10/27/2025 | Press release | Distributed by Public on 10/27/2025 11:05
| FOR IMMEDIATE RELEASE: October 27, 2025 |
| Contact: [email protected] |
| NEW: Healthcare Premiums for Wisconsinites to Skyrocket in 2026 if Republicans Fail to Extend Affordable Care Act Tax Credits |
| Wisconsinites face sticker shock on out-of-pocket healthcare coverage costswith many seeing premiums double, some seniors seeing increases of over $30,000 per year if Congressional Republicans allow enhanced Affordable Care Act supports to expire |
|
MADISON - Gov. Tony Evers, together with Office of the Commissioner of Insurance (OCI) Commissioner Nathan Houdek, today released 2026 plan year rates for Wisconsin's individual marketplacethat show healthcare coverage costs are expected to skyrocket for Wisconsinites if President Donald J. Trump and Republicans in Congress fail to extend the Affordable Care Act enhanced premium tax credits. Based on increased rates approvedby the Trump Administration for the 2026 plan year, combined with the significant consequences of Congressional Republicans failingto extend theenhanced AffordableCare Act premium tax credits, many Wisconsinites and their families willsee their premiums double, with some seniorsseeing an increase of over $30,000per year. The announcement today comes on Day 27 of the federal government shutdown as Congressional Republicans have refused for weeks to negotiate with Democrats to extend Affordable Care Act enhanced premium tax credits that are set to expire at the end of the year even as Wisconsinites and Americans across the country are set to sign up for healthcare coverage during the 2026 Open Enrollment period starting later this week on November 1. The Affordable Care Acttax credits have helped make healthcare coverage more affordable for millions of Americans. According to KFF, 78 percent of Americansand nearly 60 percentof Republicans support extending the tax credits, and according to the Center for American Progress, relativeto original premium tax credits, the Affordable Care Act's enhanced tax credits lowered marketplace premiums by an average of 44 percent for millions last year. The 2026 plan rates released today are the first real glimpse of how Wisconsinites will be priced out of being able to afford healthcare coverage, with most Wisconsinitesseeing costs soar by hundreds or even thousands more dollars a month. "At a time when costs continue to go up and families and seniors are already struggling to make ends meet, we should be doing everything we can to make healthcare more affordable and accessible. But instead, Republicans in Congress are refusing to extend key supports under the Affordable Care Act, which means some Wisconsinites will pay hundreds or thousands of dollars more every month and even tens of thousands of dollars more a year-folks, that's breathtaking," said Gov. Evers. "With Open Enrollment just days away, President Trump and Republicans in Congress must work across the aisle to ensure these Affordable Care Act tax credits do not expire and prevent Wisconsin families and seniors from seeing their healthcare coverage costs skyrocket. Republicans' reckless decisions are causing prices on everything to go up, from groceries to gas-Wisconsinites cannot afford to pay even more for healthcare, too. Republicans need to end this chaos and stop working to make healthcare more expensive. It's that simple." How much Wisconsinites' healthcare coverage costs will increase varies depending on age, income, plan selection, and available insurers in each county, but manyWisconsinites will see their premiums increase significantly,with seniors and middle-class families seeing some of the largest increasesif Republicans in Congress do not extend enhanced tax credits under Affordable Care Act. The Wisconsin Office of the Commissioner of Insurancetoday released several scenarios illustrating the enormous out-of-pocket costs Wisconsinites will seeon a monthly and annual basisbased on example ages, incomes, and countiesof residence. For example, without the reinstatement of enhanced premium tax credits, a middle-class family of four fromMarathon Countycould see their premium more than double, going from $886 a month to over $2,300 a month. In Barron County, a 60-year-old couple, making around $85,000 could see their premiums skyrocket over 800 percent, with an annual increase of over $33,000 in costs. Even in a county with more insurers available like Dane County, a 60-year-old couple could still see their premium triple, costing them another nearly $20,000 a year. A26-year-old in Eau Claire, making $48,000 a year and who is no longer eligible to be on their parent's insurancewould see their premium costan additional $2,000 a year. As a result, it'sexpected these increased costs will cause more young, healthy individuals to go without healthcarecoverage, negatively affecting the market for all age groups. During the last Open Enrollment Periodin 2024, a record-setting 313,579 Wisconsinites signed up for health insurance through the Affordable Care Acton the individual marketplace. Thanks to the efforts of U.S. Sen. Tammy Baldwin (D-Wisconsin), U.S. Rep. Gwen Moore (D-Wisconsin), and U.S. Rep. Mark Pocan(D-Wisconsin)to create and continue the Affordable Care Act's enhanced tax credits,healthcare coverage has been more affordable than ever. During the last enrollment period,277,175 of the 313,579 enrollees qualified for premium subsidies, with an average premium subsidy of $664 per month across all Wisconsin counties. According to KFF, of the over 24 million Americans enrolledthrough the Affordable Care Act, a vast majority receive an enhanced premium tax credit, and 70 percentof those who purchase their own insurance say they wouldnotbe able to afford premiumsif the tax credits go away. Further, of those who purchasetheir own insurance, 40 percent report that they would expect to be priced outfrom healthcare coverage entirely and become uninsured. In all, without federal action, an estimated 20 million Americans are facing significant premium increases, and nearly 4million Americans will be uninsured by 2027. "Wisconsin's strong market has made it possible for hundreds of thousands of residents to access high-quality health coverage," said Commissioner Houdek. "As we see changes in this market due to disruption at the federal level, we will continue to coordinate with our partners across the state to promote insurance coverage and protect healthcare access." ADDITIONAL BACKGROUND ON GOV. EVERS' EFFORTS TO ENSURE WISCONSINITES HAVE ACCESS TO HEALTHCAREUNDER THE AFFORDABLE CARE ACT Gov. Evers and the Evers Administration have worked diligently to protect and expand access to quality, affordable healthcare in Wisconsin. Among Gov. Evers' first acts in office was delivering on his campaign promiseto withdraw Wisconsin from a lawsuit aimed at dismantling the Affordable Care Act, which would have gutted coverage for 2.4 million Wisconsinites who have pre-existing conditions. In 2019, Gov. Evers created a partnership between the Office of the Commissioner of Insurance and the Department of Health Services aimed at helping improve healthcare access across the stateby increasing enrollment under the Affordable Care Act and ensuring Wisconsinites could find affordable healthcare options that work for them and their families. Under the Evers Administration, the DHS OCI Healthcare Coverage partnership hashelped improve coordination around outreach and education, increase enrollment and health insurance literacy, and improve enrollment retention. In 2020, the partnership launched WisCovered.com as an accessible resource for consumers looking for information about health coverage. Services are available in English, Spanish, and Hmong. Since the partnership was created, thousands of Wisconsinites have utilizedthe Partnership's enrollment information resource, WisCovered.com, to learn about their options and find out how to get enrollment assistance. During the previousenrollment period, over 51,000 people visited the site.Last year, in large part due to the partnership's efforts, Gov. Evers celebrated Wisconsin havingthe highest and most successful open enrollment everon HealthCare.gov, eclipsing the 2024 record-breakingenrollment yearby tens of thousands of new enrollees, which was already a 20-percent increase in enrollment over the previous period in 2023. Thanks to the efforts of the Biden-Harris Administration and U.S. Sen. Tammy Baldwin, coverage up to today-and prior to Republicans refusing to extend key Affordable Care Act tax credits, coverage has been more affordable than ever. Bolstered by the American Rescue Plan Act and extended by the Inflation Reduction Act, in 2023, the majority of Wisconsiniteswho enrolled in health insurance on HealthCare.govqualified for cost savings, with the average person saving $573.11 on their monthly insurance premiums. During the last Open Enrollment period, 313,579 Wisconsinites enrolled in coverage on HealthCare.gov-more than 88percent(277,175) of those Wisconsinites qualifiedfor premium subsidies, with an average premium subsidy of$664 per monthacross all Wisconsin counties. As it became clear in recent months that it appeared President Donald J. Trump and Republicans in Congress were considering not extending Affordable Care Act tax credits thathelp ensure hundreds of thousands of Wisconsinites can continue to afford their healthcare coverage, Gov. Evers took immediate steps urging Congress to take action. Gov. Evers, together with a coalition of 17 other governors, sent a joint letterurging Congress to extend the enhanced premium tax credits provided by the Affordable Care Act. In the letter, the governors emphasized the added impacts of President Trump's budget reconciliation bill, which was supported and passed by Republicans in Congress, including every Republican member of Wisconsin's congressional delegation, and reduces or eliminates several federal initiatives that help keep healthcare affordable and accessible to all, including making significant changes to Medicaid, Medicare, and the Affordable Care Act. ADDITIONAL INFORMATIONON THE AFFORDABLE CARE ACT AND WISCONSIN'SOPEN ENROLLMENT PERIOD The Affordable Care Act has saved Wisconsinites and Americans millions in healthcare costs. Since it was signed into law by former President Barack Obama in 2010, the Affordable Care Act has been transformational for folks and families across the state and country, providing healthcare coverage to millions of Wisconsin families and ensuring folks can access health insurance without lifetime limits and protecting the coverage of more than 100 million Americans-including 2.4 million Wisconsinites-who have pre-existing conditions. The Affordable Care Act and its related regulations were also groundbreaking in ensuring access to birth control and contraception care, as most plans are required tocover these services with no out-of-pocket costs for consumers. Another key provision of the Affordable Care Act, authored by U.S. Sen. Tammy Baldwin, allows young people to stay on their parents' insurance until the age of 26. The Wisconsin Individual Health Insurance Market Analysis conducted by OCI in 2022 found that the previously expanded premium subsidies under the Affordable Care Act, as well as the federal investments that had been made in Navigators and outreach, contributed to the growth and stability of Wisconsin's health insurance market in recent years. In addition to the expirationof the expanded premium subsidies, new federal cuts to Affordable Care Act Navigators and outreach services will only make it even harder for Wisconsinites to understand their healthcare coverage options and enroll. Wisconsin's annual Open Enrollmentperiod begins on Sat., Nov. 1, 2025.During this time, eligible Wisconsinites can enroll in one of the health plans available on the individual health insurance marketplace. Wisconsin residents can sign up for coverage through Healthcare.gov. Those who already have insurance through the marketplace can also renew, update, or upgrade their health plans during this period. Several insurers have made changes to their service areas and plan offerings in response to federal changes. In Wisconsin, there are 12insurers participating on the exchange forthe2026plan year, with 2 insurers offering Affordable Care Act-compliant plans off the exchange.An interactive map of health insurers available by county can be found here. Wisconsinites can explore their coverage options at any time at Healthcare.gov. To get connected to free, expert help and explore cost-saving options, Wisconsinites are encouraged to visit WisCovered.comor call (608) 261-1455 or (877) 942-6837 to get connected with a navigator. Consumers are encouraged to speak with a licensed insurance agent or broker. |
| An online version of this release is available here. |
| ### |
| Office of the Governor • 115 East Capitol, Madison, WI 53702 | |
| Press Office Email: [email protected] | |
| Unsubscribe |