Tampa Bay's looming health care crisis
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Illustration: Lazaro Gamio/Axios
The longest federal government shutdown in history is over, but for Floridians, a healthcare crisis could now be beginning.
Why it matters: Hundreds of thousands of Tampa Bay residents rely on expiring Affordable Care Act (ACA) subsidies to afford health care, and without them, average premiums could spike by 88%.
- The subsidies expire on Jan. 1, 2026, and that loss will have an outsized impact on the Sunshine State, where 4.7 million people are enrolled in the federal marketplace, according to KFF.
Driving the news: Congressional Democrats fought to include an extension of ACA subsidies in a deal to fund the government, but conceded without them.
- Open enrollment began on Nov. 1 and will continue through Jan. 15, 2026, and people are already seeing higher premiums that reflect the expected impact should the subsidies lapse.
The big picture: Matthew Fiedler, a senior fellow at the Brookings Institution, tells Axios that "the federal government seems on track to ratchet back what it pays to provide people with health insurance."
- "The likely consequence of that is that people are going to pay more, and some people are going to decide to go uninsured."
- The Congressional Budget Office estimates that the loss of ACA subsidies would leave 2 million more people uninsured in 2026.
By the numbers: There are about 545,000 marketplace enrollees across Tampa Bay's Congressional districts, with about 525,000 receiving subsidies, according to data from KFF.
- Residents of Florida's 14th Congressional District (which includes most of Tampa) could face the region's steepest average premium increase, at 98%.
- Florida's 15th Congressional District (which includes parts of Hillsborough, Pasco and Polk counties) is second, at 93%.
What's next: Anyone wanting coverage to start on Jan. 1, 2026, must enroll by Dec. 15.
- Senate Majority Leader John Thune has promised to put the matter to a vote in December. For an extension of the subsidies to pass, Democrats will need the support of at least 13 Republicans.
- Some GOP senators told Axios reporters Hans Nichols and Stef W. Kight that they think they can get there.