”‑branded campaign sings off the same song sheet, using similar themes to rally voters against HB 1047/SB 1122, without revealing who is paying for the message.
The legislation is dead for now, but until someone pulls back the curtain on who financed that “taxpayer” chorus, Broward residents will be left guessing which private interests were conducting it.
