“FL will be HARDEST HIT by Obamacare cuts in the nation on Nov 1st,” U.S. Rep. Darren Soto, D-Fla., wrote Oct. 13 on X[1]. “4.6 Million Floridians will see HUGE healthcare hikes of 75% or more unless Congress fixes it. The clock is ticking!”
“Florida might be tied with Texas in the percentage of enrollment increase since the credits have been in place, but it has always had a lot of people signing up for the ACA,” said Cynthia Cox, vice president of the ACA program at KFF, a health care research think tank. “This might be due to demographics and the kinds of jobs residents have, but Florida would definitely be the top, or tied as the top state affected by these cuts.”
Soto’s office pointed PolitiFact to Congressional Budget Office[5] and KFF[6] estimates[7] for coverage loss and premium increases if the credits expire.
What will happen in Florida if the enhanced ACA tax credits expire?
Florida has more people enrolled in Affordable Care Act plans than any state — around 4.7 million in 2025[8]. About 97% of enrollees receive a discount that makes their plans cheaper.
In 2021, then-President Joe Biden signed legislation that made ACA subsidies more generous, by reducing the maximum amount enrollees would have to pay for coverage and enabling households whose incomes were higher than 400% of the federal poverty level to receive the subsidies. Congress renewed these enhanced subsidies in 2022 through the end of 2025, so they are now poised to expire.
Determining whether Florida would be the “hardest-hit” state if the enhanced credits expire depends on how that is measured. Data shows Florida as one of the top states, if not the top, for the number of people affected.
“There are different ways to measure the effects,” Cox said. “For instance, if it’s the steepest premium increases for a smaller number of people, that might be West Virginia or Wyoming.”
An Oct. 14 Washington Post analysis found[9] that Florida has the highest number of people receiving the enhanced credits, which could result in the state bearing the biggest blow, relative to its population, of residents becoming uninsured or experiencing steep premium increases. The analysis puts Texas second.
About 8% of ACA enrollees under 65 nationwide use the enhanced credit; but in Florida, the same share is 24% — the highest in the country, The Washington Post found.
That disparity is largely because Florida did not expand Medicaid eligibility[10], making the ACA the main pathway for people with lower incomes to obtain affordable coverage. Many people[11] with ACA coverage are self-employed or work for a small business.
About 2.4 million Floridians[12] with ACA Marketplace plans in 2025 earn under 138% of the federal poverty limit.
“When states expand Medicaid, anyone who makes below 138% of the federal poverty level is eligible for the program, so they’re not on the ACA marketplaces,” Cox said. “In states that didn’t expand Medicaid, like Florida, Texas and Georgia, residents can get ACA coverage and qualify for the enhanced credits.”
Another study[13], by the nonpartisan Urban Institute think tank and the Commonwealth Fund health care research organization, put Texas ahead of Florida for the overall number of people who will not enroll in ACA plans in 2026.
“In terms of absolute numbers of people becoming uninsured, our tables show Texas being hit harder,” said Jessica Banthin, a senior fellow at the Urban Institute’s health policy division and one of the report’s authors. “But in terms of population share, it’s very likely the case that Florida is being hit harder.”
A KFF analysis[14] found that, in every Florida congressional district, enrollees over age 60 who make just over 400% of the federal poverty level — about $84,600 for two people — will face premiums in 2026 quadruple what they pay now, on average.
Overall, lower- and middle-income Floridians will feel the brunt of expired subsidies.
“Especially an older couple who are early retirees who may still have a moderate income,” Cox said. “They won’t have any other option and may see a premium increase of $20,000 because they aren’t eligible for Medicare yet.”
Floridians with private employer-based insurance may also see indirect effects.
“If many more people in Florida become uninsured, then hospitals and other providers will face an increase in patients who can no longer pay their medical bills,” said Sabrina Corlette, a research professor at Georgetown University’s Health Policy Institute. “These costs are projected to result in service cutbacks, hospital closures and mergers, particularly in rural areas, which affect everyone.”
Our ruling
Soto said Florida will be the “hardest hit” state if ACA enhanced subsidies expire.
Florida has 4.7 million people enrolled in ACA plans in 2025, more than in any other state. One analysis found that 24% of Florida’s enrollees under age 65 use enhanced subsidies, the highest in the country, compared with 8% of enrollees nationally.
“Hardest hit” can mean many things. In terms of the share of enrollees relative to a state’s population, Florida is safely one of the most affected states, if not the most affected for people who will see premium increases or become uninsured as a result of higher prices. By raw numbers in another analysis, Texas might be first, because it has a bigger population.
Experts said other states such as West Virginia may face steeper premium hikes, but for a smaller number of people.
Soto’s statement is accurate but needs additional information. We rate it Mostly True.
References
- ^ wrote Oct. 13 on X (x.com)
- ^ opinion editorial (www.orlandosentinel.com)
- ^ by more than 114% (www.kff.org)
- ^ estimated (www.cbo.gov)
- ^ Congressional Budget Office (www.cbo.gov)
- ^ KFF (www.kff.org)
- ^ estimates (www.kff.org)
- ^ around 4.7 million in 2025 (www.kff.org)
- ^ Washington Post analysis found (www.washingtonpost.com)
- ^ expand Medicaid eligibility (www.npr.org)
- ^ Many people (www.kff.org)
- ^ About 2.4 million Floridians (www.healthyfla.org)
- ^ Another study (www.urban.org)
- ^ KFF analysis (www.kff.org)