Maintaining Florida’s Economic Success Depends on Extending the ACA Enhanced Premium Support
10/1/2025
This article first appeared as a column in the 2025 October issue of South Florida Hospital News
By Mary Mayhew, FHA President and CEO
Congress has a full plate of must-pass legislation before the end of the year. Chief among them is extending the successful enhanced premium support that makes purchasing individual health insurance coverage more affordable.
Without immediate Congressional action, federal funding to maintain this support expires at the end of the year. And, hundreds of thousands of Floridians, many of whom are powering the small business engine of Florida’s thriving economy, will lose health insurance coverage.
If Congress fails to extend the enhanced premium support, the number of uninsured Floridians is expected to increase by more than 40 percent. And, Florida’s small business success story will come to a close. Florida currently leads the nation in both the total number of marketplace enrollees and the number of small business owners with marketplace coverage. Nearly 800,000 small business owners in Florida and more than 500,000 self-employed Floridians have private health insurance coverage through the marketplace. That’s more than any other state.
Enhanced premium support, which comes in the form of tax credits, provides additional subsidies to people who are already eligible for the regular tax credits because of their incomes. With these credits, eligible uninsured individuals can purchase a private health insurance plan with the coverage that works for them and their family. With the enhanced credits, most enrollees at the lowest income level — under 150 percent of the federal poverty level, or an annual income of $46,800 for a household of four — pay little or nothing for this coverage. Individuals with annual household incomes of $60,240 or more ($124,800 for a family of four), meanwhile, pay no more than 8.5 percent of their household income on health insurance premiums.
These enhanced tax credits, in place since 2021, have put affordable private health insurance, not Medicaid, within reach of more than 4.7 million Floridians. These are working moms, dads, and entrepreneurs who run small businesses.
Continuing the enhanced tax credits is crucial for maintaining Florida’s economic engine – small businesses. Affordable private health insurance is key to Florida’s small business success story and, therefore, to Florida’s strong economy. The Sunshine State is home to more than 3 million small businesses. Remarkably, small businesses represent 99.8 percent of all Florida businesses.
The American dream is alive and well in Florida. Florida ranks as the second-best state for business in the country. That ranking is powered by small businesses. Our state’s business-friendly regulatory and tax environment combined with the availability of affordable health insurance means entrepreneurship can flourish here. Mom-and-pop family businesses can flourish. Self-employment can flourish. Ideas and innovation can flourish.
Congress still has the opportunity to continue the enhanced premium tax credits before the end of the year, but the window to act is closing quickly. Extending the enhanced tax credits will align with pro-economic growth principles to support Florida’s families, workers, and business owners. Maintaining Florida’s enviable status as the world’s 15th-largest economy and the nation’s small businesses leader depends on it.