(The Center Square) – Florida is once again the most popular state for Affordable Care Act health insurance, according to the U.S. government.

In the most recent open enrollment period for the health insurance which ran from Nov. 1 to Jan. 16, 4.2 million Florida residents signed up for Affordable Care Act plans, according to the U.S. Department of Health and Human Services. Nationally, a record 21.3 million people signed up, the agency said.

“For decades, when it came to federal programs we could depend on to keep Americans covered, three were always top of mind – Medicare, Medicaid, and Social Security, but now it’s crystal clear that we need to add a fourth – the Affordable Care Act,” said Health Secretary Xavier Becerra. “Once again, a record-breaking number of Americans have signed up for affordable health care coverage through the Affordable Care Act’s Marketplace, and now they and their families have the peace of mind that comes with coverage.”

Florida’s large population is one factor in the state’s top ranking for Affordable Care Act, said Stefan Rayer, population program director of the University of Florida’s Bureau of Economic and Business Research.

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“The most recent American Community Survey for 2022 shows Florida having the third-largest number of uninsured in the country, behind Texas and California,” Rayer told The Center Square. “There clearly is demand for affordable health insurance, and for many Floridians who don’t have access to employer-sponsored coverage the Affordable Care Act is often the best – and sometimes the only – option to obtain it.”

A nonprofit group, Florida Decides Healthcare, has launched a petition drive to put Medicaid expansion on the ballot for 2026. Governor Ron DeSantis and the Legislature have refused to enact expanded Medicaid, leaving Florida one of 10 states in the country that has not expanded the jointly state-federal funded program.

If Medicaid expansion is approved, “billions of our tax dollars would be brought back to our state to pay for health care,” the organization said. “The increased demand for health services would create more than 130,000 new jobs in Florida.”

But Florida House Speaker Paul Renner has countered, “We can’t give all things to all people, and if it’s not a true safety net, it goes back to (former British prime minister) Margaret Thatcher’s saying that the great problem with socialism is that eventually, you run out of other people’s money,” the Tallahassee Democrat reported.