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Attorney Michael A. Pancier talks about the increase in health insurance premiums at his office in Pembroke Pines on Thursday, March 25, 2026.<\/p>\n
Pedro Portal<\/p>\n
pportal@miamiherald.com<\/p>\n
The new year brought Kellie Brvenik a choice. She could pay to keep her cancer at bay, or cover life\u2019s other necessities, like food and her mortgage.<\/p>\n
Brvenik, 44, was diagnosed in 2024 with leiomyosarcoma, a rare and aggressive form of cancer. A property manager in Lake Worth Beach, she stayed at work through 10 weeks of radiation, \u201cuntil it became unbearable,\u201d and she\u2019s since lived off a $1,952 monthly disability check.<\/p>\n
It was financially manageable, if even just barely, thanks in part to the fact that her health insurance premium, purchased through the Affordable Care Act\u2019s Federal Marketplace, was just $0.18 a month. In place since 2021, the ACA\u2019s enhanced premium tax credits capped how much enrollees could be charged relative to their income. Eighty percent of plan holders, like Brvenik, had premiums of less than $10 a month<\/a> in 2025.<\/p>\n But at the start of this year, Brvenik\u2019s monthly premium jumped to nearly $142 after the credits expired.<\/p>\n \u201cIt\u2019s rough,\u201d she conceded.<\/p>\n That\u2019s particularly so in Florida, said Matt McGough, a policy analyst who focuses on the Affordable Care Act, also known as Obamacare, at the health care research nonprofit KFF<\/a>.<\/p>\n People between 50 and 64 were set to see especially steep premium hikes, and Florida has a relatively old population. Plus, many of its workers are seasonal or part time, meaning they might not receive health insurance through their jobs, and \u2014 critically \u2014 the state elected not to expand Medicaid eligibility, leaving many residents too well-off to qualify for government insurance but unable to afford to pay for their own.<\/p>\n For many, the math was already hard before the credits expired. KFF projected that for a 60-year-old couple earning $85,000 in South Florida, the elimination of the enhanced premium tax credits would spike their premiums by nearly 350%. For a 40-year-old making $32,000 a year, that figure was over 200%.<\/p>\n And nowhere are the effects of higher ACA premiums felt more than in Miami-Dade, which has the largest Obamacare enrollment population \u2014 more than 1 million last year, according to the Centers for Medicare and Medicaid Services \u2014 of any county in the nation.<\/p>\n Those inflated bills are eating into families\u2019 budgets at a time when gas, grocery and housing costs are high and threatening to climb further, limiting many Americans\u2019 ability to save money and build wealth.<\/p>\n How we got here<\/p>\n Brvenik is one of 4.5 million Floridians who purchase health insurance through the ACA\u2019s Federal Marketplace. And, like many of them, she\u2019s now paying sharply more for the same coverage.<\/p>\n When she saw her new bill, Brvenik considered downgrading her plan, but she didn\u2019t. A lesser one wouldn\u2019t have covered many of her treatments. Her current plan barely covers them as it is.<\/p>\n Blood tests, hormone blockers \u2014 she needs both to monitor and contain the spread of her cancer, and she\u2019s now paying more for each. Those aren\u2019t covered and will run her hundreds of dollars a month.<\/p>\n \u201cI\u2019ve had to reduce the amount of times I can have [some of those tests],\u201d she said. She\u2019s also had to turn to food banks for help.<\/p>\n Congress anticipated those rising costs and debated extending the enhanced premium tax credits toward the end of last year. Democrats pushed for a three-year extension to the credits, while many Republicans favored either a one-year extension or none at all.<\/p>\n Split largely along party lines, the effort stalled in the Senate after passing the House. But some Republicans, like Miami-Dade Rep. Mar\u00eda Elvira Salazar, crossed the aisle to push the three-year extension through the House. Her district has one of the highest Obamacare enrollment rates in the country.<\/p>\n \u201cThis isn\u2019t partisan,\u201d she said<\/a> of her vote. \u201cIt\u2019s human.\u201d<\/p>\n Others, like Miami-Dade Rep. Mario D\u00edaz-Balart, opposed the extension, citing instances of fraud and abuse. Ultimately, the tax credits were a \u201ctemporary Band-Aid,\u201d he told the Herald, adding that the extension would cost taxpayers $80 billion over 10 years, citing a Congressional Budget Office report.<\/p>\n Sens. Rick Scott and Ashley Moody and Miami-Dade Rep. Carlos Gimenez, all of whom opposed the three-year extension, did not respond to requests for comment.<\/p>\n McGough, the health care policy analyst, noted that the credits can be revived at any time, if elected officials so desire.<\/p>\n \u201cCongress is essentially what controls how much people pay toward their individual market premiums,\u201d he said, \u201cand it seems that this conversation has just fizzled.\u201d<\/p>\n As a result, Obamacare premium limits reverted to their pre-2021 levels this year, meaning millions of Americans now pay more for their coverage.<\/p>\n $50,000 a year in premiums Michael Pancier felt the sticker shock immediately.<\/p>\n Pancier, 60, is an attorney in Miami-Dade. He runs his own firm and for years has purchased health insurance through the Federal Marketplace for himself, his wife \u2014 who\u2019s also self-employed \u2014 and their 21-year-old daughter.<\/p>\n In 2025, Pancier\u2019s premium was $2,167 a month, roughly what it had been for years. This year, it nearly doubled. He now pays a monthly $4,201 for the same coverage \u2014 actually, worse coverage, since one of his doctors no longer accepts his plan.<\/p>\n \u201cYou gotta be kidding,\u201d he recalled thinking when he saw his premium estimate. \u201cYou\u2019re spending $50,000\u201d a year.<\/p>\n It\u2019s money he\u2019d otherwise put toward his retirement account, home repairs, maybe a new car. \u201cI\u2019m going to have to hold off on some of that stuff,\u201d he said.<\/p>\n Pancier had hoped to retire soon. Now, \u201cI\u2019m definitely not going to retire until I\u2019m Medicare eligible\u201d \u2014 meaning 65 \u2014 and even that depends on \u201chow long these ridiculous premiums last,\u201d since his wife and daughter might still rely on the Marketplace plan.<\/p>\n A recent KFF poll<\/a> of Marketplace plan holders found that 81% said their health care costs have gone up, with more than half saying costs are \u201ca lot\u201d higher. Nearly three-quarters expressed anxiety about affording emergency care costs, and 55% said they either are or will be cutting back on household spending to afford health care costs.<\/p>\n Florida is particularly exposed.<\/p>\n The state is one of 10 that has never expanded Medicaid eligibility, leaving a coverage gap for residents who earn too much to qualify for government insurance but too little to comfortably afford higher premiums, said Aidil Oscariz, a policy consultant at Catalyst Miami, a Miami-Dade-based nonprofit that provides social services.<\/p>\n And a disproportionate share of Florida workers are employed in seasonal or part-time industries, like tourism, meaning fewer receive insurance through their employers. Only 40% of Floridians are covered by employer-based health insurance, compared to 49% nationally, according to data from the U.S. Census Bureau.<\/p>\n The state also skews older. The ACA allows insurers to charge adults ages 50 to 64 up to three times more than younger enrollees for the same plan, meaning they were already paying more before the subsidies disappeared.<\/p>\n \u201cThey\u2019re facing a double whammy,\u201d said McGough, the policy analyst.<\/p>\n The loss of subsidies has compounded with a record increase in the sticker price of unsubsidized plans.<\/p>\n \u201cThose extended tax credits really made it so that the cost of the plans were far more affordable,\u201d said Xonjenese Jacobs, director of Florida Covering Kids & Families at the University of South Florida College of Public Health.<\/p>\n Part of that affordability came from increased Obamacare enrollment.<\/p>\n Since the start of the year, almost 200,000 Floridians dropped their ACA Marketplace plans \u2014 one of the sharpest declines in the country \u2014 according to the Centers for Medicare and Medicaid Services.<\/p>\n And the people most likely to drop coverage, said McGough, are those who are younger and healthier \u2014 those who are more willing to gamble with going uninsured.<\/p>\n That leaves a sicker, older, more expensive pool of enrollees, which pushes up premiums for everyone.<\/p>\n \u201cHospitals must stabilize uninsured patients under U.S. law, even without compensation,\u201d said McGough. \u201cIf the amount of uncompensated care is increasing, hospitals raise their prices to meet that \u2014 which actually raises prices for people who have insurance.\u201d<\/p>\n Kellie Brvenik Courtesy of Kellie Brvenik <\/p>\n
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Attorney Michael A. Pancier talks about the increase in health insurance premiums at his office in Pembroke Pines on Thursday, March 25, 2026. Pedro Portal pportal@miamiherald.com <\/p>\n
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