Covering Wisconsin in the News
As ACA enrollment opens, Wisconsinites experience sticker shock
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.
Up to 60,000 Wisconsinites could lose Obamacare coverage if subsidies expire, insurance official warns
About 40,000 to 60,000 Wisconsinites who buy health insurance through the Affordable Care Act could lose coverage, the state's top insurance official estimated, if Congress does not extend subsidies that make the health plans cheaper.
The subsidies helped drive this year's record-high enrollment in the Affordable Care Act marketplace, with about 300,000 Wisconsin consumers signing up for coverage. That could be undone, Wisconsin Insurance Commissioner Nathan Houdek said, if the subsidies go back to previous, reduced levels at the end of the year, when increases to the financial aid expire.
Expanded ACA subsidies set to expire, leaving thousands of Wisconsinites at risk of losing coverage
In 2021, Congress passed premium tax credits expanded eligibility for reduced cost of Affordable Care Act healthcare plans. Initially, this was supposed to last until 2022, under the American Rescue Plan Act of 2021, but this was continued through 2025 via the FY2022 Budget Reconciliation Law, according to congress.gov.
With the subsidies about to expire, health insurance plans are expected to rise in price. Around 300,000 people enrolled in these ACA plans are lower to middle class Wisconsinites, and many of these people may decide that healthcare will no longer be affordable to them without PTCs, UW Chair of the Risk and Insurance Department Justin Sydnor said.
Within the past couple of weeks, insurance plans have risen by more than 30 percent, and Covering Wisconsin, an organization dedicated to connecting Wisconsinites with health insurance programs, is already hearing from Wisconsinites that they cannot afford these increases, according to Covering Wisconsin Enrollment, Network and Accessibility Manager Caroline Gomez-Tom.
“With the end of these enhanced premium tax credits, we’re already hearing from folks that they make go without [health insurance]…They have other bills to pay, they have food to put on the table,” said Gomez-Tom.
How to navigate the health care marketplace as premiums rise and options shrink
People who rely on the federal Affordable Care Act marketplace to choose health insurance for 2026 must contend with a host of challenges as the open enrollment period begins. Those include hikes in premiums and other fees, the potential ending of tax credits that made payments more affordable, and fewer options in some areas.
That’s as a growing number of residents have used the marketplace. More than 300,000 Wisconsinites, or about 5% of the state’s population, signed up for plans last year at HealthCare.gov — more than double the enrollment from about a decade ago.
ACA premiums expected to skyrocket for Wisconsinites
Gov. Evers and state insurance experts estimate that healthcare insurance premiums will skyrocket next year.
County Executive Crowley Highlights Open Enrollment Period for Marketplace Insurance, Calls on Congress to Extend ACA Tax Credits to Lower Health Care Costs for Working Families
MILWAUKEE — During a press conference at the Marcia P. Coggs Health and Human Services Center, Milwaukee County Executive David Crowley called on President Donald Trump and congressional leaders to extend the Affordable Care Act (ACA) enhanced tax credits to lower health care costs and prevent insurance premiums from spiking for working families in Wisconsin. Crowley also reinforced the urgency for residents to enroll in HealthCare.gov Marketplace health care coverage during the 2025–26 Open Enrollment period, which ends on January 15, 2026.
“Access to affordable healthcare coverage is fundamental to our vision of becoming the healthiest county in Wisconsin,” said County Executive Crowley. “When people lose or can no longer afford healthcare coverage, they face impossible choices. Working families should not have to decide between paying their bills, putting food on the table, or accessing quality, affordable healthcare coverage. It’s time for President Trump and leaders in Congress to both end the federal government shutdown and extend the enhanced ACA tax credits so people can access the healthcare they need at a price they can afford.”
Open Enrollment begins, Wisconsinites likely to see higher costs
EAU CLAIRE, Wis. (WEAU) - More than 24 million Americans receive health insurance through the Affordable Care Act, and over 90 percent of enrollees get federal tax credits to help lower costs.
As the government shutdown continues, many Wisconsinites may face higher prices.
“It’s really important for people to think very carefully about what their families need from their coverage because prices across the board are going to go up for 2026,” Reba Rice, the Chief Community Officer with Northlakes Community Clinic, said.
As open enrollment begins, Wisconsinites might be surprised to see higher costs. Those prices could especially go up for low-income families if lawmakers don’t extend federal subsidies that cut their costs. In the meantime, local leaders are emphasizing the importance of health insurance.
Open enrollment underway on HealthCare.gov; what to know
MILWAUKEE - The Milwaukee Enrollment Network and Covering Wisconsin on Tuesday, Nov. 4 welcomed state and local leaders to kick off the 2025-26 HealthCare.gov Marketplace Open Enrollment Season.
Open Enrollment Season runs from November 1, 2025, to January 15, 2026. During the news conference, officials shared key policy updates, information about why insurance coverage is important, and how residents can get or stay connected to Marketplace or Medicaid coverage….
With health insurance premiums expected to rise, here’s how to prepare for ACA open enrollment
Saturday marks the start of the open enrollment period for Americans who get their health insurance through the Affordable Care Act marketplace. And with pandemic-era health insurance subsidies set to expire at the end of this year, premiums are expected to spike.
Extending those tax subsidies is the central demand from Democrats in the negotiations over the ongoing government shutdown.
In Wisconsin, more than 310,000 people purchased their 2025 health insurance through the ACA marketplace, according to the Wisconsin Office of the Commissioner of Insurance. On Monday, the office released its 2026 projections for how much premiums will go up for select groups of enrollees. Gov. Tony Evers said insurance rates for many covered through Wisconsin’s ACA exchange will increase by between 200 to 800 percent next year…
Retirees Face Insurance Uncertainty During Government Shutdown
Here is what you need to know.
(JUNEAU) Americans who use advanced premium tax credits to help pay for Affordable Care Act coverage are sweating out the long government shutdown.
“The advanced tax credits are for people between 300%-400% of the federal poverty level, which is potentially a lot of retirees, depending on how they have their income stream set up,” said Amanda Higgins, an elder benefit specialist with the Dodge County Aging and Disability Resource Center.
Health care subsidies are the sticking point of the shutdown fight between Republicans and Democrats. Higgins told Daily Dodge that people with questions should contact their insurance agent or reach out to a U-W Madison Extension program called Covering Wisconsin.
What you need to know about changes to FoodShare (SNAP) and Medicaid
Here is what you need to know.
Changes to FoodShare (SNAP)
Nearly 700,000 Wisconsinites receive food and nutrition assistance through FoodShare.
Reno Wright, advocacy director for Hunger Task Force of Milwaukee, said that while no changes have been enacted yet, the bill calls for a series of modifications.
Some include:
Work requirements. The age range for adults required to meet work requirements will increase from 18–54 to 18–64. Parents of children age 14 and older will now also need to meet work requirements.
Restrictions for new legal immigrants: Before the bill, many immigrants like those with refugee status were exempt from the five-year waiting period that some legal permanent residents face to qualify for FoodShare benefits. The new law removes these exemptions, effectively making many new immigrants ineligible for the food assistance program.
Stricter exemption rules: Some people like veterans, people who are homeless and former foster youths aged 18–24 are exempt from having to meet work requirements in order to receive SNAP benefits. The bill removes those exemptions.
These changes will only be implemented once the Wisconsin Department of Health Services receives further guidance from the U.S. Department of Agriculture.
Wright said current FoodShare recipients should ensure their contact information is up to date to receive future updates.
Around 9 million people lose Medicaid each year because of paperwork mistakes. Is that preventable?
Medicaid is a federal program that provides free or cheap health insurance for more than 70 million Americans who are either low-income or have disabilities. The program is massive and costs hundreds of billions of dollars each year.
According to one finding, around 20% of people who receive Medicaid lose their coverage during the renewal process. This means that every year, more than 9 million people who were previously eligible lose their benefits because they don’t fill out the right paperwork.
How to address this issue of bureaucracy and red tape is a question that researchers like Laura Dague have been wrestling with.
She’s a professor of health policy at the Bush School at Texas A&M University and coauthor of a new working paper on this subject. She joined the Standard to discuss their findings.
This transcript has been lightly edited for clarity.
Texas Standard: You and a team of researchers designed an experiment to try and address this issue in which people lose coverage due to red tape. Could you explain how it worked?
Laura Dague: Our study was set up to look at whether sending folks outreach offering free help from trained health insurance navigators could work to help eligible people enrolled in their coverage when they tried to renew.
And so we worked with a trusted community health insurance navigator group in Wisconsin called Covering Wisconsin and sent pre-recorded phone calls to more than 55,000 households offering help from our navigators to help renew their Medicaid.
After years of growth, advocates fear Affordable Care Act is going backward
Months away from 2026, Amanda Sherman worries often about how the new year will change her health care. Sherman, a broker’s assistant in a real estate office, buys her health insurance through the federal health insurance marketplace, HealthCare.gov. Her coverage has helped her through a chronic illness and critical health setbacks.
Her health plan costs her $300 a month. Without it, she says she couldn’t afford the weekly shots that she gets for lupus — a chronic autoimmune disorder she was diagnosed with five years ago.
HealthCare.gov was established in 2014 as part of the Affordable Care Act (ACA). “It’s been there as a great resource when I haven’t been able to get insurance at work,” Sherman says.
In 2026, however, Sherman expects the cost of her health insurance to skyrocket. An enhanced federal subsidy that helped her afford the coverage is set to disappear at the end of this year. When that happens, she isn’t sure what she’ll do.
In the last few years, record numbers of Americans, including record numbers of Wisconsin residents, have been signing up for coverage that the ACA has made possible.
“When we look back over the last decade, the number of uninsured people in our state has dropped by over 200,000 thanks to the Affordable Care Act,” Wisconsin Commissioner of Insurance Nathan Houdek tells the Wisconsin Examiner. “So we’ve seen a lot of success in terms of more people getting health insurance coverage and being able to access the health care they need as a result.”
Advocates warn that that is about to change under policies coming from the administration of President Donald Trump and the Republican majority in Congress.
“It’s going to take apart a lot of the advances that have been made to extend coverage to more people,” says Bobby Peterson, executive director of ABC for Health, which provides nonprofit legal services and advocacy for people caught up in medical debt…
Caroline Gomez-Tom on ACA health plan price hikes for 2026
I'm Steven Potter for "Here& Now". >> In health care news. Affordable Care Act premiums are expected to increase sharply when people enroll, starting in November. Insurance companies are making their projections now for 2026. Rates in Wisconsin, nearly 850,000 people are enrolled in ACA plans. 12 insurers across the state that offer marketplace plans, project increases ranging from 6.6% to 34.5%, according to Health system analysts. What's driving this increase? We turn to Caroline Gomez-Tom, an enrollment manager with the covering Wisconsin program, which helps people sign up for marketplace plans. And thanks very much for being here. Frederica. >> So when you saw these projected premium hikes, what was your reaction, especially to the like 34.5% increase? >> Yeah, it was definitely a startling hike. Except we weren't necessarily surprised knowing that there were some things that were in the mix regarding enhanced premium tax credits that were going away or potentially going away. You know, Congress could still act in, you know, these several months before the end of the year and then some other policy changes that have happened at the federal level. Plus healthcare costs, rising inflation, etc, that could be a part of this. But to see the numbers that we are expecting for this year, it it took it took your breath away. >> Yeah. So these enhanced tax credits are due to expire at the end of 2025. How did those tax credits help with out-of-pocket costs? >> Yeah. So these extended tax credits, they have been in place now since 2020. And essentially they expanded really the discounts or the amount that people qualified for to lower their cost of insurance, especially for those folks that had slightly higher incomes. So that middle income range above 400% of the federal poverty level. And what that means is that people had more options to consider when they were looking at the healthcare.gov options, instead of just going directly to the lowest cost bronze plan with a crazy out of pocket cost for an individual, they could actually shop around realistically and look at the plan that may cost a little more per month, but because of those extended premiums, they could afford it, but had also lower out of pocket costs for them. >> And so did those premium tax credits. Encourage a lot more people to actually enroll? >> Absolutely. And we could see that even just this last year where we hit a milestone year in enrollment in Wisconsin, we had 313,000 people sign up, which was the highest we'd seen since the marketplace opened in 2014….
Wisconsin insurers are proposing a wide range of rate increases for next year’s ACA marketplace plans, from 6.6% up to 34.5%
From WisPolitics.com/WisBusiness.com …
These proposed premium increases were filed with state regulators by health insurers for Affordable Care Act-regulated health plans for 2026, according to a recent report from the nonprofit KFF.
Across all 312 insurers in the ACA marketplaces, the national median proposed premium increase is 18% — about 11 percentage points higher than last year. And the average proposed rate increase for these insurers is about 20%, KFF reports.
In Wisconsin, the median proposed increase is 12.9% and the average is 16.1%.
Report authors note rising health care prices “stood out as a key factor” driving costs in 2026 based on insurer documents. Provider consolidation was also referenced by some insurers as playing a role, as hospital mergers and acquisitions are seen as contributing to higher contracted prices for services and less innovation.
“Insurers cite increasing cost and utilization of high-priced drugs as well as general market factors, such as increasing labor costs and inflation, as contributing to premium increases,” they wrote.
Meanwhile, most insurers are assuming the enhanced premium tax credits will go away after they’re scheduled to sunset at the end of this year, barring action by Congress to extend them. KFF says this assumption is driving proposed rates up by 4% on average.
Adam VanSpankeren is the navigator program manager for Covering Wisconsin, a program of the UW-Madison Divison of Extension that helps state residents get connected with health insurance. In a recent interivew, he said the expected loss of expanded subsidies “is terrible,” but noted standard marketplace subsidies would still be in place.
“We saw it before the expanded subsidies were in place, the prices could be such that the subsidy is still significant, and significant enough to offset a lot of plans on the marketplace,” he said.
Still, he added the loss of expanded subsidies will have the biggest impact on people who are middle-aged and making mid-level income.
“The lowest-income people tend to get the highest tax credits, the highest subsidies … and then people who are at higher incomes can afford their insurance, even maybe without the expanded subsidy,” he said. “People in the middle tend to get squeezed the most.”
Among Wisconsin insurers’ proposed rate increases, the three highest are UnitedHealthcare of Wisconsin Inc. at 34.5%, Compcare Health Services Insurance Corporation at 30.8% and Security Health Plan of Wisconsin, Inc. at 24.3%.
The three lowest are MercyCare HMO, Inc. at 6.6%, Group Health Cooperative of South Central Wisconsin at 6.9% and Network Health at 9.8%.
A spokesperson for the state Office of the Commissioner of Insurance says the agency has received rate filings from marketplace health insurers and is “in communication with them about their proposed rates.” OCI will release final ACA rates for 2026 in the fall.
See the KFF report.
— Gov. Tony Evers announced Eli Lilly and Co. will be eligible for up to $100 million in state tax credits to boost its $4 billion investment in a Wisconsin manufacturing facility.
According to the Wisconsin Economic Development Corp., the $100 million in incentives are contingent upon the company creating at least 700 jobs and making at least $2.2 billion in capital investments.
The incentive package includes benchmarks for each year over the 12-year life of the enterprise zone with a cap on how many credits can be earned.
The Indianapolis-based company announced in December that it planned a $3 billion expansion of the Kenosha County manufacturing facility it had acquired earlier last year. The company expected to add 750 jobs to the more than 100 already working at the facility.
The guv’s office said the company’s acquisition, expansion and additional purchases of property upped the planned investment to $4 billion.
Evers yesterday praised the company’s “historic investment in our communities” as “great news for Wisconsin.”
Meanwhile, Lilly Executive Vice President Edgardo Hernandez said the company appreciates the partnership and leadership from the guv, WEDC, local officials and others.
“We look forward to contributing to the region’s strong legacy of innovation and economic vitality for years to come,” said Hernandez, who’s also president of the company’s manufacturing operations.
See the release below.
HEALTH INSURANCE EDUCATION WORKSHOPS
The Catholic Multicultural Center is partnering with Covering Wisconsin to host two health insurance workshops, one in Spanish on July 8th and one in English on July 15th. Both are from 5:00 to 6:30pm and will take place in the CMC community room (1862 Beld St, Madison – which most of you know from our former LaSup meetings there).
The workshop will cover health insurance basics, understanding plans, how to use health insurance, and resources to access insurance. All are welcome to attend but pre-registration is preferred.
Attached is the poster; here is the link to register:
U.S. Sen. Baldwin: Shaheen, Castor, Evans intro bill to reverse Trump’s cuts to key ACA program that helps more Americans sign up for health insurance
In February, Trump Administration slashed 90% of funding for Navigator program
Trump’s Navigator cuts in 2017 and 2018 contributed to 2.5 million fewer people accessing healthcare through the ACA Marketplace
WASHINGTON, D.C. – As President Donald Trump and Congressional Republicans work to gut the Affordable Care Act (ACA), U.S. Senators Tammy Baldwin (D-WI) and Jeanne Shaheen (D-NH) and U.S. Representatives Kathy Castor (D-FL-14) and Dwight Evans (D-PA-3) introduced legislation today in the Senate and House to restore a key program of the health care law that helps American families navigate the ACA marketplace and connect them with high quality, affordable health care plans. The Expand Navigators’ Resources for Outreach, Learning, and Longevity (ENROLL) Act would ensure the Navigator program, which was established under the ACA to help Americans navigate, shop, and enroll in affordable health care plans, will continue despite the Trump Administration cutting funding by 90 percent in February.
“We have seen this movie before: when he doesn’t get his way to fully repeal it, Donald Trump tries every which way to chip away at the Affordable Care Act and kick Wisconsin families off their health care, and sadly, it works. At a time when Wisconsinites are worried their care is on the chopping block under Republicans’ plan to give tax breaks to the wealthy, the Trump Administration is also gutting a key program that helps our neighbors find health care coverage that they can afford,” said Senator Baldwin. “Wisconsin’s Navigator has connected thousands of families with good health care coverage, ensuring more Wisconsinites can access the care and treatment they need to stay healthy. We should be investing in bringing the cost of care down for Wisconsinites, not jacking up costs and eliminating proven resources that connect more families with affordable insurance.”
Read more by clicking the button below:
Proposed budget cuts put health insurance navigator program in danger
A steep funding cut expected to take place later this year threatens to gut Covering Wisconsin, a statewide health insurance navigator program that provides free guidance and other resources to help people access health coverage.
Covering Wisconsin, enacted as a result of the Affordable Care Act in 2014, employs dozens of expert navigators to help people enroll in and find options for health insurance, including Medicaid and Medicare. The program assisted over 97,000 consumers with insurance-related issues in Wisconsin last year and helped nearly 10,000 individuals with insurance enrollment.
A funding cut to navigator programs nationwide, announced by the Centers for Medicare & Medicaid Services in February, would reduce current navigator funding by 90% by the time it takes effect on Aug. 27
Covering Wisconsin received $3.1 million in federal funding during the 2023-2024 budget cycle, according to federal navigator and enrollment data. A 90% cut would reduce that to around $300,000.
“With a funding cut, our work will be more limited,” said Allison Espeseth, director of Covering Wisconsin.
Wisconsin Health News
Covering Wisconsin faces funding cut - Covering Wisconsin, the statewide agency that helps people sign up for health coverage, is warning that a federal funding cut will limit its work to help the public know insurance options and find financial help. The Centers for Medicare and Medicaid Services said Friday that it will reduce money for the Affordable Care Act navigator program to $10 million annually. In plan year 2024, navigators received $98 million. CMS said the reduction will allow Healthcare.gov to “focus on more effective strategies,” arguing that performance data show that navigators are not “enrolling nearly enough people to justify the substantial amount of federal dollars previously spent on the program.” CMS also said that cutting the funding will save $360 million over four years and support lower premiums. The reduction is set to take effect for plan year 2026. Covering Wisconsin Director Allison Espeseth said Friday they did not have more details on what the planned cut means for Wisconsin. Last fall, Covering Wisconsin received $3.2 million. The announcement indicates that navigators in Healthcare.gov states will face a 90 percent cut. Espeseth said a big part of their work is raising public awareness. “A funding cut of this size will significantly limit our ability to help the public and other professionals in Wisconsin to simply know what health insurance coverage options are out there and how to get financial help,” she said. “We'll be further reduced in our capacity to offer people any assistance with enrolling, using their coverage to get care, learning how to pay for benefits and switching to a different plan when the time comes.” Espeseth noted that Healthcare.gov enrollment could drop, similar to when funding declined by 80 percent from 2017 to 2020.
Trump administration again slashes funding for Obamacare program that helps Wisconsinites find health coverage
A Wisconsin program that helps people sign up for health insurance will likely face steep cuts later this year, following an announcement that the federal government would slash its funding.
This month, the Centers for Medicare and Medicaid Services said it would cut funding nationwide for navigator programs, which help enroll people in health coverage, to $10 million, a drop of about 90%.
"A cut of this size will impact our ability to provide all the services and all the information in as timely a way as possible," said Allison Espeseth, director of Covering Wisconsin, the navigator program for the state.
Federal funding makes up about three-quarters of Covering Wisconsin's budget, Espeseth said. The cuts would occur starting in its next budget cycle in late August, she said.
Last budget cycle, Covering Wisconsin received a grant of $3.1 million from the federal government for the year, according to federal data. A cut of 90% would leave about $300,000.
In its press release, CMS said the current funding levels don't “represent a reasonable return on investment" and that reducing the program's budget will save $360 million over the next four years.