Health insurance premiums increase as Affordable Care Act open enrollment underway in Wisconsin

Price hikes under the Affordable Care Act are forcing Grafton resident Kristin Schlingman and her husband to ask themselves hard questions. The monthly cost of their health insurance plans are set to jump as much as $700 per month next year — to $2,800 per month. “My husband, he’s 60. I’m 61. He’s officially retired at this point,” Schlingman told WPR. “We just started to think: does one of us need to go get a job that will provide group health insurance so that we don’t have to pay this extra $35,000 a year out of our pocket?” Wisconsin’s individual market rates will rise about 22 percent on average, according to the state insurance commissioner. An analysis from KFF, a health policy research organization, projects ACA monthly premiums nationally to increase by 13 percent in 2027 before subsidies, with the average marketplace bronze plan for a 40-year-old rising to $511 per month. It marks the second year in a row consumers are set to see double-digit percentage increases. Understanding Wisconsin, Together. WPR’s “Wisconsin Today” newsletter keeps you connected to the state you love without feeling overwhelmed. No paywall. No agenda. No corporate filter. Facebook This field is for validation purposes and should be left unchanged. Email Subscribe Premiums increased by around 26 percent from 2025 to 2026 as enhanced premium tax subsidies expired. Schlingman said the additional costs are unexpected burdens before they reach the age to qualify for Medicare. “We saved well for retirement and have had a budget that we’ve been able to live comfortably in. However, that’s an extra $600 to $700 a month that we have to come up with. So something else has to (be) cut back or we have to dig further into our retirement savings … I don’t want to use up all my retirement paying for insurance.” Covering Wisconsin is a program within University of Wisconsin-Madison Extension that offers free guidance for consumers enrolling in health coverage. Covering Wisconsin Director Allison Espeseth told WPR’s “ Wisconsin Today ” some Wisconsin residents are seeing proposed prices for next year jump. “For many of them, the prices are going up, both in either the premium or that deductible, which is the cost that you pay before the insurance kicks in,” Espeseth said. “Some folks are seeing some lower costs, so it can happen. There’s always a range, which is always why we say it’s really important to go in to check it out. Don’t just make assumptions.” In addition to prices, other upcoming changes under the One Big Beautiful Bill will affect people looking for coverage. Vanessa Silva is a bilingual benefits navigator for Family Health Center of Marshfield. She told WPR those changes are set to leave some categories of lawfully present immigrants — like refugees, green card applicants or asylum seekers — ineligible for remaining ACA tax credits or cost-sharing help. “Some of them are in dialysis. Some of them have chronic illnesses, and they (won’t) have coverage starting in January,” Silva said. “It has been very emotional just to explain these changes to my consumers … you try to show empathy and compassion, but my hands are really tied on the options I can offer.” Silva told WPR she has been recommending that consumers apply for financial assistance programs, even if they don’t think they qualify. “That can help pay their deductibles, out-of-pocket costs, even copays,” she said. After enhanced premium tax subsidies expired, states like New Mexico and Colorado created state-based subsidies to offset new costs for consumers. Wisconsin has no such state-level subsidies. But Marquette University Professor of Health Policy Lisa Grabert said recent elections open up the possibility of this kind of policy in the future. “With the flip of both chambers in the Wisconsin (legislature) and a trifecta of alignment, I think that becomes a more distinct possibility in the state of Wisconsin.” Related Stories Report: More care is going unpaid at Wisconsin hospitals Wisconsin retirees see Social Security boost in 2027, but inflation hikes costs How Medicare experts are guiding Wisconsin patients through this year’s open enrollment Wisconsin governor candidates offer opposing plans to address rising healthcare costs Report: Health care costs rising faster than wages in Wisconsin