Wisconsin sets Healthcare.gov record
For the second year in a row, Wisconsin set a record for Affordable Care Act health plan sign-ups.
Per federal data, 313,579 Wisconsinites chose 2025 health coverage through Healthcare.gov during the open enrollment period, which ran from Nov. 1 through Jan. 15. That was about an 18 percent increase from the previous period, or 47,252 more people.
Covering Wisconsin, a program of the University of Wisconsin-Madison Division of Extension, is the state's navigator agency that helps people sign up for health insurance.
Navigator Program Manager Adam VanSpankeren said the record enrollment didn’t come as a surprise based on how busy they were.
“Our schedules were full pretty much the entire open enrollment period,” he said. “We were just doing everything we could to accommodate as many people as possible.”
VanSpankeren talked to Wisconsin Health News this week about what led to the record and what’s needed to sustain it.
Edited excerpts are below.
WHN: Last open enrollment period occurred in the midst of Medicaid phasing back in renewals, after they were on hold during the COVID-19 pandemic. That put focus on continuity of insurance coverage for those leaving the program. What were the factors behind the record this year?
VanSpankeren: When you have something like the Medicaid unwinding, there's a certain amount of awareness and education that happens. So you have people renewing and returning. But then, as you have that happen, people trust the marketplace. They trust their navigators, and that spreads word of mouth. There's not a really great way to track word of mouth. But the more people that use it, there's a ripple effect that spreads throughout the community.
I would say a lot of organizations out in the community that have a lot of trust with the public did a lot of outreach and promotion and let people know that this is a thing.
And frankly — I don't get political — but there is an element, I think, whenever there's also an election happening, of, ‘We need to use this because it sends a message that this is important.’ And I think that increases the outreach, promotion and visibility of something like the ACA and the marketplace. Because then people know, ‘Hey, we want to protect this. We want to use it. We are using it. Don't take it away.’
WHN: What’s needed to sustain the growth?
VanSpankeren: More support for navigator programs, and more support for our work. We have a really good relationship with the state. We have had a really strong federal partnership, and I would like to see that not go away. It’s a triad there, where it's state, federal and us. Those three elements working together allows us to do this work really well, and it allows the funding to flow really well.
The main thing, I think, for the strength of the marketplace, the numbers that we're seeing and the strength of the ACA as a whole, is going to be the continuation of those extensions on the increased tax credits. I don't think the average person knows, or even should have to know, what the impact of those really is. Health insurance should just be affordable, and they don't know that that's what's making them affordable. So if those go away, that could have a huge impact. People don't need to know the policy to know that the price jumped by $100 or $200.
WHN: What are you expecting to see from President Donald Trump’s administration?
VanSpankeren: One of the things we saw in the first administration was paring back the duration of the open enrollment period, from a Jan. 15 deadline to a Dec. 15 deadline. Now, as I recall from studying the ACA way back when it was rolling out, that was always going to happen. They moved that up much sooner than it should have been the first time. If that happens, it won't be the end of the world. There will still be very high numbers, and people will still get in. I find that if you give people a deadline, it doesn't really matter when it is or how long the window is. They work backwards from there and plan accordingly. But that is one thing that I expect we will see this coming fall.
In terms of our program — we just started our five-year grant — it remains to be seen. It’s hope for the best, plan for the worst. We don't want a major impact for us. The first time around, our funding was cut, and it got very difficult to do our work as a result. We leaned on our other partnerships to keep going and to remain successful. We're in that mindset of ‘what ifs,’ and we need to be realistic and plan. But I would say, as of right now, we’re just trying to do this work and do it well. We don't have anything to prove. The success of the marketplace, and the success of our navigator program here in Wisconsin, speaks for itself.
One of the things about remaining apolitical is we don't want a political ship to turn against us either. This work is apolitical. Health insurance should be apolitical, where people can just enroll and have health insurance and have their families covered. I think that's one reason it's such a strong issue because people want to not have to worry about this.