Florida, hard-hit by Obamacare drop-off, feels the squeeze of rising healthcare costs

ST. CLOUD, Fla. (AP) — Florida chef Elijah Button was chopping onions in June when his knife slipped and sliced his middle finger to the bone.

It was his worst kitchen accident to date. But having given up his Affordable Care Act health insurance plan in January because of a $100 monthly premium hike he couldn’t afford, the 21-year-old in St. Cloud didn’t have the money for emergency care.

“Going to the hospital for it wasn’t even an option,” he said, gesturing toward his finger before preparing a pot roast for his aunt and uncle in their suburban home. “My first thought was, ‘how am I going to fix this?’”

After Republicans in Congress let enhanced federal subsidies for Affordable Care Act health plans expire in January, millions of Americans including Button had to decide whether to keep insurance that often doubled or tripled in cost — or risk going without it.

Months later, with no action from lawmakers to replace the lost funds, they’re facing the consequences. Some are dealing with strained budgets and exorbitant medical bills, while others avoid the doctor in fear of the cost.

Florida, whose large population of gig workers, entrepreneurs and small business owners relies heavily on the federal health insurance marketplace, has become one of the nation’s most visible epicenters of that impact.

Figures first reported by The Associated Press showed that about 440,000 Floridians dropped their Affordable Care Act plans this year — more than in any other state. Thousands more who kept coverage are struggling to get by, as prices of necessities like groceries and gasoline remain steep, and health insurers project another year of double-digit premium hikes.

While Florida had the most affected residents, its struggles are reflective of broader nationwide concerns over rising healthcare costs and a lack of meaningful policy to address them.

In the deep-red state where congressional districts were recently redrawn to strongly favor Republicans, the cost of healthcare is a major campaign issue. Republican midterm candidates have been promoting fraud crackdowns to protect federal health programs, while Democrats have been urging voters to help Congress change hands so they can restore subsidies.

Button, who is estranged from his parents, asked his uncle for help with his bloodied finger. With a butterfly bandage, splint and daily cleanings and dressings, it healed. But the scar still gnaws at Button as a symbol of what else could go wrong.

“It just feels like I’m living in a house of cards,” he said.

Last fall, debate over the expiring subsidies consumed Congress, resulting in a record 43-day government shutdown as Democrats insisted on extending the COVID-era assistance and most Republicans refused.

Fast forward almost a year and lawmakers rarely reference the topic anymore. The administration says it is addressing affordability with fraud-busting efforts and deals with drug companies, but Congress hasn't passed any significant legislation to lower health costs.

In part due to its large number of construction, hospitality and small business workers — and also because its Republican-led legislature never expanded the Medicaid safety-net health program — Florida has the largest Affordable Care Act enrollment in the country. At just over 3.8 million enrollees, it represents about a fifth of the nation’s total enrolled population.

Of the roughly 443,000 Floridians who left the marketplace, most are likely going without insurance, according to Cynthia Cox, a vice president at the healthcare research nonprofit KFF. She said that’s because it is typically a “place of last resort” to get coverage.

The data doesn’t tell the stories of those who kept insurance. Tracy Rand, a licensed mental health counselor in Leesburg, Florida, is one of them.

Ever since getting her ovaries removed last year due to benign but painful tumors, she has had severe menopause symptoms that require medication, including an overactive bladder and hot flashes that cause piercing headaches.

She uses clear plastic containers to organize the more than 30 medicines and supplements she takes daily, their bottles crammed into a living-room drawer and a tray on her kitchen counter.

The 51-year-old’s Affordable Care Act plan was going to surge in price this year from $55 a month to $1,100 a month, so she downgraded. Her new plan, with higher deductibles and copays, costs $160 a month.

To make that work in her budget, Rand quit a doctoral program she was working toward, started buying groceries at cheaper stores, gave up once-monthly dinners out with her husband and stopped meeting friends regularly at a paint-your-own pottery studio.

It’s been a difficult adjustment, but a necessary one for her health.

Rand said the prospect of insurers raising rates again fills her with dread.

“I don’t know what else we can get rid of,” she said, covering her face with her hands. “I don’t know if we’re going to have to file bankruptcy.″

In Orlando's leafy, brick-paved neighborhood of Colonialtown South, Tarsha Watson found her lifeline. A clinic there called Grace Medical Home provides low-income, uninsured Floridians with comprehensive care for a $5 per-visit fee.

Watson, 54, has a master’s degree in business administration, but she hasn’t been able to find work since losing her job two years ago. That means she doesn't have health insurance. When she explored Affordable Care Act coverage, she was quoted $600 per month, far out of her reach.

At Grace, Watson learned her blood sugar is high and that she needed to lose weight. Now, she walks laps around her backyard pool and does Tai Chi YouTube tutorials to focus on fitness. She said she wishes everyone could have her experience.

“It's very hard out here,” she said. “It's not enough.”

At the clinic, patients cycle in and out of a wide hallway lined with appointment rooms as doctors scan supply shelves for complimentary over-the-counter medications. The expansive building has separate areas for dental, mental health, vision and pediatric care.

CEO Stephanie Garris said it’s one of 110 free or charitable clinics in Florida, but that’s not enough to handle demand. To treat more people in response to the Affordable Care Act changes, it recently started hosting a mobile acute care clinic for walk-in patients.

Garris said Grace Medical Home treated about 1,350 people last year. Every year, they take about 350 new patients.

“Would I love to double that, triple that? Of course,” Garris said. “I just think in the reality, with the huge number of uninsured that we have, it’s just not possible.”

For U.S. Rep. Darren Soto, a Democrat defending his seat in a sprawling — and now much redder — redrawn district south of Orlando, health costs are a campaign focal point.

He said his district, which is near various theme parks, had the second-largest Affordable Care Act enrollment in the nation, in part because many small tourism businesses can’t offer employees health insurance.

“I just hear it everywhere I go,” he said. His Republican opponent, Navy veteran and former Trump administration official Dan Green, did not answer emailed questions about the subsidies but has emphasized affordability of groceries and property insurance as campaign priorities.

Soto voted with Democrats and some Republicans — including a few from Florida — to save the subsidies last year. The Republican majority declined and suggested other ideas, including funding Americans' health savings accounts. No law along those lines has passed yet.

Button, a Democrat in Soto’s district, said he is open to different reforms for health costs, but said politicians aren't acting fast enough.

“They keep trying to make excuse after excuse,” he said. “I don’t have six months to a year to wait for you guys to pass this through the hoops that you need to.”

Doctor Kirsten Carter, attends a chronic care appointment for Ana Bautista, and Cesar Granda, of Orlando, Fla., during an appointment at Grace Medical Home in Orlando, Wednesday, Aug. 12, 2026. (AP Photo/Jacquelyn Martin)

Tarsha Watson, 54, of Orlando, Fla., is interviewed at her home, in Orlando, Wednesday, Aug. 12, 2026. (AP Photo/Jacquelyn Martin)

Tracy Rand uses a fan to help with her severe menopause symptoms, brought on after a surgery to remove her ovaries, at her home in Leesburg, Fla., Friday, Aug. 14, 2026. (AP Photo/Jacquelyn Martin)

Elijah Button, 21, shows a scar on his middle fingers caused by a knife wound that he was unable to seek medical help for, in St. Cloud, Fla., Thursday, Aug. 13, 2026. (AP Photo/Jacquelyn Martin)

Elijah Button, 21, poses for a portrait in St. Cloud, Fla., Thursday, Aug. 13, 2026. (AP Photo/Jacquelyn Martin)

It was a telling remark, especially when revisited two months later.

“I probably won’t be real happy and smiley,” then-England cricket captain Ben Stokes told reporters after beating New Zealand in a hard-fought test match at Lord’s in June, “until I get up there and share a proper beer with the boys.”

After all, having a post-match drink with teammates and sometimes rivals in the dressing room is a cricketing tradition as old as time.

Is English cricket taking it to the extreme?

The off-field conduct and drinking habits of England's men's squad are back under scrutiny this week after another nightclub incident involving one of its players.

This time it was Brydon Carse, a 31-year-old fast bowler and one of the team’s success stories in recent years. The images of him — outside a club in the early hours of Sunday in handcuffs and surrounded by police officers — were hard to ignore, especially as the saga came days after a plea by newly appointed England captain Joe Root.

“Ultimately you’re grown adults,” said Root, speaking after England's leadership opted to scrap a midnight curfew that had been imposed on the men's team following a string of controversial late-night incidents.

“You know what it takes to play for England, you know what your responsibilities are off the field, and we need to make sure we don’t find ourselves with any little situations off the field.”

And so, with England's Cricket Regulator getting down to work investigating another off-the-field issue, it's back to square one.

Is it time for a cultural reset? In this age of sports science and ultra-professionalism, there are wider questions over whether cricketers should have a beer after a match. Or do players just need to be a bit smarter?

“Just have some kind of brain cells amongst you, seeing what’s just gone on,” former England captain Alastair Cook said on the Stick to Cricket podcast released Tuesday. “Surely someone says either don’t go to that place, or at 12 a.m. or 1 a.m. say, 'Let’s go and find ourselves somewhere quieter if we want to carry on.”

Here's a look at the late-night incidents that have brought shame on English cricket:

Before going to Australia for what proved a humiliating Ashes series, England traveled to New Zealand in October for a white-ball tour.

A day before the third and final one-day international, team captain Harry Brook was hit by a bouncer after being denied entry to a club in Wellington, with teammates Jacob Bethell and Josh Tongue also present on the night out.

Brook was fined about 30,000 pounds ($40,300) at the time and given a final warning for his future conduct — sanctions not made public until months later, after the Ashes series that England lost 4-1.

“I want to apologize for my actions,” Brook said. “I fully accept that my behavior was wrong and brought embarrassment to both myself and the England team.”

Between the second and third tests in the Ashes series against Australia in December, England visited the resort town of Noosa on the Sunshine Coast north of Brisbane for some downtime in the midst of a long tour.

While there, footage was taken of England opening batter Ben Duckett looking disorientated as he talked to a group of people on a night out and saying he was unable to remember how to get back to his hotel.

“I am sorry for that incident, it was not professional and shouldn’t have happened,” Duckett later said. “There is no hiding away from it.”

Rob Key, England managing director of men’s cricket, said he would investigate the drinking habits of the England team.

Chastened by the Ashes hammering in the winter, England began its so-called “reset” with a home series against New Zealand in June.

After winning the first test, Stokes and fast bowler Gus Atkinson continued their post-match celebrations at Lord's by going on a night out in London, during which a member of England’s security staff was reportedly struck by a rugby player from English club Saracens.

The fallout was huge: Stokes and Atkinson were left out of the second test amid an investigation that ultimately found that no “regulatory breach” had occurred. Stokes then returned for the third match, only to announce his retirement from international cricket midway through it, saying the past few months had “taken its toll.” Brendon McCullum then was fired as test coach, while Key said the England and Wales Cricket Board was considering imposing an alcohol ban on the team.

Strictly speaking, Carse's night out wasn't while he was on England duty. It came after his club side, Durham, completed a big win over Derbyshire in the domestic County Championship on Saturday.

Carse was among the players selected in the England squad for the first test against Pakistan last week, but wasn't picked to play in the match and was released to feature for Durham.

Ahead of his ill-fated night out, Carse had been retained in England's squad for the second test starting Thursday. He was dropped on Monday because an investigation was ongoing into the incident, which saw Carse held in handcuffs by police after, according to Britain's Press Association, being briefly arrested.

England bowler Matthew Potts was with Carse on the night out, while footage that circulated on social media showed Stokes watching on as Carse was in handcuffs.

See AP’s full cricket coverage here

FILE - England's Ben Duckett leaves the pitch after losing his wicket during the first day of the test match between England and New Zealand at Lord's cricket ground in London, Thursday, June 4, 2026. (AP Photo/Kirsty Wigglesworth, File)

FILE - England's captain Harry Brook,plays a shot during the second T20 cricket match between England and India in Manchester, England, Saturday, July 4, 2026. (AP Photo/Dave Thompson, File)

FILE - England's captain Ben Stokes walks onto the field before the start of play on the fourth day of the Test match between England and New Zealand at Lord's cricket ground in London, Sunday, June 7, 2026. (AP Photo/Kirsty Wigglesworth, File)

FILE - England's Joe Root leaves the pitch after losing his wicket during the second day of the test match between England and New Zealand at Lord's cricket ground in London, Friday, June 5, 2026. (AP Photo/Kirsty Wigglesworth, File)

FILE - England's Brydon Carse appeals unsuccessfully for the wicket of Australia's Travis Head during play on the last day of the fifth and final Ashes cricket test between England and Australia in Sydney, Thursday, Jan. 8, 2026. (AP Photo/Mark Baker, File)