The state of Florida has more people enrolled in ACA individual coverage through than any other state in the nation, and it’s not particularly close. According to a list published by CMS:

  • Florida has more than 1.9 million enrollments
  • Texas is second with 1.1 million enrollments
  • North Carolina occupies the third spot with just over half a million enrollments

This list does not include the 11 states and Washington D.C. which do not use the federal marketplace because they have set up their own state-based exchanges. (Click here to view a state-by-state list maintained by the Kaiser Family Foundation.) Those states account for about 25% of ACA enrollment according to Reuters.

A January article in the Tampa Bay Times quotes Anne Swerlick with the Florida Policy Institute in Tallahassee: “We’ve always outpaced enrollment in other states, and I think it really shows that the marketplace coverage is extremely popular in Florida.” One reason for that popularity might be the number of options consumers have to choose from. Florida “had more insurance providers participating on the exchange than most other states, including a few companies that were new to the market this year.”

Despite the success of ACA plans in the state, Florida’s uninsured rate of 12.9 percent is still above the national average. Again from the Tampa Bay Times: “Florida’s uninsured rate has dropped dramatically,” but Swerlick reports that “about 2.7 million people remain uncovered.”

A big reason for the high number of uninsured is that Florida, as we can see from an interactive map developed by the Kaiser Family Foundation, is one of only 14 states nationwide that failed to expand Medicaid under the Affordable Care Act. Ironically, CBS 12 News reports that “Florida has one of the largest Medicaid programs in the nation, with the state expected to spend about $29 billion in the program during the 2020-2021 fiscal year providing care and services for an estimated 3.8 million people.”

Still, the Affordable Care act offered states the opportunity to expand Medicaid with the federal government picking up the majority of the cost, and failure to take advantage of this opportunity, according to Nathanial Sweet, Opinion Editor for USF’s school paper The Oracle, is hurting Florida’s young adults. Sweet explains that Florida’s decision is leaving “young people without access to vital services.”

While it is true that the ACA allows young people to remain on their parents’ insurance plan until age 26, many college-age students cannot afford the “huge out-of-pocket costs” that many of these plans come with. Sweet says that expanding the Medicaid “program would give these underinsured young adults access to vital care without breaking the bank.”

Sweet’s opinion piece concludes by citing a 2019 study by the Center for Budget and Policy Priorities which “found that 2,776 deaths in Florida could have been prevented from 2014 to 2017 if the Medicaid program were expanded,” and he believes that “Floridians deserve a fair and equitable healthcare system.”

With concern over costs associated with the coronavirus and the possibility that some workers will lose their health coverage during the associated economic slowdown, Medicaid expansion is a debate that state lawmakers will no doubt continue to have in the months ahead.