I'm Ionel Roiban. I've spent twenty years as a software engineer fixing broken systems, and here's what I know: you can't fix what you can't measure, and you can't shop for what you can't see. Healthcare in Florida fails both tests. The prices are hidden, the bills arrive as surprises, and the laws that are supposed to protect you sit unenforced on the books.
This page shows the math. Every number is sourced — check them yourself at the bottom.
Roughly 7 in 10 Florida hospitals still don't fully show you their prices. A federal rule has required hospitals to post their real prices since 2021. Yet only 21.1% of U.S. hospitals reviewed were fully compliant, according to PatientRightsAdvocate.org's November 2024 report — the most recent nationwide review. Florida does somewhat better — 29% fully compliant in that review — but only 3% of Florida hospitals reviewed posted pricing sufficient for a consumer to actually compare. Better than average is still failing.
Enforcement is nearly nonexistent. Since 2022, federal regulators have fined just 31 hospitals nationwide for hiding prices — out of thousands. That's CMS's own enforcement tally, June 2022 through February 2026. The rule exists; the teeth don't. It got serious enough that Florida's Attorney General opened an investigation in mid-2025 and subpoenaed major hospital systems over price transparency and billing practices — amid reporting, based on PatientRightsAdvocate.org data, that some Florida hospitals' charges run more than ten times their costs.
The ambulance is the last legal surprise bill. Florida's 2016 balance-billing law and the federal No Surprises Act protect you in the emergency room — but ground ambulances are excluded from both. A study cited in the Florida House's own staff analysis found 71% of ambulance rides carry surprise-bill risk, with a median bill around $450. You can't comparison-shop from a stretcher.
Fraud is an affordability issue too. In June 2026, a national healthcare-fraud takedown charged 455 defendants in schemes involving more than $6.5 billion in false claims — and the Southern District of Florida alone charged 12 defendants tied to over $4 billion in fraudulent claims, with $27.4 million seized. Much of it was Medicare and Medicaid fraud that exploits seniors. In a district with a median age of 47.1 — well above Florida and the nation — that money comes out of programs our neighbors paid into their whole lives.
Here's the part that should make you angry: most of the rules already exist. They just aren't enforced — and nobody told you about them.
Florida Statute 395.301 already says a hospital must:
Did anyone at a hospital ever hand you that list? Me neither. That's the gap: a law with no enforcement culture and no public awareness is just a suggestion.
And when the Legislature had a clean fix in front of it, it stalled. HB 425 — the 2025 bill to end surprise ground-ambulance billing — passed its first committee 16–0, then died without a floor vote; its Senate companion died too. The 2026 session passed useful clinical bills, but no major price-transparency, facility-fee, or surprise-billing reform. A 16–0 idea shouldn't need a eulogy. It needs a legislator who files it again and walks it through the process — and I'll say it plainly: that bill died under my own party's process. I'm not running to make excuses for that. I'm running to push it from inside the majority, where the calendar is actually set.
Meanwhile the federal government just raised the bar. Under the CMS rule finalized in November 2025, hospitals must post actual dollar figures — the median, 10th, and 90th percentile amounts actually paid — drawn from real claims data, with the hospital's CEO (or a designated senior official) attesting that the data is true, accurate, and complete. Enforcement began April 1, 2026. Your state representative should be checking whether every hospital serving District 90 met that deadline. I will — and I'll publish what I find.
An engineer's approach: don't reinvent — enforce, instrument, and close the gaps.
1. Enforce the law we already have. Push the state to audit compliance with Fla. Stat. 395.301 and the new federal posting rules, make the existing fines automatic rather than theoretical, and back the Attorney General's transparency enforcement with statutory support. 2. A patients' "know your rights" requirement. Require hospitals to hand every patient a plain-language notice of their existing rights — the 3-day estimate, the 7-day itemized bill, the observation-status notice. Costs almost nothing; changes the power balance at the billing desk. 3. File and finish the ambulance fix. Refile the HB 425 ground-ambulance surprise-billing protection and carry it past the committee where it died. 4. Take on facility fees. Free-standing ERs look like urgent care but bill hospital-grade facility fees, and no Florida law caps those fees or requires them to be posted up front. As of March 2026, nine states prohibit facility fees for certain services or settings — Connecticut has restricted them since 2017 — and Florida isn't one of them. Florida should lead, not follow. 5. Protect access close to home. Support telehealth and the safety-net clinics that serve this district — the Health Care District of Palm Beach County runs the C.L. Brumback primary-care clinics, nine sites countywide including a Delray Beach health center — so an older, coastal district isn't driving an hour for routine care. 6. Guard seniors from billing fraud. Back the enforcement behind the June 2026 takedown's South Florida cases with state-level prosecution resources and simpler reporting for seniors who spot a bogus charge. Protecting Medicare from thieves is affordability policy.
None of this is a culture-war issue. Knowing the price before the procedure is not partisan — it's arithmetic, and it's your money. The laws are half-written; what District 90 needs is a representative in the majority that controls the calendar, with the habit of checking whether the rules on paper are working in practice. That's the job I've done for twenty years.
Hold me to this page. Every number here has a source below — if you find one that's wrong, send me the correction with a source, and I'll fix it and say that I did.
Every figure on this page is sourced. Find an error? Send me the source and I will fix it.
Updated: 2026-09-04