Health insurance rates are set to see significant increases for over 4 million Floridians who depend on Affordable Care Act (ACA) plans or small employer health insurance in the near future. Data from the Florida Office of Insurance Regulation (OIR) indicates that starting January 1, 2026, approved health plans will experience double-digit hikes in monthly premiums for individual policies sold through the federal health insurance exchange at healthcare.gov. Florida currently leads the nation in enrollment for these exchange plans.
For instance, a 28-year-old resident of Duval County making $35,000 annually and enrolled in a silver-level individual health insurance plan could see their monthly premium rise from $149 to $281. Similarly, a family of four earning $85,000 in Duval County may face an increase to $864 per month after tax credits, up from $558. In Miami-Dade County, the monthly premium for a similar 28-year-old could reach $322, while in Hillsborough County, it could be approximately $298. Families in these counties could pay $1,019 and $932, respectively. The situation is even more acute in rural areas, like Okeechobee County, where a family of four may have monthly costs as high as $1,630.
While the OIR initially posted these figures on August 25 for “illustrative purposes only,” it did not proactively inform the public of their availability ahead of the open enrollment period that begins on November 1. OIR spokesperson Kylie Mason noted that posting the data online made it accessible for public review.
The anticipated increases coincide with significant reductions to Medicaid as outlined in the 2025 Budget Reconciliation Act, also known as the One Big Beautiful Bill, which could potentially leave an additional 730,000 residents uninsured within a decade, according to an analysis by the Kaiser Family Foundation (KFF). Most of these individuals—about 500,000—may lose coverage due to changes in Obamacare, particularly the termination of enhanced advanced premium tax credits that were designed to lower out-of-pocket costs for “silver” level plans.
If these enhanced tax credits expire, the number of uninsured residents in Florida could swell by an estimated 1.2 million—another finding by KFF. Many advocacy groups, including the Florida Hospital Association, are urging Congress to renew these tax benefits as they are set to expire at the end of the year. Florida Decides Healthcare representative Karol Molinares expressed concerns about a looming “healthcare cliff,” warning of increased emergency room congestion, difficulty accessing primary care, and rising uncompensated care costs for hospitals, which would create further financial strain on the state.
The rate hikes are also relevant for small employers, as the ACA mandates that certain benefits and coverage must be included in their health plans. Although the increases in small business premiums are not as steep as those for individuals, they still represent a significant financial burden. The average cost is projected to rise from $728 per individual in 2025 to $821 in 2026.
Despite ongoing resistance from Florida Republicans to expand Medicaid to low-income, childless adults, the ACA remains popular among residents who seek affordable health coverage. The health insurance exchanges are a central feature of the law, which prohibits insurance companies from medically underwriting policies and limits pricing to four factors: age, tobacco use, geographic location, and family size.
The OIR recently provided county-specific breakdowns of potential premiums for 28-year-olds earning $35,000 and families of four making $85,000, illustrating the financial implications of these new rates. Most enrollees in Florida purchased individual coverage through the federal exchange, with over 5.8 million people holding commercial health insurance policies in 2023.
As the situation continues to evolve, advocates underscore the need for Medicaid expansion as a crucial strategy to mitigate the approaching healthcare challenges. Molinares articulated that this expansion could be vital in preventing the state’s healthcare system from reaching a critical breaking point in light of the forthcoming rate increases.
