MARY LOUISE KELLY, HOST:
Open enrollment for Affordable Care Act plans started yesterday. Healthcare premiums have risen by 10% on average. That's at the same time voters are headed to the polls. In some ways, that makes this a healthcare election, especially in places where ACA enrollment has been high. NPR political reporter Maham Javaid has been following this. Hey there.
MAHAM JAVAID, BYLINE: Hi.
KELLY: Hi. So it's funny -I would think of a healthcare election as being some huge new proposal is being rolled out or rolled back or something. That's not what's going on.
JAVAID: Yeah. The implication is that the rising cost of healthcare is on the ballot this year, even if you're not seeing it as a ballot measure. At the end of last year, the Trump administration let federal subsidies for the Affordable Care Act expire. A lot of people across the country, and especially in Florida, could not afford insurance anymore. And this year, the rates have gone even higher. Many, many people are finding out that their new premiums are high, just as they're deciding who to vote for.
KELLY: Did you just say especially in Florida when federal subsidies - I mean, they expired everywhere, all over the country. Why, especially Florida?
JAVAID: Yeah. So in 2025, there were about 4.3 million Floridians enrolled in ACA plans. These plans are also called marketplace plans or Obamacare. And this year, more than 400,000 people in Florida lost their insurance. This is because Florida has a large tourism and service industry that doesn't always offer private insurance. And there are a lot of people who are self-employed and part of the gig economy. It's also because Florida is one of the handful of states that did not expand Medicaid. All of this is why I went to the 22nd Congressional District in Florida.
KELLY: The 22nd - I'm not sure I know where that is or how that fits into the picture.
JAVAID: So it's a newly redrawn district. It's an open seat, and it's huge. It starts on the Gulf Coast, on the western part of the state, and sprawls across the Everglades. The district is really diverse, and it's a true toss-up. Both candidates are campaigning heavily on healthcare. It's one of the main issues in the district.
KELLY: And what were people there telling you?
JAVAID: Yeah. So we met with people who used to have insurance until the Trump administration stopped renewing the subsidies. There was a woman in Collier County. Her name is Bianca. She asked us to withhold her last name because political activists in her community have faced threats for speaking up. Bianca had to drop her health insurance because it got too expensive. She's going to vote for the Democratic candidate, she says.
BIANCA: She is trying to expand the Affordable Care Act, which I think is really important, especially for, like, families like mine and my husband, where we're working 40 hours a week, and we can't afford healthcare.
KELLY: So do we know, to what extent healthcare is really moving the needle in this election?
JAVAID: Well, we also met retirees and others who are very satisfied with Medicare, and they said healthcare has no impact on their vote. Most of the retirees we spoke to said they've always voted Republican and will continue to do so. But I think what's interesting are people in the district who have voted Republican in the past, who have lost their health insurance, and now they say they're going to vote for the Democrats.
DEYANA JOHNSON: I voted for the red last time, but this time now I'm thinking about voting blue to get our country back in order.
JAVAID: That was Deyana Johnson. She's a dental hygiene student. She's uninsured, and she's been looking for a plan she can afford. She says she hasn't found anything.
JOHNSON: I hope we get free healthcare like, you know, in other countries - they get free healthcare.
KELLY: Reporting there from NPR's Maham Javaid. Thank you so much.
JAVAID: Thank you. Transcript provided by NPR, Copyright NPR.
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