Fewer Wisconsinites enroll in ACA Marketplace as health care premiums skyrocket

Just under 290,000 Wisconsinites signed up to receive health care coverage in 2026 through the Affordable Care Act Marketplace, according to a report from the Centers for Medicare and Medicaid Services . 

That’s down from the nearly 307,000 who enrolled last year.

Enhanced ACA tax credits created under the American Rescue Plan Act expired at the end of last year. Without them, premiums have jumped sharply, leaving many worrying about how they will afford health care in 2026.  

But the extent of the ACA premiums’ affect on enrollment in Wisconsin likely won’t be known until more data is released. The open enrollment deadline was Thursday.

Cynthia Cox is senior vice president at the KFF, a health research group. She said the sign-up numbers only show a partial picture.

“What we have right now are called sign-up numbers or plan selections, and that’s kind of like when someone puts something in their shopping cart but hasn’t necessarily checked out yet,” Cox said.

The data released represents how many Wisconsinites have signed up or were automatically renewed into a new 2026 plan on healthcare.gov. Cox said those automatically signed up may be able to miss a couple monthly payments before losing coverage. 

“What we are waiting for to really understand the true impact of the enhanced premium tax credits expiring is how many people actually pay their premium,” Cox said. “Because if they don’t make a premium payment, then they lose their coverage.”

Cox said they will know more when the effectuated enrollment data is released, but that likely won’t be until the summer. She said the KFF expects the numbers to “drop off quite a bit” as the year continues. 

The number of uninsured Wisconsinites has decreased by 200,000 since 2013 when the Affordable Care Act went into effect. Last year, the state saw a record number of residents who opted for insurance covered by the ACA Marketplace. 

Sarah Smith is the director of public affairs at the Wisconsin Office of the Commissioner of Insurance. She said the lack of investment in health care at the federal level will leave many without coverage. 

“So those who work for small businesses, those who own small businesses, barbers, farmers, retired teachers, dentists, these are all people in our communities who rely on this Marketplace coverage and really don’t have anywhere else to turn.” Smith said.

She said it will also burden hospitals across the state. 

“Wisconsin hospital systems will see those uncompensated care costs increase when people no longer can afford this insurance coverage,” Smith said.

On Jan. 8, the U.S. House of Representatives voted to extend ACA tax credits for three years. The Senate has not reached a deal.

Republican Congressman Derrick Van Orden changed his stance on the credits after he and 16 Republican colleagues sided with Democrats to pass the bill. Van Orden had previously called for the Affordable Care Act to be repealed.