The number of Floridians relying on a federal health care exchange established under the Affordable Care Act has dropped by more than 261,000 people after Republicans in Congress let expire the enhanced premium tax credits that help hold down coverage costs.
The Centers for Medicare & Medicaid Services said 4,474,300 Florida residents used the federal health exchange known as healthcare.gov to procure health insurance for 2026, down from 2025 enrollment of 4,735,415.
Florida Health Justice Project policy director Melanie Williams called the 5.5% drop in coverage a “warning sign for families and for Florida’s economy.”
“When people lose health insurance, they delay care, face higher medical debt, and are more likely to end up in emergency rooms, which drives up costs for everyone. This enrollment dip doesn’t just affect individual households, it puts pressure on hospitals, local governments, and the state budget, and it underscores how fragile access to affordable coverage remains for working families across Florida,” she said in a statement to the Florida Phoenix.
“Florida Health Justice Project will continue to fight for vulnerable Floridians who deserve access to meaningful health coverage,“ Williams added.
Nationwide, nearly 22.8 million consumers had signed up for 2026 coverage, also a dip from 2025 enrollment of 23.6 million.
Despite the decline in 2026 enrollment, Florida still leads the nation in ACA, or Obamacare, enrollment, ahead of Texas, where 4,113,465 people enrolled.
Open enrollment for 2026 health insurance coverage began Nov. 1 and ended Dec. 15 for policies that took effect Jan. 1, 2026. Enrollment continued through Jan. 15 for Feb. 1, 2026 coverage.
The fate of the enhanced premium tax credits has been source of constant speculation and wrangling in Congress.
–Christine Sexton, Florida Phoenix
Richard Fay says
It is bad enough that folks are losing access to the market place across the country but in Florida the State has cut 10,000 people from the Ryan White AIDS Drug Assistance Program. Folks will lose access to these life saving drugs as of March 1st. The State mailed letters out this month, as announced two days ago, informing recipients, who depend on this care to remain healthy and increase the health and wellbeing of our communities. Accessing the needed medication and medical care to address potential illnesses before they result in a serious condition that potentially leads to death is a tall order for individuals of any socio-economic status. It is sad. See Tampa Times article: https://www.tampabay.com/news/florida-politics/2026/01/14/hiv-aids-drugs-costs-aca-desantis-ladapo/
BTW, open enrollment closed on 1/15 and it is unclear what alternative are available to these patients. Stopping medications abruptly or not taking them as prescribed can result in death, unfortunately not quickly but a slow withering away.
R.S. says
Even Greenlanders don’t want to become part of the US because of our abortive healthcare options as one of the main reasons. In fact, it’s amazing that anyone wants to become US citizen with our abortive healthcare.
Al says
Are you people aware that retired people pay $205 per month. Then I see a supposed business owner crying that hers is going up from $ 20 per month. I know of couples of SS that pay $400 between them and no one cares for them. When you want to cry and rant about the cost then join the movement to make Medicare free. After all these people have been paying into it for years. Sorry Charlie but go cry your elephant tears somewhere else.
Kennan says
We are conditioned little animals. That’s all we are. How telling and sad it is when Americans are willing to play Russian roulette, and bypass healthcare altogether. The so-called richest country in the world, that could afford to give Americans healthcare for all would rather see American suffer. For profit. PURE PROFIT.
Our for profit healthcare system is the worst in the world! Bar none! Great doctors. Great nurses. Great equipment. SHTTY SYSTEM.
Oh, and if you’re a Republican you gave away your rights to weigh in on healthcare almost 20 years ago. The Republicans never tried to weigh in with a plan on healthcare when Ted Cruz held Hill hostage, because he had a problem with a black guy being president. How dare he try to give 27 million Americans healthcare access!
Richard Fay says
Thank you for the example it required research but I think what I discovered clarified the issue to my satisfaction but I do wonder what was the business owner referencing. I am just shy of being able to enroll in Medicare, I do think some scheme similar to Medicare for all would greatly benefit all citizens and I would like to say it will result in cost savings but I do not have any data to support that claim.
Medicare for all would definitely be of benefit for the next generation and may likely result in better health outcomes in the US. The available international data shows that the US spends the most on health care and shows the poorest outcomes. See the several Commonwealth Fund reports “Mirror, Mirror on the Wall” https://www.commonwealthfund.org/search?search_api_fulltext=Mirror,%20Mirror%20on%20the%20Wall&sort_by=newest The reports were produced at regular intervals.
Regarding the claim about the business owner if the plan was purchased through HealthCare.gov or the other mechanism Florida has developed for individuals and families to enroll in a health plan (there is another approach to accessing insurance for small businesses 2 – 50 employees, but I am not familiar with how it works) the statement “hers is going up $ 20 per month” is not supported by the available public data. Possibly her prescription co-pay was increasing by $ 20. The following reports lay out the costs and increases year over year 2024 – 2025 https://floir.gov/docs-sf/life-health-libraries/federal-health-insurance/2025-plan-year/individual-ppaca-market-monthly-premiums-for-plan-year-2025.pdf?sfvrsn=32ca0453_2 and the average 2026 costs across the State of Florida by County https://floir.gov/docs-sf/life-health-libraries/federal-health-insurance/2026-plan-year/aca-2026-web-tables-individual-subsidy-individual_final.pdf?sfvrsn=1d9b1e0b_1
Al says
The business owner was on WESH news crying about her rate. She had some boutique shop which was probably a hobby disguised as a business. I don’t back Medicare for all, only for those that have paid into it for 50 years of their lives.
The problem with obamacare is it covers everything no matter how stupid of a lifestyle you live. Sometimes people have to take responsibility for things they do and not expect everyone else to bail them out.
Pierre Tristam says
AI is misinformed. Obamacare by no means covers “everything,” as indeed Medicare does. It covers a bare-bones base and forbids denying insurance to those with preexisting conditions. Beyond that, it’s the usual bevy of private insurers’ stinginess and absurd deductibles and other out of pocket expenses. AI, whose hobbies are bigotry and homicidal cruelty, wants his Medicare and is happy to deny equal coverage to all. We’re all paying for it.
Joe D says
I’ve got to clarify one point. Although “regular” Medicare ( as opposed to Medicare “Advantage “) does have a robust list of coverages, Medicare does NOT cover “everything.” I have a list of my PRE-Surgical lab work for $300 sitting on my desk at home, that was denied by Medicare ( one of the reasons why, was the lab tech needed to MANUALLY input the lab request due their automated registration system being down that day…she failed to put the MD REASON for the lab work). I did appeal, and got most of my money back, but not all.
There are several treatments and procedures that are still “denied” by Medicare retroactive audits, despite being ordered as medically necessary by Physicians. Thankfully those denials are no where near as frequent as most of the FOR PROFIT Medicare “Advantage” plans whose cheaper costs to consumers are FREQUENTLY the results of RIDICULOUS and TIME CONSUMING preauthorizations and denials of payment to providers . I know of the Advantage plans high denial rates personally from 18 1/2 years as a Utilization Management Review Nurse, who had to supply documentation of “Medical Necessity” for treatments and assisted in “standard” Medicare and “Advantage” Medicare plans appeals for denial of payment.
I do agree with Pierre that the only way the private Advantage plans can turn a profit is their FREQUENT “stinginess,” and the high deductibles and out of pocket copays, along with their high levels of DENIAL of either pre-authorization or denying “medical necessity” after the fact.
R.S. says
AI, your comment is infuriating. What misstep should be penalized for a lifetime, in your view? So, I smoked for many years. Did I know that it would harm me? The cigarette companies spent millions to dissuade me from making the assumption that it would eventually hurt me. Now I’m stuck on a habit. You would deny me any medical help? Unless I happen to have been one of those tobacco moguls who made it rich and can pay my healthcare way? Under single payer no one bails anyone out; we simply chip in a tiny amount for someone whose cost otherwise would kill him or her. Or do you think that someone who got stuck with the wrong genes and didn’t know it should go down with any disease? What notion of justice lurketh behind this comment?
Richard Fay says
I did a google string search “WESH 2 healthcare market increase 2025 business woman”; if this is the correct story “‘A double-edged sword’: Brevard entrepreneur hit with major health insurance hike” https://www.wesh.com/article/brevard-entrepreneur-hit-with-major-health-insurance-hike/69713997
My perception of the Woman differs greatly from “crying”; she discovered her “premiums will more than double” she sounded like a rational person weighing the available options and trying to identify what will work given her situation; she thought about this seriously, exploring different scenarios, including entering a higher income, based on an optimistic projection (i.e. this is her fourth year and her projection is business will be better), a great statement of hope in her capacity, Brevard County’s economy and her current client base. Her planning seems prudent, possibly she may pay more upfront and avoid getting hit with a large expense at tax season, paying back subsidies. Even using the higher amount “her typical $95-per-month payment more than tripled”, using her lower estimated income the premium more than doubled. At the lower level of the available HealthCare.gov plans the maximum out of pocket cost is $10,000.00. The plan she is exploring is not a “Cadillac” class plan. It seems like a bare bones option for healthier young adults. See https://www.healthcare.gov/choose-a-plan/plans-categories/ for an explanation of Bronze, Silver, Gold and Platinum, there is a link pointing to an explanation of Catastrophic plans.
The article concludes with Rep Soto and Rep Haridopolos staking out the position of their respective party – this is the point in time that the “crying” begins. Unlike the Entrepreneur neither elected Representative helped us think about the issue or provide insight or a sense of direction as to how to address this problem as individuals or collectively.
That’s what I took from the video and written report. If I am referencing the wrong news story please correct me. Possibly by using the same search string you can locate the report you referenced.
Deborah Coffey says
I can’t wrap my mind around this. Why do Republicans still believe that the people they vote for and put into office actually care about them at all? Single payer is needed in a country the size of America and, no, it isn’t cheap. But, it could be paid for if Republicans would stop cutting taxes for the wealthiest among us. If we all just paid our “fair share,” we could all have healthcare without worry. Stop the greed. Commit to taking care of one another.
The pig was committed, the chicken was involved says
Who determines “fair share”?
Deborah Coffey says
Moral leadership determines “fair share.” The power hungry greed mongers are seeing the end of their days….
R.S. says
This is a typical question that keeps us from reaching the goal of Single Payer. Fear of paying for someone else!!! Very selfish and very dumb!!! Actually, as with taxes, your income determines your fair share–unless we can plan now what diseases we shall have in the rest of our respective lifetimes. The point is that the system is a one-for-all and all-for-one approach. If you have major surgery, I’d be happy to pay a share of it, as will everyone else; and you will be very happy to pay a tiny bit for my surgery also. The system is one where we all share in the cost of one person’s need. Remember Christianity’s lessons about loving your neighbor like yourself? Apply that system to healthcare and you get a single-payer system. Two ways to achieve it: (1) is to hold all insurance companies to principles of non-profit companies and (2) is to abolish all health-insurance companies and pay into one central pot to be doled out as needed. Bottle necks in the supply system will be taken care of by a kind of triage and not by wealth and power. Under (2), the physician, then, is practically in the employ of the society for the good of all. No more pre-existing conditions; no more “we cannot take the risk of insuring you because you might cost us something–and we need to stock up our CEO’s income and boni for next year.”
Larry says
I am one of the Floridians currently on an ACA plan aka Obamacare. So grateful that ACA exists. Wish we could enroll in Medicare early for an extra “early enroll” premium. I would be glad to get on original Medicare early and would gladly pay a lot extra for this option, but this option doesn’t exist. Wish orig Medicare was one of the ACA plan options along with the other private plan options we could choose from. This way people can pick the plan that works best for them. Orig Medicare has a much wider network of providers compared to many of the existing marketplace plans.
Joe D says
In the concern about “fair share”…taxes are income based.
However my Medicare B premium is the same, whether I make $60,000 per year or $35,000 per year. Now someone at the lowest end of the Social Security benefit scale “MAY” qualify for supplemental MEDICAID coverage which usually takes care of the “copays” and “deductibles” I would normally pay for myself at the higher level of retirement income( or I could choose a Medicare “Advantage plan” but then I frequently would have to get PREAUTHORIZATION for treatment and some meds, I have to chose a MD and hospital /lab “IN NETWORK” with the insurance plan, and I might NOT be able to use that Plan away from my home “in network” area). However in addition to the $205 Medicare B monthly payment, I have elected to buy a Medicare private supplemental plan, which covers the medical copays and any normal deductibles after the Medicare basic ~$275/ year deductible. That coverage costs me an ADDITIONAL $260/ month (and then another $40/ month for a medication plan that doesn’t kick in until I’ve spent $450/ year out of pocket for copays). Luckily I have fairly BASIC 3 medications that have copays that total about $100 every 3 months…so technically none of my medications are covered by my insurance until I’ve spent $450/ year. So…if I’ve done my math correctly my (one person) medical coverage with Medicare is $505/ month. It’s a very good plan…no surprise bills even if I’m admitted to the hospital 4 times in a year ( my expensive supplemental plan covers the hospitalization admission cost each time). There ARE CHEAPER supplemental plans, but they come with more copays and deductibles and do not pay the hospitalization admission cost, which goes up EACH YEAR. If I was still married, those costs would be DOUBLED each month! Technically the ADDITIONAL monthly cost of Medicare A (pays hospital fees) has been paid for out of each paycheck my ( and your) ENTIRE WORKING LIFE! So the TOTAL cost of my Medicare coverage is MORE than $505/ month!
I am FORTUNATE (at least at the moment) to be able to afford these yearly increasing medical insurance costs…but each year the Cost of Living Social Security increase BARELY covers the increase in Medicare B , supplemental coverage and medicine coverage. Although I do have to praise President Trump for putting pressure on Drug companies to lower some medication costs. My Medication plan through my private insurance company was actually $20 CHEAPER for 2026 than last year, but lots of ( more expensive) Medications ( luckily none of mine) have been dropped from insurance coverage, or they have increased the copay for those meds erasing the $20 cut in premiums. There is an upper limit ( passed by the BIDEN Congress) that set an upper limit for medication deductibles out of pocket each year. However to get around that limit, many insurance companies have simply STOPPED COVERING THOSE MORE EXPENSIVE MEDS!
I’m a retired nurse that has worked for 18 1/2 years(out of my 43 year Nursing career) in Hospital Utilization Management and review…and keeping track of this all makes MY HEAD SPIN!
Larry says
@Joe D: Your Medicare Supplement plan sounds good – I think it’s what I’d like to get when I reach Medicare age. What is the letter (G?) of your Supplement (Medigap) plan?
Joe D says
Yes My Supplemental plan is plan “G”….it’s comprehensive along with the automatic Medicare A hospital coverage( from lifelong paycheck deductions) Medicare B ( for doctors bills) and the Medicare D for medications. The supplement G balances a little bit of copay ($275 per year) …there is a plan N that is cheaper , but has MD copays for each visit, and more deductible payments.
I also realized I didn’t mention in my first post optional Medicare DENTAL coverage ~$45-65/ month for basic coverage, and Medicare vision plans ~ another $50-70/ month. I have chosen not to purchase those 2 additional plans, and pay out of pocket when I use those services.
Most Medicare “Advantage “ plans have SOME limited dental and vision coverage included in their basic fee, but check EXACTLY what they cover, because FREQUENTLY it’s just bare bones added care.
R.S. says
How bizarre a quilted system of bits and pieces?! Why are we not pushing for a simpler and kinder system than all this patchwork? Not everyone delights in memorizing this messy arrangement of private companies trying to make a buck for themselves!
Joe D says
There is probably not a big push for a one system medical payer, because it’s the COST…think of EVERY taxpayer having to absorb $513/ month to provide their medical services ( I just realized when I paid my February Medicare supplemental bill it went from $245–> $253…so my earlier listed total of $505/ month for a FAIRLY COMPREHENSIVE Medicare plan(s) is now $513/ month )…with no vision or dental benefits. And the payments ( under a one payer system) would probably be higher for taxpayers making higher salaries vs those at the lower end of income levels, rather than the across the board $513 charges everyone pays now. Only Medicare A is “required” but any other costs ( Medicare A only pays 80% of hospital costs…no doctors bills or out of hospital care), would have to come out of pocket if you didn’t choose Medicare B, a supplement plan ( or a narrow network “Advantage plan” with frequent pre-authorization requirements and frequently high levels of denial of payments once your care starts getting costly to the insurance company) , and at least a medication “D” plan ( and your “option” of dental and vision).
Kind of why the United Kingdom ( Great Britain) hospitals/Nurses/Doctors are protesting and striking for the low level of government salary payments under their National Health Insurance. Many English citizens decide to buy EXTRA PRIVATE medical insurance, because increasing groups of English doctors are not participating in the National Healthcare Insurance system.
There is no EASY ANSWER to these questions…currently the Republican controlled Congress doesn’t even want to consider extending the AFFORDABLE CARE ACT “subsidies “ for lower income workers…IMAGINE if there was a push for a one payer system costing $513/ month (per citizen)!?!
R.S. says
Joe, you need to revisit your assumptions. Simple example: Jardiance made by Boehringer Ingelheim costs in Europe €200 for a one-month supply; a strictly regulated insurance system pays it. In Canada with a national healthcare system, it costs for a one-month supply CA$120 but to the patient nothing; in the US under the silly patchwork system and a major deal-maker in the WH, $700 for a one-month supply and if you’re lucky, the patchwork–depending on which patch you’re landing on and what deal you may have arranged for yourself–may pick up half of the cost. You forget that we’re paying more for healthcare than any other developed nation and we have a lower life expectancy than any other developed nation–if you consider that a homeless person in the US has a life expectancy of about 47 years and so on up the ladder of social and income strata until you get to the wealthy oligarchs with a life expectancy of 90 plus years. And about those physicians not participating, I suspect you’ve been fed some fake news. Actually, you’ll find some of our physicians and hospitals not accepting anything but standard Medicare because the private companies have bean-counters at work who’ll tell the physician what s/he may or may not prescribe or do for you.
Pogo says
@Time and fortune come to all
… including the mercenary, bloodless, soulless sons-of-bitches responsible for the so-called health care system of the United States of America.
Here is a search string, and a prescription: read twice and say goodbye.
https://search.brave.com/search?q=death+from+shit+life
You may not be able to change the world, but at least you can embarrass the guilty.
— Jessica Mitford
https://www.brainyquote.com/authors/jessica-mitford-quotes