By Christine Sexton, Florida Phoenix
In Summary:
New data from the Centers for Medicare & Medicaid Services shows 4.47 million Floridians enrolled in health coverage through Healthcare.gov for 2026, down from 4.74 million in 2025. Advocates say the decline is tied to the expiration of enhanced premium tax credits that helped lower monthly premiums for many families. Florida still leads the nation in ACA enrollment, but health policy groups warn the true coverage drop could be larger once “effectuated” data is released later this year.
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The number of Floridians relying on a federal health care exchange established under the Affordable Care Act has dropped by more than 261,000 people after Republicans in Congress let the enhanced premium tax credits that help hold down coverage costs expire.
Related: How 17 million Americans enrolled in Medicaid and ACA plans could lose their health insurance by 2034.
The Centers for Medicare & Medicaid Services said 4,474,300 Florida residents used the federal health exchange, healthcare.gov, to obtain health insurance for 2026, down from 2025 enrollment of 4,735,415.
Florida Health Justice Project policy director Melanie Williams called the 5.5% drop in coverage a “warning sign for families and for Florida’s economy.”
“When people lose health insurance, they delay care, face higher medical debt, and are more likely to end up in emergency rooms, which drives up costs for everyone. This enrollment dip doesn’t just affect individual households, it puts pressure on hospitals, local governments, and the state budget, and it underscores how fragile access to affordable coverage remains for working families across Florida,” she said in a statement to the Florida Phoenix.
“Florida Health Justice Project will continue to fight for vulnerable Floridians who deserve access to meaningful health coverage,“ Williams added.
Nationwide, nearly 22.8 million consumers had signed up for 2026 coverage, also a dip from 2025 enrollment of 23.6 million.
Despite the decline in 2026 enrollment, Florida still leads the nation in ACA, or Obamacare, enrollment, ahead of Texas, where 4,113,465 people enrolled.
Open enrollment for 2026 health insurance coverage began Nov. 1 and ended Dec. 15 for policies that took effect Jan. 1, 2026. Enrollment continued through Jan. 15 for Feb. 1, 2026 coverage.
The fate of the enhanced premium tax credits has been source of constant speculation and wrangling in Congress.
The drop in enrollment caught the ire of at least lawmaker. U.S. Rep. Darren Soto, a Democrat from Kissimmee, took to social media.
Florida Voices for Health Executive Director Scott Darius said the dip in Florida Obamacare sign-ups could be even greater than what appears because the new CMS data shows enrollment, which includes returning customers whose coverage was automatically renewed. CMS will release what’s called “effectuated” data later this year. That will show the number of people who have paid their premiums and have coverage in effect.
“We don’t know how many of them will actually keep the coverage,” Darius said in a statement to the Phoenix. He added: “The numbers also don’t show the people who are feeling the pressure of paying double for the same coverage, the impact of the people who are paying the same for less coverage.”
Key Points:
- Florida ACA enrollment fell from 4,735,415 in 2025 to 4,474,300 in 2026, a drop of more than 261,000 people.
- The decline follows the expiration of enhanced premium tax credits that reduced premium costs for many enrollees.
- Nationwide enrollment also dipped, though Florida remains the top state for ACA sign-ups.
- Advocates warn coverage losses can lead to delayed care, increased medical debt, and higher emergency room use.
- Experts say the final impact may not be clear until “effectuated” enrollment data shows who paid premiums and kept coverage.
This story has been updated to include comments from Florida Voices for Health and U.S. Rep. Darren Soto.
