Florida has experienced a significant decline in health insurance coverage following the expiration of enhanced subsidies for Affordable Care Act plans in December 2025. According to federal enrollment data, nearly 443,000 fewer people had healthcare coverage in Florida in 2026 compared to 2025, when 4.3 million people were enrolled in ACA plans. The expiration of the subsidies, which had been implemented during the Covid-19 pandemic, caused insurance premiums to spike across the country, but the impact proved particularly acute in Florida due to its large number of ACA enrollments and extensive gig economy workforce.
The timing of these coverage losses coincides with open enrollment and the general election, making healthcare access a prominent political issue in several competitive districts. In Florida’s 22nd Congressional District, Democratic nominee Pia Dandiya has centered her campaign on restoring the subsidies, reversing Medicaid cuts made by the Trump administration, and lowering drug prices. Her Republican opponent, Casey Askar, advocates for eliminating the ACA entirely while implementing fraud prevention measures for Medicare and Medicaid. According to United Health data from 2024, more than 10 percent of Floridians remain uninsured. The situation was further complicated by the passage of the One Big Beautiful Bill, which affected ACA subsidies and reduced federal Medicaid funding.
Experts and advocacy organizations note that confusion surrounding changing policies has compounded the coverage crisis. Many individuals are uncertain about their eligibility for assistance programs or have abandoned medical care after receiving notices of policy changes. Florida remains one of the states that has not expanded Medicaid coverage. As premiums are projected to rise again this November during open enrollment, healthcare concerns are influencing voter decisions across the state, particularly among those who have recently lost coverage or face affordability challenges.
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