Broward Health and Memorial Healthcare System are again asking the Florida Legislature for authority to increase cooperation between the two government-run hospital systems, arguing that closer collaboration would enhance efficiency and improve health care.
If enacted, the proposal would allow the two organizations, which between them operate 11 hospitals in the county, to do more together — without running afoul of antitrust laws prohibiting anticompetitive behavior.
By declaring such activity in the public interest and state policy supervised by the state, the Legislature’s blessing would permit the public hospital systems to act in ways that otherwise could be considered anticompetitive.
The renewed push, outlined by Shane Strum, who is the top executive at both health systems, comes months after similar legislation stalled in Tallahassee, where it was opposed by one of the biggest hospital companies in the country, HCA Healthcare, which operates four hospitals in Broward County.
The biggest selling point from Strum and his allies: closer collaboration would improve care.
He and Paul Tanner, chair of the board that oversees the Broward Health system, pointed to parts of the county where pregnant women don’t have access to maternity care.
Broward is densely populated and isn’t in a rural area in the middle of the country, “and we still have health care deserts,” Tanner said.
Doug Harrison, secretary/treasurer of the Memorial system board, also said the two districts could join to provide services that aren’t available in the county. “We don’t believe that anybody should be leaving Broward County,” he said.
State Rep. Hillary Cassel, R-Dania Beach, who sponsored a similar measure in the 2025 legislative session and said she would sponsor the 2026 version, said there are “things that we need here in Broward County, desperately, and by allowing the hospitals to collaborate with one another, deal with scales of economy, negotiate better insurance rates, it’s just a win-win.”
Different approach
Strum and the boards of the county’s two public hospital districts are taking a different approach in advance of the 2026 legislative session after the effort failed in 2025. “This year we decided we’re just gonna come out and share everything,” Strum said.
The 2026 attempt is starting earlier in the legislative calendar and is more public than the 2025 effort.
Strum pushed for the proposed law at an Oct. 27 meeting of the Broward Legislative Delegation. The location: the Memorial Regional Hospital conference center in Hollywood. Large screens at the front of the room, above the heads of lawmakers, touted the “better together” partnership between the two systems that began almost nine months ago.
Multiple commissioners from the hospital systems’ governing boards were at the legislative delegation meeting, along with hospital staff and supportive elected officials who aren’t members of the Legislature. After the 2025 legislation was filed in Tallahassee, some commissioners said they weren’t familiar with it.
“Last year we filed [the bill] relatively late. [The] legislative session was tied up with a lot of other issues,” Cassel said in an interview. “Now we have a lot of support under us from the community, from Broward County, that I’m going to be able to bring to Tallahassee to say, ‘This is something the county needs. This is good for Broward. This is good for the community. And it’s good for the residents.’”
Hospital districts
What now operates as Broward Health is the brand name for the North Broward Hospital District, the government district that operates hospitals and other health services in the two-thirds of the county north of Griffin Road. It’s an evolution from what was called Broward General Hospital when it opened in Fort Lauderdale in 1938.
Memorial Healthcare System is the brand name for the South Broward Hospital District, which provides services in the southern third of the county.
Each district is overseen by separate boards of commissioners appointed by Gov. Ron DeSantis.
Strum was DeSantis’ chief of staff during the first half of the governor’s first term. He was hired as president and CEO of the North Broward Hospital District in February 2021. In September 2024, the boards of both districts approved his appointment as interim CEO of the South Broward district.
Earlier in his career, Strum was senior vice president at the South Broward district.
Collaborate or merge?
During his presentation to lawmakers, and later in an interview, Strum emphasized enhanced collaboration, not the politically fraught concept of a merger. He said the “merger” is “not accurate.”
“This legislation is not a merger,” he said, adding the districts “will continue to operate in the sunshine and transparency, and with legislative oversight.”
Some viewed the 2025 effort as a way to effect a merger. Strum said the word “merger” was used against the proposals by opponents.
“We went up [to Tallahassee in 2025] thinking we’d be OK. We had all the support in the world, but let’s just say our competitors were unhappy with the two systems working together, and they were able to frame the conversation. They just said, ‘Hey, that’s a merger. It’s a merger,’” Strum said.
Some leaders in Broward believe the two systems should merge.
“I think we should move toward that. I think we should work toward a merger and one hospital district. It could be very economical at a time when we’re so concerned about the cost of health care,” said County Commissioner Nan Rich, a former Florida Senate Democratic leader. “I’m not saying overnight. I’m saying begin with a strong collaboration and move toward a merger of the districts.”
Miami-Dade County has one hospital system and Palm Beach County has one government health care district. Rich and Tanner said Broward’s two-district setup — created seven decades ago — is a historical anachronism.
“We’re only one of the 67 counties that has split its health care. There’s a lot of reasons why it was split in the ’50s, but today there is no reason to have it split. And so it’s just more efficient, particularly as people look to address costs,” Tanner said.
He said he wasn’t advocating for a merger, and echoed Strum’s statements that the legislation being sought now wouldn’t bring one about.
Merging is a “complicated question. Maybe in five years, 10 years down the road that becomes obvious,” Tanner said. “But today I think you just have to be able to deliver health care as best you can and as efficiently as you can just to provide the best benefit to the taxpayers of Broward County. You’ve got to take it one step at a time.”
Harrison, one of the longest-tenured commissioners on the South Broward Hospital District Board, where he is a former chair, said the county is a far different place than it was when the separate districts were established.
And, he said, it’s different than it was when he was growing up in the 1970s in southwest Broward and a trip north was a major excursion; physical distance was a much greater obstacle than today.
He said merging the districts is “a political nonstarter right now” and raising the question ends up overwhelming the discussion. “People think that there’s something going on, nefarious.”
Legislative maneuvering
Getting an idea through the Legislature and signed into law often takes more than one legislative session.
The biggest unknown is what HCA will do. The company’s media representatives didn’t respond to questions about why the company opposed the legislation in 2025 and whether it would oppose the 2026 version.
HCA fields a formidable lobbying force in Tallahassee.
During the 2025 session, the legislative lobbying database showed 23 people from seven different lobbying and law firms registered to represent the company.
Filings show Heather Turnbull, managing partner of Rubin, Turnbull & Associates, one of the state’s most influential lobbying firms, lobbied against the hospital district proposal in 2025, along with Oak Strategies.
Though they can’t make political contributions like the private sector’s HCA, Broward’s two hospital districts had significant lobbying firepower.
Powerhouse lobbyist Ron Book’s firm was among those trying to advance the legislation, along with lobbyists from the GrayRobinson law firm and from Continental Strategy, Ericks Consultants and Floridian Partners.
For the 2025 session, 15 people registered as lobbyists for one or both of the hospital districts.
The legislation
The 2026 legislation hasn’t been filed yet.
House Bill 1253 and Senate Bill 1518, which didn’t advance in 2025, said the hospital districts could “jointly enter into, participate in, establish, and control any venture, partnership, corporation, business entity, organization, joint operating network, service line, facility, or any other joint relationship or collaboration, public or private, for profit or not for profit, anywhere within the boundaries of either or all such special districts, if the governing bodies of such districts, in their discretion, determine that it is consistent with, and in furtherance of, the purposes and best interests of such districts.”
The legislation also said the districts “may exercise such powers, regardless of the competitive consequences thereof, including any actions that may be deemed anticompetitive within the meaning of state and federal antitrust laws.”
The Legislature’s blessing would provide immunity for “state action,” permitting acts normally seen as anticompetitive — but are allowed when they are deemed state policy and supervised by the state.
Opponents of the plan posted an anonymous petition on change.org asserting dire potential consequences from the 2025 legislation. “Clinics could close,” the petition said. “Procedures may be outsourced. Services that aren’t deemed ‘profitable’ may quietly disappear.”
Even though the legislation would authorize actions that could otherwise be deemed anticompetitive, Strum said it “opens up competition, leaning into the free enterprise system that allows us better to compete and serve better community goals. It creates economies of scale that will actually help lower health care costs in our community.”
This report includes information from South Florida Sun Sentinel archives.
Political writer Anthony Man can be reached at aman@sunsentinel.com and can be found @browardpolitics on Bluesky, Threads, Facebook and Mastodon.