Florida faces the greatest impact nationwide if the expiration of ObamaCare subsidies occurs at year-end, a scenario growing more probable as Congressional Republicans struggle to agree on a plan to continue these tax credits.

Should these subsidies lapse, over 1.5 million Floridians might find themselves without healthcare coverage, as monthly premiums could soar. For those currently benefiting from enhanced ObamaCare subsidies, premiums may increase by 132 percent, or approximately $521 annually, as reported by the Center for American Progress.

Florida ranks highest in the nation for individuals enrolled in Affordable Care Act (ACA) marketplace plans. One in five residents, totaling 4.7 million people, currently receive subsidized health insurance, according to data from the Kaiser Family Foundation, an organization dedicated to health policy research.

The state’s significant population of small business owners and hospitality workers heavily relies on ACA plans, explains Erica Li, a health policy analyst with the Florida Policy Institute.

“Unfortunately, we are likely to see an increase in the number of uninsured individuals,” Li noted. “This is regrettable, as even younger people opting out of health insurance due to their current health should consider that unforeseen accidents or diagnoses can necessitate continuous healthcare coverage.”

The rising costs could also be front of mind for voters heading into next year’s midterms, though Susan MacManus, political analyst at the University of South Florida, said it’s too soon to say whether Democrats can gain an advantage in the increasingly red state.

“The bottom line is that we don’t know how it’ll play out, because we don’t know what the Florida legislature might do to affect health care costs. There are some proposals and bills that are on the table. They haven’t really been publicized much yet, so we don’t know exact details, a lot of moving pieces here, but without question, people are very worried about it,” MacManus said. 

“You can’t predict from one week to the next what’s going to dominate people’s thinking. And right now, the first thing on people’s minds is something that’s going to cost them more,” she added.

Gallup polling on Monday showed that across the country, ACA approval hit a new high of 57 percent, up from 54 percent in November 2024.

Carlos Otero, a 60-year-old Miami resident, is among the millions of Floridians bracing for rising health insurance costs. He used to own a small consumer research consulting firm, but was hit hard by cuts to the U.S. Agency for International Development earlier this year and has since turned to gig work to pay the bills. 

Unless Congress acts before Jan. 1, his premium of $20 for him and his husband through AmeriHealth is set to jump to $200. Otero said he plans on switching to a lower-cost plan that will also cover less. 

“For a household that is living from paycheck to paycheck [needing] to pay $200 [for healthcare coverage] will be $200 less for food, applications that I need to find [a] job or for [the] internet. [These] are vital,” Otero said. 

“We need to cover the basics, and having affordable care helps a lot,” he added.

Florida is also among a handful of states that declined to expand Medicaid coverage during the Biden administration, further compounding concerns over health insurance costs. 

Eric Johnson, a Florida-based Democratic strategist, said the issue will have particular resonance with voters given a broader anxiety over affordability. 

“This is going to have hit them at a time that’s already hard, and I think Republicans and the administration will take a great deal of blame for that, and it is an issue Democrats will do very good to communicate,” Johnson said. 

Last month, Tony Fabrizio, a top pollster for President Trump, said one way for Republicans to steer conversations away from expiring subsidies would be to focus on reducing drug prices, given Trump’s recent deals with drug companies.  

Johnson said voters want to see action on drug prices and health insurance costs. 

“It’s certainly smart for them to be talking about drug prices as an issue, but people don’t see it as an either or. People see it as, ‘Yes, we need that fixed too,’” he said. 

Otero comes from a family of Cuban Americans who overwhelmingly voted for Trump. He sees his family changing their tune because of concerns stemming from healthcare affordability. 

“I am seeing right now more and more relatives that are very red, very Republican, considering changing. I have an aunt that became a citizen, and she voted for Trump, and now she called him ‘El Loco,’” Otero said, which means “The Madman.” “Now, she sees there are a lot of problems with health care as well because one of my cousins has a brain tumor that has been controlled [and] is being treated.”

“For them, affordable care is important, and they have been having issues too. So now it’s real.”

Florida ranks third in the nation for percentage of uninsured residents, topped only by Texas and Oklahoma, according to a Miami University report. 

Florida Policy Institute projects that rate could increase by 6 percentage points in 2026, from almost 11 percent to almost 17 percent, which would leave between 1.1 million and 1.9 million additional Floridians being priced out of receiving healthcare coverage. 

Public health and policy experts point out that the pain will not only be political. 

Aside from hurting the pockets of millions of Floridians, the state could lose $5.5 billion of its GDP and nearly 50,000 jobs, according to the Commonwealth Fund. 

Hospitals in Florida could also see an influx of uninsured people utilizing emergency services, which could put more strain on an already overwhelmed healthcare system, said Mary Mayhew, president of Florida Hospital Association.

Scott Darius, executive director of Florida Voices for Health, said people are overlooking the impact the coming ObamaCare storm will have on people who have insurance through employers or other programs. 

“We missed the lesson that we’re all really dependent on each other, especially in terms of public health,” he said.

“My big fear when you have this many more uninsured people introduced into the population [is] more disease and untreated conditions that continue to proliferate, but then you also have less money in the system to really bolster those points of care,” he added.