Facing rising costs of insurance premiums, about 202,000 fewer Floridians purchased insurance from the Affordable Care Act Marketplace during the 2026 enrollment period.
It was one of the starkest declines in ACA enrollment across the nation, just behind Georgia, which had a decline of 206,000, according to new data released by the Centers for Medicare and Medicaid Services.
Despite the decline, Florida still has more ACA enrollees than any other state.
“While we do recognize that costs have increased, there still is a demand for coverage and a demand for work,” said Xonjenese Jacobs, director of the Covering Florida Navigator Program, which assists ACA customers in choosing a plan.
She says navigators experienced a lot of customer frustration over the jump in premium prices.
“Oftentimes they'll call, and they'll say, ‘Well, I thought this was supposed to be affordable,’” she said. “There was a lot of frustration, a lot of folks that say, ‘I think I did something wrong’ (seeing the high cost).”
According to KFF estimates, premiums were expected to increase by 114% on average nationwide. That’s because the federal government didn’t renew the “enhanced premium tax credit,” which kept monthly premiums down. In Florida, about 97% of customers used the tax credit, KFF research shows.
The enhanced premium tax credit became most effective in 2021 during the COVID-19 pandemic when the American Rescue Plan Act increased subsidized payments and removed the income limits, so a household with an income above 400% of the federal poverty line could qualify.
Since that time, ACA enrollment saw sharp increases in Florida from a total enrollment of 2.7 million customers in 2022 to 4.7 million in 2025.
During this year’s coverage period, total customer enrollment fell to 4.5 million.
“Consumers were increasingly concerned about higher premiums following the expiration of enhanced premium tax credits, with many indicating that affordability was a primary factor in their enrollment or re-enrollment decisions,” Jacobs said.
Jacobs says the types of plans consumers typically buy also shifted. Consumers focused more on cheaper monthly premiums in exchange for a higher out-of-pocket deductible.
In some instances, consumers decided to forego “silver plans,” where they might have had an additional savings, but it cost them more money each month – for example, in some cases the premium jumped from $0.00 to $20 a month, Jacobs said. Many instead decided to go with a plan that was $0.00 in a “gold plan” category, but has a higher max out of pocket.
“When we're looking at the numbers, it just tells me that Floridians want access to affordable, quality health care, and they're willing to ensure that this is one of those priorities for themselves and their family,” she said.
Earlier this month, the U.S. House of Representatives voted to extend the tax credit by another three years. The U.S. Senate is discussing its own version of an extension, but no movement has been made yet.
While open enrollment is closed, special enrollment remains open for people who experienced a significant life change. The Covering Florida Navigator Program is also still open, with navigators ready to answer questions on the best plans to fit an individual or family.
Those interested in speaking with a navigator can visit coveringflorida.org or call 877-813-9115.
