Affordable Care Act premiums for Wisconsinites to rise hundreds a month if tax credits allowed to expire

Premiums for 275,000 Wisconsinites enrolled in the Affordable Care Act health insurance marketplace could rise by hundreds of dollars a month next year if Congress allows tax credits meant to keep plans affordable to expire, according to projections the Office of the Commissioner of Insurance released Monday.

On average, expanded tax credits under the Affordable Care Act had been saving people $664 a month on their health care plans. With those credits expiring, there's not a standard increase people can expect, but premiums are due to rise fastest for older residents and families.

A family of four across the state making $130,000 can expect monthly premium increases of more than $1,000; for a 60-year-old couple, their monthly premiums could jump between $1,600 and $2,700 a month. A 26-year-old who is on their first health insurance plan will see a monthly increase of between $111 and $178.

That would mean that family of four could pay between two and four times more for their monthly premiums, with rural residents being hardest hit; for that hypothetical 60-year old couple, rates could skyrocket nine times higher than they currently are, into the low $3,000 range per month.

Wisconsin's Democratic federal lawmakers decried the price increases on Monday, saying they will cause people to reconsider whether it's worth even having health insurance at all. In some areas, like in Fond du Lac County, insurers are dropping out of the ACA marketplace because of the cost of the unsubsidized health plans.

"For more than 275,000 Wisconsinites, care is about to get drastically more expensive," U.S. Sen. Tammy Baldwin said during a press conference. "This is like taking the entire population of Madison, or the combined population of Green Bay, Kenosha and Appleton, and saying they all have to pay potentially thousands more every year for health care. All the while, 30,000 of them are poised to just not be able to pay at all."

Open enrollment for the ACA insurance market starts Saturday, giving federal lawmakers less than a week to come to an agreement before people start purchasing their insurance.

A disagreement over whether to extend ACA tax credits, which were expanded in 2021 during the height of the pandemic to reach more people, is at the core of the current federal government shutdown. The expanded tax credits are set to expire in 2025, and were not extended in the budget reconciliation bill passed in July.

Democrats have refused to budge on keeping the credits in place. Republicans say Democrats want to expand health care to people who are not citizens, but that's misleading: People who are not U.S. citizens cannot access any government-based health insurance plans such as Medicaid, Medicare or receive ACA subsidies.

Republican leaders are demanding that Democrats agree to end the government shutdown before negotiating ACA tax credits, but "that's not how we govern," Baldwin said.

"We need to end this crisis by extending these tax credits and give Americans some more breathing room in their budgets," the Madison Democrat said.

Wisconsin can't foot benefits costs if shutdown continues past Nov. 1, governor says

Since the launch of the expanded tax credits in 2021, participation in the ACA marketplace has grown from 11 million that year to 24 million in 2025, according to health news organization KFF. The vast majority of people, around 22 million people, qualified for some kind of tax credit this year. KFF had reported in September that monthly premiums would more than double this year if the expanded tax credits were allowed to expire.

Nearly 78% of Americans support extending the expanded tax credits, as well as 60% of Republicans, a poll conducted by KFF showed. The issue has drawn attention from far-right U.S. Rep. Marjorie Taylor Greene, who is breaking with her party, noting that her own children's monthly premiums for health insurance are set to double.

Kyle LaFond, owner of hygiene manufacturing company American Provenance, relies on the ACA for his health insurance, as do his eight employees, he told reporters earlier this month at a press conference organized by U.S. Rep. Mark Pocan, D-Black Earth. His health insurance premiums are going to double without federal subsidies, he said, while his employees are looking at annual increases of up to $12,000.

"For a growing family, those price hikes are almost insurmountable," LaFond said. "The ACA really leveled the playing field in terms of able to provide coverage where I couldn't. I searched for years to find plans or programs that would work for all of my employees. With the ACA subsidies expiring, I might lose some good people."

Health care compromise appears far off as the government shutdown stalemate persists