The preliminary numbers are in and Florida saw the most people of any state stop getting their health insurance through the Affordable Care Act (ACA).
Congress failed to approve extended subsidies for the Obamacare health insurance plans beginning with the new year, leading to sharp premium increases for tens of thousands of people in the state.
More than a quarter of a million fewer Floridians now get their health coverage through the ACA, the largest net drop in the country. About 4.5 million people in the state signed up for a plan this year, according to data released this week by the Centers for Medicare and Medicaid Services (CMS). That's a decrease of 5.5%.
Nationwide, the number of ACA enrollees fell 6.3%, or 1.5 million people, comparing the CMS report to 2025 data from KFF. Almost 23 million Americans signed up for health plans that took effect Jan. 1. Forty three states saw enrollment drop compared to last year.
Florida continues having more people on the exchange than any other state. Texas actually experienced an increase in ACA enrollment this year – up 3.7% to 4.1 million people.
The federal government report indicates almost 20 million people who bought plans this year were returning patients and 2.8 million new enrollees signed up across Healthcare.gov and all the state exchanges. Florida does not have a state exchange and instead participates in the federal Healthcare.gov plans.
The debate over expiring COVID-era expanded subsidies to help people pay their premiums was at the heart of the longest federal government shutdown in October. Democrats wanted to continue with the extra payments while Republicans refused, insisting that the issue should be discussed separately after reopening the government.
Spending bills were approved and the government reopened in mid-November, however, any effort to extend the extra tax credits failed. They ran out at the end of the year.
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