For over 50 years, I’ve been involved in healthcare leadership, spending 34 of those years as the president and CEO of Lee Health. Throughout my career, I’ve met families who postponed seeking medical help until a minor issue turned into a severe crisis. I’ve seen uninsured individuals arrive at our emergency rooms because they had nowhere else to go. I understand the weight of uncompensated care, which ultimately impacts every insured Floridian.
When I hear a governor candidate talk about making healthcare affordable, I try to look beyond the catchy phrases and examine their past actions.
In late September, Byron Donalds’ campaign removed several mentions of President Trump’s endorsement from its website. This change reflects a trend among Republican candidates who are distancing themselves from an administration that many voters blame for rising healthcare costs. Donalds is now emphasizing affordability, a crucial issue since many Florida families are feeling financial pressure, particularly due to healthcare expenses. However, it’s fair for voters to question whether this is a steadfast belief for him or just a tactic for the campaign.
Looking at Donalds’ record reveals a lot. As a member of Congress, he supported the so-called One Big Beautiful Bill, which, according to the Congressional Budget Office, would leave about 10 million more Americans without health insurance, mainly due to cuts in Medicaid. The benefits from that law mainly went to the wealthiest households. Additionally, Donalds and his Republican colleagues in Congress did not extend the improved ACA subsidies, resulting in soaring health insurance premiums for millions of working families. Policies that strip coverage from working people while benefiting those who need it the least do not contribute to affordability.
On a positive note, Donalds has suggested that healthcare providers be required to display actual cash prices for common services. While price transparency is a challenging issue—since clinical complications and insurance terms often complicate things—patients should indeed have access to this information. However, simply knowing the cost doesn’t guarantee access to care. A price tag means little to a family without insurance or a nearby clinic. Florida is one of just ten states that has not expanded Medicaid, leaving many working individuals in a difficult situation—earning too much for Medicaid but too little to receive marketplace assistance. Price lists won’t solve that issue or save lives.
Public health is another critical area where a governor’s decisions can make a significant difference in the lives of children.
The Florida Department of Health, led by Surgeon General Joseph Ladapo, has proposed to remove four vaccines—hepatitis B, chickenpox, Hib, and pneumococcal disease—from school entry requirements. The Hib and pneumococcal vaccinations are essential as they can prevent severe infections, including meningitis, in young children. This change is not based on new scientific findings but rather treats proven vaccines as just one option among many.
In an August national television appearance, Donalds expressed support for the DeSantis administration’s vaccine plan, which has faced criticism from Florida’s medical community.
We’ve seen the consequences of reduced vaccination rates before—preventable diseases can make a comeback when communities lose the immunity that widespread vaccinations provide. The children at the highest risk include the youngest, those with medical conditions, and those who cannot be vaccinated. While “freedom of choice” sounds appealing, the reality is that one family’s choice can lead another family to end up in a pediatric intensive care unit.
If elected, Donalds would become Florida’s first Black governor—a significant milestone in a state with a complex racial history. I admire what his candidacy represents. However, my support relies on how his policies would affect the health of Floridians. By that standard, I cannot endorse him.
Florida needs a governor who understands that true affordability starts with access to care, who will expand coverage rather than cut it, and who will prioritize the health of our children based on the best available science. Public health policies should evolve with scientific evidence, not shift based on political agendas.
Jim Nathan is the retired president and CEO of Lee Health and currently serves as an adjunct professor at Florida Gulf Coast University.
