Florida lost 450,000 ACA enrollees as Trump officials and analysts clash over why

At 40%, Florida has the smallest proportion of its workforce receiving health insurance through their employer in the nation.

The state also has one of the highest rates of individuals under age 65 who are uninsured and the highest number and proportion of users of health insurance subsidies under the Affordable Care Act , also known as the ACA or Obamacare.

In December 2025, Congress let ACA subsidy increases that were put in place during the COVID-19 pandemic lapse .

At that time, policy analysts and scholars predicted dire consequences for Florida .

The decision not to extend these increased government subsidies of health insurance premiums came after heated partisan debate in Congress and the longest federal government shutdown in U.S. history.

As a gerontologist interested in healthcare policy , I’ve been looking at the ACA enrollment data during the period since the subsidy changes went into effect to see how Florida residents were affected and how the state compares to the nation overall.

In July 2026, the health policy research group KFF reported the most recent available ACA enrollment data on people who both enrolled and paid their first insurance premium – a process known as effectuated enrollment.

This data looks at the period from January 2026 through the end of February 2026.

Who buys their health insurance through the ACA While the majority of American workers between the ages of 19 and 64 receive health insurance through their employers, many people, especially those who are self-employed or working for smaller businesses, do not.

Florida had and continues to have the most individuals insured through the ACA in the nation, with more than 20% of Floridians under age 65 using the ACA, compared to 7% for the nation overall.

The subsidy change controversy Under the original ACA legislation that President Barack Obama signed into law in 2010, everyone whose premium was subsidized by the federal government was required to contribute to their insurance plan premium.

People earning 115% of the poverty level – $18,000 in 2010 – contributed 2.1% of the plan’s cost, and those earning 400% of the poverty level, which was $60,240 in 2010, contributed 10%.

Individuals earning above that amount were not eligible for the subsidy.

In 2021, in hopes of alleviating economic pressures during the pandemic , Congress passed legislation eliminating premiums for people with the lowest incomes and reduced the cost for people with higher incomes.