Opinion: Florida is the first state to require EKGs for high school athletes. It’s a mistake

OpinionFirst Opinion Florida is the first state to require EKGs for high school athletes. It’s a mistake A well-intentioned law will lead to unnecessary stress and expense Manage alerts for this article Email this article Share this article By Katherine HofmannJune 30, 2026 Hofmann is a fourth-year medical student in the M.D./M.P.H. dual degree program at the University of Miami Miller School of Medicine. As a new 18-year-old during my first week of college orientation, I marched through the doors of the local hospital for an appointment I never expected to need. A few days earlier, I had undergone a mandatory electrocardiogram (EKG) to screen for potential heart problems before joining my varsity crew team. Soon after, I was told my EKG showed a possible abnormality, something that might indicate a condition that could cause a heart attack during exercise. I needed further testing before I could practice with my team. So there I was, in a new hospital, in a new town, sitting on a procedure table as electrodes were attached and medication was injected. Five minutes later, it was over. The result? I was completely fine. I paid the copay and went to Freshman Convocation.Advertisement A month later, I started receiving calls and letters from the insurance company and hospital. I had been left with a huge, unexpected bill, on top of the large amount my insurance had already paid. My family was fortunate enough to be able to cover this. Many would not be. That’s why I was concerned to see that Florida is now the first and only state requiring EKG screening for all high school athletes. While well-intentioned, this mandate is costly and ultimately more harmful than helpful. Beginning in the 2026-2027 school year, Florida’s Second Chance Act will require high school athletes to obtain an EKG before participating in sports. Students with abnormal results must receive medical clearance before returning to play.Advertisement The law says school districts are responsible for finding “partnerships to provide low-cost EKGs to each student,” and students are exempt if the school district cannot obtain them for less than $50 per student. But the real issue isn’t the cost of the EKG. It’s everything that comes after. In healthy adolescents with no personal or family history of heart disease, EKG screening can produce false-positive results in up to 15% of students, with even higher rates among Black athletes. That means for every 20 students screened, as many as three may be told something is wrong when nothing actually is. Those students are sent for additional testing, like cardiology visits, echocardiograms, stress tests, and monitors, which the bill does not address. These tests can cost up to thousands of dollars and are not always fully covered by insurance. At the same time, students are often held out of sports while waiting for clearance. What starts as a “low-cost” screening can quickly become expensive and stressful. These burdens don’t fall evenly. Students from lower-resource backgrounds are more likely to face delays in care, difficulty accessing specialists, or financial barriers to completing follow-up testing. Some families may decide not to pursue further evaluation at all, or may keep their child out of sports entirely. In trying to detect rare conditions, this policy risks excluding students from activities that improve mental health and physical well-being as well as offer future opportunities, like college scholarships. Sudden cardiac death in young athletes is absolutely devastating. The Second Chance Act is named for Chance Gainer, a Port St. Joe High School football player who collapsed on the field and died during an away game in September 2024. His loss moved lawmakers to act, and that impulse is right. But sudden cardiac death is also rare, occurring in roughly 1 in 70,000 adolescent athletes. And importantly, universal EKG screening is not what experts recommend. The American Heart Association and American College of Cardiology, two leading cardiovascular guideline organizations in the U.S., do not support routine EKG screening for all adolescent athletes. Instead, they recommend targeted screening based on personal and family history and physical exam. Policy should reflect that balance.Advertisement There are better ways for schools to protect student athletes, such as strong pre-participation evaluations, better access to automated external defibrillators at practices and games, and CPR training for coaches and staff. Because for many students, the difference between playing and not playing won’t be the EKG itself. It will be the appointments, the costs, the delays. I know this because I went through it, and with this new law, more families will, too. Katherine Hofmann is a fourth-year medical student in the M.D./M.P.H. dual degree program at the University of Miami Miller School of Medicine. She is applying into pediatrics with special interests in adolescent health and public health policy. Letter to the editor Have an opinion on this essay? Submit a letter to the editor. cardiovascular disease, children’s health, health care costs, law, Policy, states Submit a correction requestReprints Katherine Hofmann Newsletter The smartest thinkers in life sciences on what's happening — and what's to come Recommended First Opinion July 1, 2026 Maryland Gov. 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