WLRN has partnered with PolitiFact to fact-check Florida politicians. The Pulitzer Prize-winning team seeks to present the true facts, unaffected by agenda or biases.
As the government shutdown entered its third week, Democrats continued to withhold their support for a government funding bill unless Republicans agree to extend expiring Affordable Care Act marketplace subsidies.
A Democratic lawmaker said Florida will be affected by the expiring subsidies more than any other state after the Nov. 1 ACA enrollment start.
"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. "4.6 Million Floridians will see HUGE healthcare hikes of 75% or more unless Congress fixes it. The clock is ticking!"
Soto, who represents Florida’s 9th Congressional District, which includes eastern Orlando and the cities of Kissimmee and St. Cloud, expanded on his point in an Oct. 12 Orlando Sentinel opinion editorial. "The top 10 Obamacare congressional districts are all in the state," Soto wrote. "Our district has the second-most enrollment in the nation, with 271,000 people receiving the Premium Tax Credits."
Without congressional action, the pandemic-era enhanced ACA credits will expire Dec. 31, and researchers estimate premiums around the U.S. will rise by more than 114% on average for enrollees who use the credits, leading to an estimated 3.8 million more people becoming uninsured over the next decade.
Health care experts said Soto’s Florida warning is on point.
"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 and KFF estimates 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. 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 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, making the ACA the main pathway for people with lower incomes to obtain affordable coverage. Many people with ACA coverage are self-employed or work for a small business.
About 2.4 million Floridians 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, 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 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.
Our Sources
- X.com, Rep. Darren Soto post, Oct. 13, 2025
- Orlando Sentinel, Commentary: Florida hit hardest by Obamacare cuts | Rep. Darren Soto, Oct. 12, 2025
- KFF, ACA Marketplace Premium Payments Would More than Double on Average Next Year if Enhanced Premium Tax Credits Expire, Sept. 30, 2025
- KFF, Which Congressional Districts Could See the Greatest ACA Premium Payment Increases?, Oct. 9, 2025
- KFF, Marketplace Enrollment, 2014-2025, Accessed Oct. 16, 2025
- American Cancer Society, State Data on Enhanced Affordable Care Act (ACA) Tax Credits, Dec. 13, 2024
- NPR, 5 things to know about the health care fight behind the shutdown, Oct. 12, 2025
- NPR, A push is underway for voters to make Florida the next state to expand Medicaid, March 22, 2024
- Florida Policy Institute, Raising the Alarm on the Oncoming Tidal Wave of Health Care Coverage Loss for Florida, Aug. 20, 2025
- Healthyfla.org, Press Release: Floridians Raise Alarm Over Soaring Health Insurance Premiums and Looming Expiration of Tax Credits, Accessed Oct. 15, 2025
- Congressional Budget Office, Distributional Effects of Public Law 119-21, Aug. 11, 2025
- Congressional Budget Office, The Estimated Effects of Enacting Selected Health Coverage Policies on the Federal Budget and on the Number of People With Health Insurance, Sept. 18, 2025
- The Washington Post, Who will lose out when ACA health insurance subsidies expire?, Oct. 14, 2025
- Urban Institute, 4.8 Million People Will Lose Coverage in 2026 If Enhanced Premium Tax Credits Expire, Sept. 17, 2025
- KFF, How Will the 2025 Reconciliation Law Affect the Uninsured Rate in Each State?, Aug. 20, 2025
- Email interview, Belen Sassone, spokesperson for Rep. Darren Soto, Oct. 16, 2025
- Email interview, Sabrina Corlette, research professor at Georgetown University's Health Policy Institute, Oct. 16, 2025
- Phone interview, Cynthia Cox, vice president of the ACA program at KFF, Oct. 16, 2025
- Phone interview, Jessica Banthain, senior fellow at the Urban Institute’s health policy division, Oct. 17, 2025
