Investigations
Florida led the nation in ACA coverage losses in 2026
In Putnam County, patients without Medicaid faced chemo bills and insurer network denials as a Senate race tested Medicare for All in Trump country.
In Northeast Florida’s Putnam County, where about one in five residents lives in poverty and Trump took nearly 74 percent of the vote, patients described a healthcare system that left them uninsured, underinsured, or unable to find a doctor. More Perfect Union reported from the county as Affordable Care Act subsidies expired and Florida kept Medicaid expansion off the table.
Nearly 450,000 people in Florida lost Affordable Care Act coverage this year, more than in any other state. Florida is one of ten states that still refuse to expand Medicaid, and most adults without children do not qualify at any income level. A family of three earning just over $7,200 a year makes too much for the program.
Twenty-eight-year-old Michael Depew worked part time at Walmart when pain in his back and stomach sent him to the hospital during a shift. A doctor told him testicular tumor cells were outstripping their blood supply and that he needed chemotherapy immediately. Depew had no insurance. His urologist, Dr. Kuruvilla, told him treatment could cost $50,000 or more and that he had about three months to live without it. Depew said staff told him the cancer was fully survivable with treatment.
Walmart required more hours than Depew’s schedule allowed for marketplace coverage, he said, and Florida Medicaid was unlikely to help. When the crew checked his account, Depew had $48.20 in the bank after paying $320 out of pocket for one urologist visit. Dr. Kuruvilla said the clinic hoped Medicaid or Walmart would come through but that nobody would pay out of pocket for him.
Fifty-six-year-old Amie Johns, a former hairdresser with multiple myeloma, carried Affordable Care Act insurance but said her share of more than $1 million in billed care this year topped $10,000, plus $500 monthly premiums. She and her husband said they were on the verge of bankruptcy because of the cancer bills. About 3.9 million Floridians bought marketplace coverage in 2026, and Johns said affordability was the change she wanted most.
Putnam County had about nine physicians per 10,000 residents, less than half the Florida average. Dr. Gurnoor Singh and nurse practitioner Katya Tsangarakis-Singh opened Community Roots Health on a sliding scale, sometimes charging $25, after insurers including Humana declined to add their group to networks. Singh said he and his wife put about $500,000 of their own money into the clinic and that the pace was not sustainable.
On a Tuesday forum organized with residents, state Representative Angie Nixon, the Democratic nominee for U.S. Senate, pitched Medicare for All as one government plan replacing private insurance. Attendance far exceeded what organizers expected in a county where many families work in insurance and distrust Washington. Veterans in the room argued TRICARE worked for them while neighbors could not get similar coverage without deploying overseas.
Senator Ashley Moody, appointed by Governor Ron DeSantis and Nixon’s opponent, said in a recorded message that Nixon and her comrades want to destroy the country. Moody also voted against moving forward on extending Affordable Care Act tax credits and backed Medicaid cuts. Moody did not return a request for comment on her healthcare policy.
Republican voter Amie Johns said she voted for Trump in the presidential race but would leave a party line if universal coverage sounded feasible, and she did not see it as communism. Depew, also a Republican, said everyone having insurance would be amazing and that he would be more likely to vote if leaders proposed policies that helped him stay alive. Florida voters face a Senate choice on Nov. 3, with recent polls showing Moody ahead by about seven points or the race tied.
Source video: We Went To Deep Red Florida. Can Medicare For All Win Here?