How many people would become uninsured in Texas and Florida if enhanced ACA subsidies expire in 2025?

1. What people are claiming — clear, competing headlines that need reconciling

Multiple reputable analyses make competing claims about how many people in Texas and Florida would become uninsured if enhanced ACA subsidies lapse in 2025. The KFF/CBO-based allocation places about 1.5 million newly uninsured in Florida and about 1.4 million newly uninsured in Texas, within a larger projection of roughly 14 million additional uninsured nationally in some analyses tied to the 2025 reconciliation law ^{[1] [2]}. The Urban Institute frames the impact as percentage increases — Texas +39%, Florida +29% — contributing to a different national total of about 4.8 million in one report ^[4]. A Texas A&M analysis offers a smaller Texas estimate of ~800,000 newly uninsured, and media fact-checks cite CBO/KFF figures closer to 3.8–4.0 million excess uninsured nationwide, underscoring a spread of estimates across respected groups ^{[3] [5] [6]}. These divergent headlines reflect different modeling choices, baselines, and time horizons, so the apparent contradiction is methodological rather than purely factual.

2. The most defensible state numbers — why KFF/CBO estimates carry weight

The most commonly referenced state-level numbers—1.5 million for Florida and 1.4 million for Texas—derive from KFF’s allocation of partial Congressional Budget Office estimates and are explicit about being tied to the 2025 policy change and the reconciliation law context ^{[1] [2]}. KFF’s approach translates CBO’s national coverage effects into state-by-state changes using enrollment and demographic patterns; that translation produces concrete state counts that are useful for planning and public debate. Those figures are widely cited because they combine a federal fiscal-model baseline (CBO) with a recognized health-policy tracker (KFF), making them a practical midpoint among divergent projections. Nevertheless, they are not definitive predictions but scenario-based estimates built from assumptions about how many people will respond to premium changes.

3. Where other credible estimates differ — Urban Institute and Texas A&M offer alternative lenses

The Urban Institute emphasizes percentage change in uninsured rates (Texas +39%, Florida +29%) and reports a different national total (about 4.8 million) by using its own microsimulation of coverage responses; that leads to a different framing—greater relative increases for some states but smaller absolute national totals in that report ^[4]. Texas A&M’s work produces a smaller Texas absolute figure (around 800,000 newly uninsured) by using alternate assumptions about enrollment elasticity and state-specific market dynamics, producing a lower-bound scenario for Texas ^[3]. These differences reflect competing but legitimate modeling choices: whether to prioritize elasticities from past enrollment behavior, to weight state-level take-up differently, or to account for recent policy and legislative changes.

4. What the media fact-checks and KFF regional breakdowns add — nuance, not contradiction

Media fact-checks and regional analyses stress that the states in the South, especially Texas and Florida, account for a large share of projected coverage losses but sometimes report different national totals—3.8–4.0 million in some CBO/KFF summaries versus larger totals when tied to reconciliation-law interactions ^{[5] [6]}. Florida is notable for having the highest share of enrollees using the enhanced credits (about 24% of enrollees under 65), which explains why Florida shows up as among the hardest-hit in share terms even when absolute numbers vary ^[7]. The takeaway is that Florida’s vulnerability is high in percentage terms, and Texas tends to lead in absolute numbers depending on the modeling approach.

5. Big-picture reconciliation — ranges, drivers, and what matters for policymakers

Reconciling these studies yields a defensible state-level range: roughly 0.8 million to 1.4 million in Texas and about 1.5 million in Florida, with the upper Texas estimate tied to KFF/CBO allocations and the lower Texas estimate coming from Texas A&M ^{[1] [3]}. Key drivers of the spread are model assumptions about enrollment elasticity to premiums, the baseline period used, whether analyses include interactions with other 2025 policy changes, and differing time horizons ^{[4] [2]}. Policymakers should treat point estimates as scenario outputs rather than immutable forecasts and focus on the policy levers—subsidy design, outreach, and state-level mitigation—that determine how many people actually lose coverage.

6. Caveats and watching points — how to interpret future reporting

All these projections are scenario-based and sensitive to updated enrollment data, state actions, and congressional decisions; the most recent public-facing allocations point to ~1.5 million in Florida and ~1.4 million in Texas under the central KFF/CBO scenario, but credible analyses produce a meaningful lower bound for Texas (~800,000) and differing national totals ^{[1] [3] [4]}. Watch for updates from CBO, KFF, Urban Institute, and state-level actuaries as they incorporate new enrollment seasons and any legislative fixes; reporting is likely to cite one of these dominant models, so look for explicit mention of the model and time horizon to understand which scenario a headline reflects.