Rick Scott backs cash payouts to replace Affordable Care Act subsidies

For those worried about Affordable Care Act subsidies, U.S. Sen. Rick Scott has a solution.

The second-term Republican from Naples says it’s easier to just send money to people currently benefiting from the subsidies.

“We could fix health care pretty simple. Let’s just say, let people buy what they want to buy. If you’re entitled to a subsidy under the original Obamacare, give it to you in cash so you’re a buyer of health care,” Scott said on “Mornings with Maria.”

The Senator believes people “can buy health care cheaper many times if you just go buy it yourself, rather than go through an insurance plan.”

It’s uncertain whether Scott believes people should just go to cash pay rather than have plans, or whether this fix would lead to socialized health savings accounts. But odds are these concepts wouldn’t have a path to become reality before new health plans take effect in January.

Scott’s constituents face uncertainty and grim choices amid the 24-day federal shutdown, with the choice to go without health insurance looming.

Alexis Bakofsky, the Deputy Commissioner of Life and Health Insurance for Florida’s Office of Insurance Regulation, said enrollment could be lowered by 25% to 30% if subsidies are terminated, as Republicans prefer.

Currently, 4.7 million Floridians have Affordable Care Act individual insurance, meaning 1.4 million people who have insurance this year could be uninsured in 2026.

“Enrollment increased ~0.4M from 2024-2025 to a total market size of ~4.6M, but is on the decline and expected to drop significantly during 2026 Open Enrollment with the expiration of enhanced subsidies & Federal Rule implementation,” read a PowerPoint presented to the Florida House Health Care Facilities & Systems Subcommittee this month.

Chief Actuary Kyle Collins observed that increased “market morbidity” is creating a death spiral for the market, which could lead to a sicker risk pool that could drive up costs further.

“With the subsidies expiring, members going from zero-dollar premium to a non-zero-dollar premium, what you typically see is people who need the coverage, they’re going to find that extra 20, 30 bucks. People who don’t need the coverage, they’re going to drop. And so then the average health of the remaining population is significantly worse, needing a much larger rate increase,” he explained.