Soaring ACA premiums hit Wisconsin families as enhanced subsidies come to an end
Fewer enroll, costs spike, and health systems feel the strain in 2026
By Jean Kiernan Detjen
Average marketplace premiums have nearly tripled in some Wisconsin counties after enhanced federal subsidies under the Affordable Care Act (ACA) expired on Jan. 1, leaving thousands of families facing bills that top $1,000 a month. These temporary pandemic-era credits had capped out-of-pocket costs for millions, helping middle-income households afford coverage. With the support gone, many families now face the full cost of their plans – often for the first time in years.
Across the state, the increases are dramatic:
- Cudahy: Donna Cuyler, a retired teacher, saw her monthly plan jump from $412 in 2025 to over $1,100. “That money is going to come from our retirement. We don’t know if this is sustainable.”
- Waukesha County: A family of four earning $130,000 reported their annual premiums rose by more than $12,000.
- Vilas County: A small business owner said the family’s premiums doubled this year, forcing tough choices between coverage and other essential household expenses.
- Ashland County: A farmer said rising premiums are forcing him to weigh insurance against other farm operating costs, highlighting pressures on rural families.
Rural hospital administrator Mark Jensen in Marathon County said patients are delaying care due to higher costs, straining both families and local health systems.
Enrollment declines amid uncertainty
Preliminary figures show roughly 289,000 Wisconsinites enrolled in ACA marketplace plans for 2026, down from more than 313,500 the previous year. Wisconsin’s marketplace had seen record enrollment in 2025, making this drop especially notable. Allison Espeseth, director of Covering Wisconsin, described the decline as about 6 percent but emphasized that coverage options remain for households whose circumstances have changed.
“Coverage remains available despite higher premiums, though families face tough financial choices,” Espeseth said. Analysts warn that rising costs could discourage healthier individuals from enrolling, skewing risk pools and potentially driving premiums higher over time.
Insurers adjust, risk pools shift
Some insurance carriers have reduced participation in certain counties, limiting choices for consumers and leaving higher-cost plans as the only available options in some areas. Economists say this could reinforce the cycle of rising premiums if healthier individuals opt out of coverage.
Hospitals and health systems are already feeling the impact. Rural and safety-net providers report increased uncompensated care as patients delay or skip treatment due to costs. Emergency departments, already stretched, are experiencing heightened demand, underscoring the broader consequences for local communities.
Political divide shapes coverage landscape
The expiration of subsidies has intensified debate in Washington. Democratic Sen. Tammy Baldwin criticized the rollback, warning that families may be forced into untenable choices or go without coverage. Republican Sen. Ron Johnson, who voted against extending temporary credits, says broader ACA reforms – not short-term subsidies – are necessary to make coverage sustainable and improve affordability.
Johnson said he is in discussions with Democrats about a limited proposal to assist some higher-income households who lost tax credits, though he continues to oppose restoring the enhanced subsidies more broadly.
Legislation to extend the enhanced credits stalled in Congress last year, leaving Wisconsin families to navigate higher premiums and fewer options on their own. Observers note that upcoming federal decisions could determine whether the 2026 enrollment decline is temporary or the start of a longer-term trend.
Looking ahead
Since the ACA’s enactment, Wisconsin’s uninsured population has fallen by roughly 200,000, aided by marketplace coverage and Medicaid expansion. The 2026 dip interrupts that progress, highlighting ongoing tensions between federal policy, household finances, and access to care.
For Wisconsin families, the challenge is immediate: decide how to afford coverage, adjust household budgets, or risk being uninsured. With premiums soaring and subsidies gone, 2026 may be the toughest year for coverage in a decade. How lawmakers, insurers, and households respond in the coming months will shape health coverage and access across the state for years to come.
