The open enrollment window to sign up for health care through the Affordable Care Act marketplace begins Saturday. In Florida, home to the greatest number of ACA recipients in the country, health care advocates are bracing for coverage costs to skyrocket.
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"What we're seeing this year is the biggest single-year increase in a very long time, between 20 and 40% here in Florida specifically," said Scott Darius, executive director of Florida Voices for Health. The nonprofit is a coalition of community groups, businesses and people advocating for equitable health care reform.
Although health care rates tend to gradually increase each year, Darius said, this year's hikes are significantly larger because of the expiration of the ACA's "enhanced premium tax credit." President Donald Trump's One Big Beautiful Bill Act eliminated that tax credit. That tax credit reduced the cost of ACA insurance premiums.
"What every insurer pointed to, in large part, for their increase, was the fact that they did not expect Congress to reauthorize the premium tax credits," Darius said.
As health care plans become more expensive, it's typically healthier people who end up opting out of health care altogether — leaving a "sicker risk pool" behind, Darius said. "(That) just goes to make health insurance more expensive — not just for people enrolled in ACA plans, but as we're seeing, for everyone, in every kind of insurance market."
Statewide, about 4.7 million Floridians are enrolled in the ACA marketplace, according to the Centers for Medicare and Medicaid Services. Of those Floridians, Darius said he expects about 1.4 million — about 30% — will be priced out of health care coverage completely. Others will likely have to make tough decisions about what else to sacrifice in order to stay covered.
"What we heard from one person is that they will do what they need to (do) to keep their health insurance, but they won't have wind insurance next year," Darius said.
For Winter Park resident Lisa Ferrigno, a violinist who freelances and works part-time as a Disney cast member, the question isn't whether or not to buy health insurance but rather what level of coverage she can actually afford.
"It's not going to be a situation of going without health insurance, because I would never do that," Ferrigno said. "I just feel like I don't have any choices."
After spending hours perusing cost estimates on healthcare.gov, Ferrigno said she determined she won't be able to continue paying for the "very bare-bones, bronze plan" she's had for the last two years.
"The increase is well over two times what I've been paying. And it's to a point where it's unaffordable," she said.
Ferrigno said she's concerned for some of her fellow Central Floridians who won't be able to afford health care at all.
"It's interesting, because everyone's situation will be uniquely horrible, in my opinion," Ferrigno said. "It's kind of stark. It's not like, 'Oh, it went up 20%.' It's like, 'Oh, it went up 200%.'"
For people looking to sign up for ACA insurance plans, Florida Voices for Health offers three pieces of advice: narrow down your health care priorities, shop early and seek out trusted sources for help. For free assistance navigating the marketplace, Darius recommends reaching out to the statewide Covering Florida coalition.
"We're just encouraging folks, once you kind of have a sense of your priorities, to shop early," Darius said. "Knowing that costs have gone up, you may have to make other plans and arrangements to really get exactly what you need."
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