\u201cGoing to the hospital for it wasn\u2019t even an option,\u201d he said, gesturing toward his finger before preparing a pot roast for his aunt and uncle in their suburban home. \u201cMy first thought was, \u2018how am I going to fix this?\u2019\u201d<\/p>\n
After Republicans in Congress let enhanced federal subsidies<\/a> for Affordable Care Act health plans expire in January, millions of Americans including Button had to decide whether to keep insurance that often doubled or tripled in cost \u2014 or risk going without it.<\/p>\n Months later, with no action from lawmakers to replace the lost funds, they\u2019re facing the consequences. Some are dealing with strained budgets and exorbitant medical bills, while others avoid the doctor in fear of the cost.<\/p>\n Florida, whose large population of gig workers, entrepreneurs and small business owners relies heavily on the federal health insurance marketplace, has become one of the nation\u2019s most visible epicenters of that impact.<\/p>\n Figures first reported by The Associated Press showed that about 440,000 Floridians dropped their Affordable Care Act plans this year \u2014 more than in any other state<\/a>. Thousands more who kept coverage are struggling to get by, as prices of necessities like groceries and gasoline remain steep, and health insurers project another year of double-digit premium hikes<\/a>.<\/p>\n <\/p>\n <\/p>\n <\/a><\/p>\n While Florida had the most affected residents, its struggles are reflective of broader nationwide concerns over rising healthcare costs and a lack of meaningful policy to address them.<\/p>\n In the deep-red state where congressional districts were recently redrawn to strongly favor Republicans, the cost of healthcare is a major campaign issue. Republican midterm candidates have been promoting fraud crackdowns to protect federal health programs, while Democrats have been urging voters to help Congress change hands so they can restore subsidies.<\/p>\n <\/p>\n 1 of 2\u00a0|\u00a0<\/p>\n Elijah Button, 21, poses for a portrait in St. Cloud, Fla., Thursday, Aug. 13, 2026. (AP Photo\/Jacquelyn Martin)<\/p>\n Read More<\/p>\n 2 of 2\u00a0|\u00a0<\/p>\n Elijah Button, 21, shows a scar on his middle fingers caused by a knife wound that he was unable to seek medical help for, in St. Cloud, Fla., Thursday, Aug. 13, 2026. (AP Photo\/Jacquelyn Martin)<\/p>\n Read More<\/p>\n 1 of 2\u00a0|\u00a0<\/p>\n Elijah Button, 21, poses for a portrait in St. Cloud, Fla., Thursday, Aug. 13, 2026. (AP Photo\/Jacquelyn Martin)<\/p>\n Read More<\/p>\n 1 of 2<\/p>\n Elijah Button, 21, poses for a portrait in St. Cloud, Fla., Thursday, Aug. 13, 2026. (AP Photo\/Jacquelyn Martin)<\/p>\n Add AP News on Google <\/p>\n Add AP News as your preferred source to see more of our stories on Google.<\/p>\n Share<\/p>\n Read More<\/p>\n 2 of 2\u00a0|\u00a0<\/p>\n Elijah Button, 21, shows a scar on his middle fingers caused by a knife wound that he was unable to seek medical help for, in St. Cloud, Fla., Thursday, Aug. 13, 2026. (AP Photo\/Jacquelyn Martin)<\/p>\n Read More<\/p>\n 2 of 2<\/p>\n Elijah Button, 21, shows a scar on his middle fingers caused by a knife wound that he was unable to seek medical help for, in St. Cloud, Fla., Thursday, Aug. 13, 2026. (AP Photo\/Jacquelyn Martin)<\/p>\n Add AP News on Google <\/p>\n Add AP News as your preferred source to see more of our stories on Google.<\/p>\n Share<\/p>\n Read More<\/p>\n Button, who is estranged from his parents, asked his uncle for help with his bloodied finger. With a butterfly bandage, splint and daily cleanings and dressings, it healed. But the scar still gnaws at Button as a symbol of what else could go wrong.<\/p>\n \u201cIt just feels like I\u2019m living in a house of cards,\u201d he said.<\/p>\n Florida\u2019s population and politics make it ground zero for ACA fallout<\/p>\n Last fall, debate over the expiring subsidies consumed Congress, resulting in a record 43-day government shutdown<\/a> as Democrats insisted on extending the COVID-era assistance and most Republicans refused.<\/p>\n Fast forward almost a year and lawmakers rarely reference the topic anymore. The administration says it is addressing affordability with fraud-busting efforts and deals with drug companies, but Congress hasn\u2019t passed any significant legislation to lower health costs.<\/p>\n <\/p>\n Doctor Kirsten Carter, attends a chronic care appointment for Ana Bautista, and Cesar Granda, of Orlando, Fla., during an appointment at Grace Medical Home in Orlando, Wednesday, Aug. 12, 2026. (AP Photo\/Jacquelyn Martin)<\/p>\n Doctor Kirsten Carter, attends a chronic care appointment for Ana Bautista, and Cesar Granda, of Orlando, Fla., during an appointment at Grace Medical Home in Orlando, Wednesday, Aug. 12, 2026. (AP Photo\/Jacquelyn Martin)<\/p>\n Add AP News on Google <\/p>\n Add AP News as your preferred source to see more of our stories on Google.<\/p>\n Share<\/p>\n Read More<\/p>\n In part due to its large number of construction, hospitality and small business workers \u2014 and also because its Republican-led legislature never expanded the Medicaid safety-net health program \u2014 Florida has the largest Affordable Care Act enrollment in the country. At just over 3.8 million enrollees, it represents about a fifth of the nation\u2019s total enrolled population.<\/p>\n Of the roughly 443,000 Floridians who left the marketplace, most are likely going without insurance, according to Cynthia Cox, a vice president at the healthcare research nonprofit KFF. She said that\u2019s because it is typically a \u201cplace of last resort\u201d to get coverage.<\/p>\n The data doesn\u2019t tell the stories of those who kept insurance. Tracy Rand, a licensed mental health counselor in Leesburg, Florida, is one of them.<\/p>\n Ever since getting her ovaries removed last year due to benign but painful tumors, she has had severe menopause symptoms that require medication, including an overactive bladder and hot flashes that cause piercing headaches.<\/p>\n![\"Employees](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2026\/08\/1787680162_893_.jpeg\")
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