Moving to the United States comes with enormous opportunities — and one of the most common surprises immigrants face is the cost of health insurance. Unlike systems in Brazil and many other countries, the U.S. does not have a universal public health program. Health coverage here is largely private, and without guidance, the costs can feel impossible.
In 2026, the situation became even more challenging for many Floridians. The enhanced ACA subsidies that had been in place since 2021 expired at the end of 2025, and while the U.S. House passed a three-year extension in January 2026, the Senate has not yet voted. That means millions of people in Florida are now facing higher premiums than they did just one year ago.
But here’s what we want you to know: not having a plan does not mean you have no options. There are real, accessible alternatives — some government-funded, some private, and one that does not require any insurance at all. This article breaks them down clearly so you can make an informed decision.
ACA Marketplace and Subsidies (Premium Tax Credits)
The ACA Marketplace — found at HealthCare.gov — remains one of the most powerful tools for finding affordable health insurance in the United States. Even with the expiration of the enhanced subsidies, standard premium tax credits are still available for people who qualify.
In 2026, if your annual income falls between 100% and 400% of the Federal Poverty Level (FPL) — roughly $15,650 to $62,600 per year for a single person — you may be eligible for a tax credit that reduces your monthly premium. The lower your income within that range, the larger the subsidy tends to be.
For those earning between 100% and 150% FPL (approximately $15,650 to $23,475 per year for one person), Silver plans on the Marketplace may offer very low monthly premiums — and reduced out-of-pocket costs through Cost-Sharing Reductions (CSRs), which can significantly lower your deductible and copays when you use care.
Important: ACA Marketplace enrollment follows a set schedule. Outside of the annual Open Enrollment Period (typically November through January), you can only enroll if you experience a Qualifying Life Event — such as losing job-based coverage, getting married, having a baby, or moving to a new state. Contact an Assureline agent to find out if you qualify for a Special Enrollment Period.
Medicaid in Florida: Who Qualifies?
Medicaid is a joint federal and state program designed to provide health coverage for low-income individuals and families. However, Florida is one of ten states that have not expanded Medicaid under the ACA — and that creates what is known as the “coverage gap.”
Here is what the coverage gap means in practice: if your income falls below 100% of the FPL (under approximately $15,960 per year for a single person), you likely do not qualify for Florida Medicaid (unless you are a child, pregnant woman, elderly, or person with a disability) — and you also cannot receive ACA Marketplace subsidies, because those begin at exactly 100% FPL.
This gap affects an estimated 260,000 to 388,000 Floridians. That said, there are important exceptions:
- Children and teenagers have broader access through Medicaid and the CHIP (Children’s Health Insurance Program)
- Pregnant women may qualify at higher income levels
- People with disabilities or specific medical conditions may qualify through separate pathways
FQHCs: Reduced-Cost Clinics for Everyone
Regardless of whether you have health insurance, anyone in Florida can access FQHCs — Federally Qualified Health Centers. These are federally funded community clinics that serve all patients regardless of their insurance status or immigration status.
What makes FQHCs stand out is their sliding fee scale: you pay based on your income. Those with very low incomes may pay little to nothing for primary care visits, women’s health services, dental care, mental health services, and prescription medications.
Florida has more than 850 FQHC locations across the state, including in the Orlando area. To find the nearest location, visit findahealthcenter.hrsa.gov.
Short-Term Health Plans: A Temporary Safety Net
Short-term health insurance plans can be a practical solution for people who need temporary coverage — for example, during a job transition, after losing work authorization, or while waiting for the next ACA Open Enrollment Period.
These plans typically have lower monthly premiums than ACA Marketplace plans, but they come with important limitations:
- They may not cover pre-existing conditions
- They often have limited benefits — maternity care, mental health, and preventive care may not be included
- They do not count as “minimum essential coverage” under the ACA
An Assureline agent can help you compare available short-term plans and assess whether this option fits your situation.
Frequently Asked Questions (FAQ)
1. I am undocumented. Can I still use any of these options?
FQHCs serve all patients regardless of immigration status and do not ask about documentation.
2. I just lost my job and my employer health plan. What should I do?
Losing job-based coverage is a Qualifying Life Event. That gives you a Special Enrollment Period — typically 60 days — to enroll in a Marketplace plan. Acting quickly is important.
3. Can my children get coverage even if I don’t qualify?
Yes. In Florida, children may qualify for Medicaid or KidCare (Florida’s CHIP program) at higher family income levels than what is required for adults.
Conclusion
Not having health insurance in the U.S. can feel overwhelming — especially when you are navigating an unfamiliar system in a new country. But lack of information is not the same as lack of options. Between the ACA Marketplace, Medicaid, FQHCs, and short-term health plans, there are paths forward for most people.
At Assureline, we specialize in guiding the Brazilian and immigrant community in Orlando and across Florida. We understand the questions, the concerns, and the challenges you face — and we are here to help.
Have questions about the right coverage for you and your family? Talk to an Assureline Insurance specialist today! Call us at (407) 502-0203 or visit our website to request a free quote.
