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When federal subsidies and Affordable Care Act healthcare plans expired last year, Florida was hit especially hard. This weekend, as open enrollment begins just days before Election Day, Floridians who use the healthcare exchange are learning what their new premiums are. On average, they're going up 10.4%, according to the state's Office of Insurance Regulation. NPR's Maham Javaid went to a competitive congressional district in Florida, spanning from the Gulf Coast to the suburbs of Palm Beach, to find out if rising healthcare insurance costs are moving votes.
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MAHAM JAVAID, BYLINE: Bordering Naples Beach are palm trees and pastel-colored mansions. Brittany Garcia (ph), a 23-year-old registered nurse, is walking the shore after an overnight shift. Garcia has no health insurance.
BRITTANY GARCIA: I would hope that there is some reform soon because I literally have no access to healthcare.
JAVAID: She works as a contractor, so Garcia wants to buy insurance on the healthcare marketplace. Those are plans under the Affordable Care Act, also known as Obamacare. Premiums are rising as COVID-19-era subsidies have expired. For many like Garcia, healthcare has become unaffordable.
GARCIA: I started looking and nothing was available, so I couldn't buy insurance. And to me, that was scary. You know, it made me think maybe I have to go to another country.
JAVAID: Garcia has previously voted Republican. Now, without access to insurance, she's not sure how she will vote.
GARCIA: This time, I'm just voting with my convictions.
JAVAID: The newly redrawn 22nd Congressional District sprawls across south Florida. Made up of rural, urban and suburban areas, it's home to wealthy communities and working-class families. Politically, it swings between red and blue. Northeast of Naples, Collier County is a diverse area, home to immigrants from Haiti, Mexico and Guatemala. This is where Bianca (ph) and her husband live. They've been without insurance since January. That's when her insurance agent called and said...
BIANCA: But I do want to let you know that because they're going to take away the subsidy, that it's now going to be this amount of money. And at the time, I think it was, like, doubled or tripled of what we were paying.
JAVAID: She's had to pay out of pocket for an emergency visit to the hospital and pneumonia treatment. Bianca asked NPR not to use her full name because political activists in her community have faced harassment for speaking up. She's going to vote for the Democratic nominee, Pia Dandiya, and her reason is healthcare.
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.
JAVAID: Nice to meet you.
ROHIT DANDIYA: Nice to meet you. I'm Pia's father.
JAVAID: On the western edge of the district, Dandiya's father welcomes us into her campaign office.
R DANDIYA: Here. Come on in. Hello. Pia, are you here?
PIA DANDIYA: Hey, Dad.
R DANDIYA: They're here.
P DANDIYA: Amazing. Come on in.
JAVAID: If Democrats were to win back the House, Dandiya says she's going to work on restoring ACA subsidies, expanding funding to Medicaid and lowering drug prices.
P DANDIYA: Healthcare is not a blue issue or a red issue. It's a red, white and blue issue. It's something that is impacting all of us.
JAVAID: Her Republican opponent, Casey Askar, wants to eliminate the ACA altogether and crack down on fraud to preserve Medicare and Medicaid. His campaign did not reply to interview requests.
The district is home to many retirees and veterans who often vote for Republicans. Several of those we spoke to express satisfaction with the healthcare options they already have, including Medicare and private insurance. But Dandiya says the district she's running in doesn't lean either way.
R DANDIYA: This district is actually a microcosm of our country's politics, that it is truly purple, and voters are just trying to find a way to make their ends meet.
JAVAID: Deep in the Everglades that span the district, besides the swamps, you'll also find sugarcane fields, cattle farms and people picking up their groceries at the Dollar General.
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JAVAID: Deanna Johnson (ph) is one of them. The 24-year-old dental hygiene student has been looking for insurance plans on the marketplace.
DEANNA JOHNSON: We're kind of in the middle of trying to get health insurance 'cause currently, everything is so high now.
JAVAID: She says her family is feeling the affordability crisis. They had to move inland from West Palm Beach when rent got too high. She's hoping things get better in the future.
JOHNSON: I hope we get free healthcare like you know, in other countries. They get free healthcare.
JAVAID: Johnson is the kind of swing voter candidates will need to win here.
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.
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JAVAID: At an early voting site in the suburb of Sunrise, Brent Harris (ph), a 58-year-old who works in construction, is thinking about...
BRENT HARRIS: Democracy, corruption, how people are treated. Then, of course, there's healthcare, immigration. I'm really, really not happy with the way things are.
JAVAID: He voted for President Trump in 2016. This year, he's voting for the Democrats. Harris worries about insurance for his family. One of his daughters is on Medicaid, but her 1-month-old daughter is uninsured. Two other adult kids working multiple jobs can't afford insurance. Harris thinks healthcare is a bipartisan problem.
HARRIS: But I think working together collectively is hopefully going to be solved.
JAVAID: For voters like Harris, in this affordability election, healthcare is just one more way the math has stopped working.
Maham Javaid, NPR News, Broward County, Florida. Transcript provided by NPR, Copyright NPR.
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