Why is Florida on the brink of a healthcare disaster? Congress, fix this
Miami Herald
By the Miami Herald Editorial Board
This article originally appeared in the Miami Herald.
Applicants in Miami line up at a mall to register for Obamacare in 2014.
Miami Herald File
In less than six months, roughly 2.2 million Floridians are poised to lose their health insurance when enhanced premium tax cuts for the Affordable Care Act marketplace expire at the end of 2025.
These tax credits, first expanded during the pandemic, made insurance plans affordable for working families and retirees too young for Medicare. Now the tax credits are set to end unless Congress acts to extend them. If an extension isn’t granted, Florida will face a healthcare insurance crisis of epic proportions.
The Sunshine State leads the nation with 4.7 million enrollees in insurance plans under the ACA marketplace, a program also widely known as Obamacare. In Miami-Dade, roughly 54% of Miamians depend on this coverage.
“A healthcare disaster is approaching, and South Florida is in the eye of the storm,” warned Holly Bullard, chief strategy and development officer at the Florida Policy Institute and co-chair of Florida Decides Healthcare. “Miami-Dade relies more on the ACA marketplace than any other county in America.”
More than one in three residents of Miami-Dade use tax credits to pay for their healthcare, she said. Without congressional action, “...their healthcare is about to become dramatically more expensive.“
Two cities in Miami-Dade county will acutely feel the impact: Doral and Hialeah. That’s where the two ZIP codes with the most enrollees in 2022 were located. When the credits expire, federal data shows that proposed Florida insurance premiums are set to increase for ACA recipients between 18% and 41%, and some experts predict the state’s uninsured rate will increase as much as 50%.
The pending insurance crisis extends beyond premium increases.
President Donald Trump’s “One Big Beautiful Bill Act,” — H.R. 1 — which was signed into law on July 4, is likely to have enormous negative impacts on healthcare across the nation and especially in Florida. It cuts Medicaid coverage for millions of Americans as well as imposing more restrictions on the ACA marketplace, such as stricter income verification, shortened enrollment periods and the exclusion of Dreamers, undocumented children brought to the U.S. by their parents.
Roughly 2.4 million Floridians are enrolled in the marketplace and have incomes below 138% of the federal poverty level. These are people who don’t qualify for employer-sponsored insurance and earn too much or aren’t eligible for Medicaid, the public insurance program for the poor. In Miami-Dade, where affordability is already at the top of residents’ minds, premium increases could leave more families financially vulnerable.
Small-business owners and gig workers will also be affected. As Scott Darius, executive director of Florida Voices for Health put it, the “ACA has been so helpful for them in getting coverage.” Eliminating these affordable options now would leave those workers out in the cold.
When it comes to Medicaid, the pending cuts under H.R. 1 will have broader implications beyond recipients — hospitals are also at risk for losing funding.
“When it comes to what was in the H.R. 1, I think the biggest impacts will be on hospital funding,” Darius, told the Miami Herald.
Darius, who is also co-chair of Florida Decides Healthcare, underscored why Miami-Dade is uniquely vulnerable: “It’s just the sheer number of people who are enrolled in Medicaid or enrolled in the ACA, and who fall in the coverage gap already.”
There’s little that Florida can do on its own to avert this crisis. It requires action by Congress to extend ACA subsidies and protect Medicaid funding. The state could finally expand Medicaid — an option that would provide insurance up to 3.7 million Floridians — but that’s highly unlikely. Florida is one of only 10 hold-out states that have refused expansion since 2014.
Bullard pointed out that Medicaid expansion could blunt the impact of the pending health coverage crisis.
But South Florida’s Republican congressional delegation supported the One Big Beautiful Bill Act. Why aren’t they helping their constituents before one in five Floridians is without health insurance?
Darius said his organization has heard from Florida members of Congress that there’s “a lack of awareness that these tax credits are going to expire and that so many people rely on them.”
Whether you believe that or not, Floridians deserve better representation than members of Congress who vote for policies that will strip them of healthcare coverage.
Florida is about to become ground zero for a healthcare crisis, and time is running out for millions of Floridians on their healthcare coverage. In Miami-Dade County, the consequences could be devastating.
By the Miami Herald Editorial Board
This article originally appeared in the Miami Herald.
Applicants in Miami line up at a mall to register for Obamacare in 2014.
Miami Herald File
In less than six months, roughly 2.2 million Floridians are poised to lose their health insurance when enhanced premium tax cuts for the Affordable Care Act marketplace expire at the end of 2025.
These tax credits, first expanded during the pandemic, made insurance plans affordable for working families and retirees too young for Medicare. Now the tax credits are set to end unless Congress acts to extend them. If an extension isn’t granted, Florida will face a healthcare insurance crisis of epic proportions.
The Sunshine State leads the nation with 4.7 million enrollees in insurance plans under the ACA marketplace, a program also widely known as Obamacare. In Miami-Dade, roughly 54% of Miamians depend on this coverage.
“A healthcare disaster is approaching, and South Florida is in the eye of the storm,” warned Holly Bullard, chief strategy and development officer at the Florida Policy Institute and co-chair of Florida Decides Healthcare. “Miami-Dade relies more on the ACA marketplace than any other county in America.”
More than one in three residents of Miami-Dade use tax credits to pay for their healthcare, she said. Without congressional action, “...their healthcare is about to become dramatically more expensive.“
Two cities in Miami-Dade county will acutely feel the impact: Doral and Hialeah. That’s where the two ZIP codes with the most enrollees in 2022 were located. When the credits expire, federal data shows that proposed Florida insurance premiums are set to increase for ACA recipients between 18% and 41%, and some experts predict the state’s uninsured rate will increase as much as 50%.
The pending insurance crisis extends beyond premium increases.
President Donald Trump’s “One Big Beautiful Bill Act,” — H.R. 1 — which was signed into law on July 4, is likely to have enormous negative impacts on healthcare across the nation and especially in Florida. It cuts Medicaid coverage for millions of Americans as well as imposing more restrictions on the ACA marketplace, such as stricter income verification, shortened enrollment periods and the exclusion of Dreamers, undocumented children brought to the U.S. by their parents.
Roughly 2.4 million Floridians are enrolled in the marketplace and have incomes below 138% of the federal poverty level. These are people who don’t qualify for employer-sponsored insurance and earn too much or aren’t eligible for Medicaid, the public insurance program for the poor. In Miami-Dade, where affordability is already at the top of residents’ minds, premium increases could leave more families financially vulnerable.
Small-business owners and gig workers will also be affected. As Scott Darius, executive director of Florida Voices for Health put it, the “ACA has been so helpful for them in getting coverage.” Eliminating these affordable options now would leave those workers out in the cold.
When it comes to Medicaid, the pending cuts under H.R. 1 will have broader implications beyond recipients — hospitals are also at risk for losing funding.
“When it comes to what was in the H.R. 1, I think the biggest impacts will be on hospital funding,” Darius, told the Miami Herald.
Darius, who is also co-chair of Florida Decides Healthcare, underscored why Miami-Dade is uniquely vulnerable: “It’s just the sheer number of people who are enrolled in Medicaid or enrolled in the ACA, and who fall in the coverage gap already.”
There’s little that Florida can do on its own to avert this crisis. It requires action by Congress to extend ACA subsidies and protect Medicaid funding. The state could finally expand Medicaid — an option that would provide insurance up to 3.7 million Floridians — but that’s highly unlikely. Florida is one of only 10 hold-out states that have refused expansion since 2014.
Bullard pointed out that Medicaid expansion could blunt the impact of the pending health coverage crisis.
But South Florida’s Republican congressional delegation supported the One Big Beautiful Bill Act. Why aren’t they helping their constituents before one in five Floridians is without health insurance?
Darius said his organization has heard from Florida members of Congress that there’s “a lack of awareness that these tax credits are going to expire and that so many people rely on them.”
Whether you believe that or not, Floridians deserve better representation than members of Congress who vote for policies that will strip them of healthcare coverage.
Florida is about to become ground zero for a healthcare crisis, and time is running out for millions of Floridians on their healthcare coverage. In Miami-Dade County, the consequences could be devastating.
