Democrats Warn About Florida’s Looming Health Care Crisis

Florida has more to lose than any other state if Congress doesn’t extend enhanced premium tax credits for so-called Obamacare coverage.

That was the message a trio of Democratic members of Congress delivered Tuesday on Day 14 of the government shutdown. At the center of the shutdown is a partisan battle over extending the tax credits to lower the costs of health care coverage. 

The credits expire at the end of the year. Democrats are holding up government funding to pressure Republicans into extending them. While Republicans have said they are open to talks, they insist Democrats vote to continue government operations until late November.

“If Trump and Republicans continue to refuse to negotiate our way out of this health care coverage crisis, it’s going to be absolutely brutal, disproportionately for Florida,” said U.S. Rep. Debbie Wasserman Schultz, a Democrat from Weston.

Florida leads the nation in the number of people who purchase insurance through the federal exchange (healthcare.gov), which was established under the Affordable Care Act (ACA), sometimes called Obamacare. 

U.S. Centers for Medicare & Medicaid Services data from March show that of the 4.7 million Florida residents with an Obamacare plan in 2025, 4.6 million receive the tax credits.

Obamacare enrollment for 2026, meanwhile, is set to begin next month.

“If these credits expire, millions of people will — and thousands of people that we represent,  really, hundreds of  thousands — will face double, triple, or quadruple price hikes in their [health insurance] premiums. That’s not exaggeration or hyperbole. We’ve seen the notices,” said Wasserman Schultz, whose district includes 209,000 Obamacare enrollees, 203,000 of whom receive the tax credits. 

“We’ve talked to insurance companies and we know that that’s what’s coming,” she added. “And you all know what that really means. Families will be forced to drop coverage, chronic diseases will go undiagnosed, ERs will be flooded.”

Joining Wasserman Schultz in a Zoom meeting were U.S. Reps. Darren Soto and Maxwell Frost, who said the loss of the enhanced premiums plus Florida’s decision to not expand Medicaid to low-income childless adults will prove devastating.

Soto said his congressional district has the second highest Obamacare enrollment (271,000) in the nation.

“And there’s a good reason for that. We have a lot of folks working for small businesses. We have a lot of folks who are independent contractors, and they don’t have access to affordable, employer-based health care, so they’ve gone on the exchange, and the fact that Florida didn’t expand Medicaid only made it more desperate for folks to have to use the ACA exchange,” Soto said.

He added: “Remember when Donald Trump ran on lowering costs? Well, now he’s running away from lowering costs with this key negotiation.”

Advanced premium tax credits have been available since passage of the Affordable Care Act. During COVID, Congress agreed to make the premium tax credits more generous. Those enhanced credits lower out-of-pocket costs for the coverage and allow people who earn more money to qualify for the subsidies.

Only Alabama, Mississippi, and Texas (all of which have lower Obamacare enrollment) have lower average monthly premiums.

While the battle over the tax credits has been partisan, conservatives including Associated Industries of Florida President and CEO Brewster Bevis, Florida Hospital Association President and CEO Mary Mayhew, President and CEO of Florida Association of Community Health Centers Jonathan Chapman, and President and CEO of the Florida Hispanic Chamber of Commerce Julio Fuentes aligned under the Florida Conservatives for Affordable Health Care moniker and came out in support of their continuation over the summer.

“I have been around this debate over health care coverage for decades and, while the politics of the ACA have been heated over the years, there should be a unified political voice in support of the federal marketplace and the premiums assistance in Florida,”  Mayhew said during a press conference this summer.

U.S. Sens. Rick Scott and Ashley Moody both oppose extending the tax credits. Moody’s position could hurt her election bid next year, a public opinion survey conducted by the Tyson Group shows.

Scott, the multimillionaire former health care executive who launched his political career opposing Obamacare, doubled down on his opposition to the longstanding federal health care law last week on Fox News’ The Sunday Briefing.

Working class hero

For his part, Frost said the argument is an extension of the battle this summer over the GOP’s “One Big Beautiful Bill” and that he was “proud” that Democrats are “standing strong” on the issue.

“We are the party of the working class, we’re the party of working people, and we don’t want people’s health care costs to go up anywhere from 50% to 300%. We don’t want millions of people in this country losing their health care, because we believe health care is a human right for every single person in this country, and that’s what we’re fighting for,” he said.

Frost said his office has asked constituents to share videos of themselves talking about the looming health insurance premium increases they face. His office, he said, has been posting them online.

One “heartbreaking” story he described involved a woman who said her monthly premiums were about to double.

“She’s having to cut from her grocery trips. She had to cancel a trip to go see her parents that she hasn’t seen in a long, long time. And a lot of people are considering having to change their housing situation because the rent is too damn high,” Frost said.

“We have to remember that Donald Trump is throwing us into this healthcare crisis while he’s also thrown us into a grocery store crisis, while he’s also thrown us into a housing crisis, even worse than it ever was before. Everything is so much more expensive.”

With wages stagnant and costs of living increasing, Frost said, “working people just need a break, and taking away their health care — it’s one of the most inhumane things a person can do.”

Silence

Meanwhile, state political leaders to date have been silent on the issue.

The three Democrats were critical of Insurance Commissioner Michael Yaworski and Gov. Ron DeSantis for not warning state residents about the increases.

“Absolutely,” Soto said when asked whether the governor and insurance commissioner should be making people aware.

“They can’t hide these numbers. Obviously, people want to know, and they should know, and there’s a duty to tell them ahead of time.”

Frost said DeSantis and Yaworski are motivated by political considerations.

“The governor knows that in about a year, he’s going to become pretty irrelevant on the national stage, and he’s trying to find relevancy. He doesn’t want to rub Trump the wrong way. And so instead of looking out for Floridians and what’s best for the people he’s supposed to lead and represent, he’s going to keep his mouth shut and continue to play partisan games,” Frost said.

OIR presentation

Meanwhile, OIR Deputy Commissioner for Life and Health Alexis Bakofsy updated the House Health Health Care Facilities & Systems Subcommittee Tuesday afternoon, including news that a statewide average 34% increase in premiums will take effect Jan. 1.

An OIR slide presentation shows the state expects Obamacare enrollment to “drop significantly during 2026 Open Enrollment with the expiration of enhanced subsidies & Federal Rule implementation.” OIR has a demographic breakout but Bakofsy said she didn’t have the information available with her.

She did tell committee members that 95% of Obamacare enrollees live in a county with at least four carriers. Monroe County is the only area in the state with only one health insurer offering an Obamacare plan through the exchange, the result of Aetna exiting the market (in Florida and nationally).

Bakofsy repeatedly said Florida consumers should shop, given the changes that are occurring.

“When I say ‘shop’ I mean understand how you’re going to be impacted both on the exchange but also what are your options off exchange. Every consumer is going to be different to the extent that we can provide you with resources so that they can go. I would hate for someone to come to Dec. 15 and realize that the plan that they had, the plan they want to keep, is no longer available.”

Bakofsy also told members that the OIR plans to collect data on enrollment and claims starting next year to ensure the office can effectively track participation in the market.

The OIR had not publicized the steep rate increases, a fact that Bakofsy acknowledged and which irked committee member and state Rep. Robin Bartleman, a Democrat from Weston.

Bartleman said many residents haven’t even received notice from insurance companies warning them of the rate increases (Florida law requires the notice to go out 45 day in advance. Bakofsy said that gives the carriers until mid-November to send the notices).

“So, what? What is your plan? Because everyone this committee, we’re going to be left holding that ball, and we had nothing to do with this. But you work for the state. You work for the governor. What are you going to do, because it’s not just low-income people or minority people. I can give you the numbers of every person in this community and how many people in your district aren’t going to be able to afford health care insurance. What can you do to help us, help Floridians get this information out?”