Frederica Wilson warns Miami-Dade will be center of health care crisis if Republicans don’t relent on subsidies

U.S. Rep. Frederica Wilson says Miami-Dade County will be the epicenter of calamity if Affordable Care Act (ACA) subsidies expire.

“We all know what is going to happen if these tax credits’ expirations are allowed to go into effect,” Wilson told Florida Politics. “That is what we are fighting for.”

The Miami-Dade Democrat released figures^[1] earlier this week showing that the 10 districts in the country with the most people enrolled for coverage through the Insurance Marketplace, better known as Obamacare, all sit in Florida. It’s a concern Democrats have sounded across the state^[2].

According to the Kaiser Family Foundation^[3], Wilson’s South Florida district has 258,000 individuals currently enrolled on Obamacare plans. That’s the third-highest number in the country, behind only districts represented by Republican U.S. Rep. Mario Díaz-Balart (300,000 enrollees) and Democratic U.S. Rep. Darren Soto (275,000).

But more importantly, all four congressional districts covering part of Miami-Dade County are in the top five. That includes districts represented by Republican U.S. Reps. Carlos Giménez (244,000) and María Elvira Salazar (236,000).

Wilson said it’s a looming nightmare for South Florida lawmakers, even if no Republican in Florida’s delegation will publicly address it. For the last nearly five years, Wilson has been the only Democrat representing Miami-Dade County in Congress.

“We don’t know how to even approach this in Miami-Dade County,” she said. “Our hospitals, our emergency rooms, our doctors’ offices, family health centers, everyone is just astonished and asking what we can do to circumvent this health care crisis. And it’s just alarming this is affecting one state so much, Florida, and one county, Miami-Dade.”

Díaz-Balart, Giménez and Salazar did not respond to requests for comment on whether Republican leadership should compromise on whether to eliminate subsidies. Wilson suggested that’s only because all are afraid of upsetting Speaker Mike Johnson or, more importantly, President Donald Trump.

“They are just as frightened as I am,” she said. “They are not sure how their constituents are going to handle this huge price increase.”

Soto, a Kissimmee Democrat, said he expects some solution to be reached soon.

“A lot of other House Democrats have been spending a lot of time in Washington trying to make the case for getting this resolved,” he said.

Meanwhile, Wilson said she has spoken with hospital leaders in the region who have stressed to officials the high percentage of patients who rely on ACA plans. The fear many have is that most, when confronted with premiums that leap thousands of dollars each year, simply won’t reenroll. That means emergency rooms will eat the costs of treating people who show up for all levels of care there, exactly the situation the ACA aimed to address when it was passed more than 10 years ago.

Wilson personally feels appalled that the U.S. remains the only Western nation without single-payer health care. But more of her constituents are satisfied to keep the current financial burden they already absorb for insurance.

“They are not asking for it to be free, but are asking for it to be affordable,” she said.

That’s at least true of the ones already aware of the coming price hike. Many won’t be notified until November that their premiums will rise, either through notifications in the mail or when it’s time to reenroll. If the federal shutdown has lingered until then and Republican leadership hasn’t offered any compromise on subsidies, she expects the number of calls coming into Florida offices to skyrocket.

As things stand now, only House Democrats, outside of Republican leadership, are even holding office hours in Washington. That surprises Wilson, who has served through past shutdowns and saw constant negotiations even if a solution took a long time to be reached. This has fed a sense throughout Capitol Hill that the shutdown won’t end any time soon.

“But when everyone is suffering, I’m not sure the American people are going to continue to accept this,” she said.