Wisconsin Residents Experience Sticker Shock on New Insurance Rates
Tax credits to offset premiums are set to expire unless Congress intervenes.
Connor Tarter (CC-BY-SA)
When Cyan Kelly logged into healthcare.gov, she says she was alarmed to discover that her monthly premium had skyrocketed.
The Marshfield area resident says she has numerous medical conditions including multiple sclerosis.
“I need health insurance,” said Kelly, an independent research contractor who also works retail.
Open enrollment through the Affordable Care Act Marketplace is now underway, and many Wisconsinites are seeing much higher premiums.
Experts have pointed to factors driving higher costs, including inflation, tariffs and the popularity of expensive drugs like GLP-1s.
Another major factor for people is the impending sunset of enhanced federal tax credits, which have offset monthly premiums for millions of Americans with ACA health insurance since they were first enacted in 2021.
Those subsidies are set to expire next year, unless Congress intervenes. Meanwhile, a partisan fight over those enhanced credits is fueling a record-long federal government shutdown after Senate Democrats refused to vote for a short-term spending bill that doesn’t include the subsidies.
How much are ACA premiums increasing by?
Hundreds of thousands of Wisconsinites are seeing higher ACA premiums, but the exact amount of those increases depends on a number of factors — like where they live, how much money they make and what level of coverage they select.
An analysis from the KFF finds that, for the average 40-year-old in Wisconsin, that monthly premium is set to rise from $495 to $611 for the second-lowest cost silver plan — an increase of 23 percent.
Those jumps are even steeper for some groups. A Dane County family of four with $130,000 in income, for instance, could see their monthly silver plan premium more than double from $1,026 to $2,073, according to Wisconsin’s Office of the Commissioner of Insurance. For a 60-year-old couple in Eau Claire County making $85,658, those monthly premiums would rise more than 600 percent from $396 to $3,103, according to the OCI.
What happens if the subsidies are extended?
It’s likely that those higher costs will lead many people to drop ACA coverage. The Congressional Budget Office estimates that 4 million Americans will lose their coverage if the enhanced credits expire.
Still, Allison Espeseth, the director of Covering Wisconsin, urged Wisconsinites to consider their options, and recognize that high costs that may come from going without health insurance. Covering Wisconsin is a federally funded nonprofit that helps people sign up for health insurance.
“There’s a lot of risk if you don’t sign up for a plan,” Espeseth said. “It’s something that most people can’t afford to go without.
Over the last year, more than 270,000 Wisconsin residents residents qualified for a total of $1.9 million in enhanced tax credits, making up the vast majority of the more than 310,000 Wisconsinites who enrolled in the ACA for 2025.
If lawmakers do renew the enhanced subsidies, Espeseth says it’s not year clear what the process would be for restoring them, now that open enrollment has already begun.
“Depending on the timing, it may be fairly seamless,” Espeseth said, adding that it’s possible the credits could be automatically applied. “I don’t know for sure, and nobody does. This is all theoretical.”
What is the ACA open enrollment deadline?
In the meantime, Espeseth said people shouldn’t wait to sign up.
“What we’re encouraging people to do is go ahead and start shopping for your plan and even enroll,” she said.
If you want coverage that starts Jan. 1 in Wisconsin, the deadline to enroll is Dec. 15. After that, you have until Jan. 15 to make changes or to enroll in coverage that starts Feb. 1.
Kelly, the greater Marshfield resident, hasn’t enrolled in next year’s plan yet. Over the last few weeks, she’s been waiting anxiously to see whether the enhanced credits are extended by Congress.
“I hope they are,” Kelly said. “But I don’t have anything beyond hope.”
As ACA enrollment opens, Wisconsinites experience sticker shock was originally published by Wisconsin Public Radio.
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