The State of Florida has experienced the largest drop in Affordable Care Act (ACA) enrollment in 2026 across the U.S.
The new data from the Center for Medicare & Medicaid Services (CMS) comes after enhanced tax credits under the American Rescue Plan Act of 2021 (ARP) expired.
440,000 Floridian Exodus
According to the data, more than 440,000 Floridians left the ACA marketplace entirely after premiums reportedly increased an average of 58% among all consumers.
Initial reports from health policy organization KFF projected that premiums would increase by 114% for individuals who remain on the same health plans.
Instead, the 114% increase applied only to individuals receiving subsidies under the ARP who remained on the same plan rather than switching to higher-deductible coverage after the credits expired.
Tax Credits Helped Red States
In Mar. 2021, former President Joe Biden signed the ARP into law, which expanded ACA Marketplace tax credits for individuals earning 400% above the poverty line while increasing subsidies for those earning between 100% and 400% of the poverty line.
The tax credits helped lower premium payments for roughly 15 million uninsured people eligible to purchase health plans in the Marketplace and for nearly 14 million enrolled in the individual market.
According to an analysis from investment banking firm Raymond James, these subsidies significantly benefited Republican states that haven’t expanded Medicaid, such as Florida.
Between 2020 and 2023, ACA enrollment increased by more than 2.5 million individuals in Florida and Texas alone, with nearly 15% of Floridians enrolled in an ACA plan.
One Big Beautiful Bill Act
Changes in ACA enrollment and pricing are reportedly due in part to the One Big Beautiful Bill Act (OBBA).
The OBBA includes over $1 trillion in spending cuts to health care through 2034, impacting federal support for Medicaid, the ACA Marketplace, and Medicare.
Despite the largest drop in nation, Florida still leads in enrollments, with nearly 4 million in 2026.
