Florida has been the top enrolling state in the ACA marketplace for several years running, and 2026 continued that trend. The open enrollment period that ran November 1, 2025 through January 15, 2026 produced strong participation statewide, though the numbers also highlight persistent coverage challenges—particularly for low-income adults and those in rural counties.
Key Findings from 2026 Open Enrollment
Enrollment data from CMS and KFF for the 2026 plan year shows Florida continuing to lead nationally in ACA marketplace participation:
- Florida once again ranked first or second nationally in total marketplace enrollment
- Enhanced premium tax credits continued to drive participation, with the majority of Florida enrollees receiving subsidies
- Silver plan enrollment remained strong, particularly among lower-income enrollees eligible for cost-sharing reductions
- Bronze plan enrollment grew among younger, healthier enrollees attracted by low premiums
Who Enrolled
Florida's marketplace enrollment reflects the state's demographic diversity:
- Hispanic/Latino enrollees make up a disproportionately large share of Florida marketplace enrollment, particularly in South Florida counties
- Self-employed and gig workers continue to be a major enrollment cohort, with no employer coverage alternative
- Near-retirees (55–64) are a significant enrollment group given the gap between early retirement and Medicare eligibility at 65
- Young adults (18–34) showed increased participation, particularly with Bronze and catastrophic plans at low or no premium cost
Enhanced subsidies—extended through 2025 and renewed for 2026—have been the single biggest driver of Florida enrollment growth. At current subsidy levels, a significant share of Florida enrollees pay $0–$50/month for a Silver or even Gold plan. The fear of unaffordability is often larger than the actual cost once subsidies are applied.
Who Is Still Uninsured
Despite high enrollment numbers, a significant share of Florida's population remains uninsured:
- Adults in the Medicaid coverage gap (below 100% FPL, not eligible for Florida Medicaid or marketplace subsidies)
- Undocumented immigrants ineligible for marketplace coverage
- Workers offered employer coverage that doesn't meet ACA affordability standards but can't afford it
- Young adults who perceive themselves as invincible and see insurance as unnecessary
What Changes in 2026 Affected Enrollment
Several changes influenced 2026 enrollment patterns in Florida:
- New carrier entries in some counties expanded choice and moderated premiums
- Enhanced subsidies under the American Rescue Plan continued to apply
- Ongoing post-COVID Medicaid unwinding continued to push former Medicaid enrollees into the marketplace
If you missed open enrollment, check whether you have a qualifying life event for a Special Enrollment Period. If not, open enrollment begins again November 1. In the meantime, talk to an advisor about options. Community health centers can provide care to the uninsured at reduced cost while you wait for the next enrollment window.