Families across Central Wisconsin are confronting significant increases in health insurance premiums as federal Affordable Care Act (ACA) premium tax credits are set to expire. This looming deadline, December 31, is forcing many to re-evaluate their healthcare options, with some considering drastic changes to maintain coverage.
The potential expiration of these credits could mean a substantial financial burden for thousands of residents who rely on the federal marketplace for their health insurance needs. The situation highlights a critical challenge for many households already managing tight budgets.
Key Takeaways
- ACA premium tax credits expire on December 31, 2025, leading to significant cost increases.
- Many Wisconsin families face premium jumps of over 400% without the credits.
- Enrollment in ACA plans surged by 60% in Wisconsin due to these tax credits.
- Healthcare clinics anticipate a rise in uninsured patients and a strain on services.
- Lawmakers are divided on extending the credits, with bipartisan support needed.
Soaring Premiums Create Financial Strain
For many families, the upcoming expiration of ACA premium tax credits means a dramatic increase in monthly healthcare costs. Dawn Lass, a former teacher from Stevens Point, shared her family's struggle. Her monthly premium is projected to jump from $500 with a $14,400 deductible to an alarming $2,475 with a $20,000 deductible.
"I don't know what we're going to do," Lass stated. "We had no idea this was coming, and so we're just finagling, trying to find ways to make sure that we're going to be able to afford this."
Impact on Families
- Dawn Lass's family premium will increase by nearly 400%.
- Her deductible will rise from $14,400 to $20,000.
Lass and her husband, also a former teacher, are part of the "sandwich generation." They care for both their parents and their children's generation. Lass retired early to help care for her parents, one of whom has since passed away. The new rates could force her back into the workforce, impacting her ability to support her family.
"I wanted to be able to be around to help my mom, and now I won't be able to be there as much for her. And also, I like to help out with my granddaughter as well, so it just takes away from all of that," Lass explained.
Widows and Vulnerable Populations Hit Hard
The situation is particularly dire for individuals like Julia Jiannacopoulos from Coloma. After losing her husband, she sought ACA coverage for herself and her 14-year-old daughter. The tax credit helped keep her modest coverage at about 20% of her income. However, next year's rate has more than doubled.
Jiannacopoulos is now considering a catastrophic plan, which would mean paying for most of her care out of pocket. Forgoing necessary medical care is not an option for her.
"My kid has already lost one parent, and I'm going to be around as long as I can, so I'm taking really good care of myself," Jiannacopoulos affirmed.
ACA Enrollment Surge
More than 300,000 Wisconsinites enrolled in Affordable Care Act health insurance for 2025. This represents approximately a 60% increase in enrollment since before the enhanced tax credits were first offered. In 2021, income eligibility for these tax credits was expanded to include more middle-income earners, contributing to the surge in enrollment.
Healthcare Providers Prepare for Changes
Healthcare providers, such as Bridge Community Health Clinic in Wausau, are also preparing for the potential fallout. The clinic's mission is to provide care to patients regardless of their insurance status. Jennifer Smith, the clinic's executive director, expressed deep concern over the personal stories she heard.
"Even though we hear this every day, as I was sitting, listening to their personal stories, I couldn't help but tear up in thinking, like these are the choices that people are really making in their lives," Smith commented.
The clinic serves 4,000 patients annually across multiple Central Wisconsin locations. If the tax credit is not extended, Smith anticipates a significant increase in patients needing uninsured rate adjustments for care. This would directly impact the clinic's operating expenses.
Clinic Operations
- Bridge Community Health Clinic serves 4,000 patients annually.
- Grant revenue makes up about 25% of the clinic's operating budget.
Clinic staff are already engaging in scenario planning. A lack of extension could mean cutting back on other programs or care offerings that the clinic has been working to expand. The biggest concern on the clinical side is that people will avoid necessary preventative care and chronic disease management.
"On the clinical side, our biggest concern is people avoiding care, preventative care that they need, chronic disease management that they need, which could kick problems down the road, not identify problems early enough," Smith warned.
Political Divide on Future of Tax Credits
The urgent need for action before the December 31 deadline has brought the issue to the forefront in Washington. Senator Tammy Baldwin (D) stated that while the healthcare system needs broader reforms, the immediate deadline demands swift action. She believes some Republicans share this view.
However, securing an extension would require bipartisan support, with 13 Republicans needed to join Senate Democrats to pass a bill. When asked about working with Republican colleagues, Senator Baldwin expressed some doubt about specific individuals.
Republican Criticism
Representative Tom Tiffany (R) criticized the ACA itself, arguing it has led to increased premiums and deductibles. He suggested that the Democratic tax credits merely hide these underlying issues. "Since Obamacare went into effect, premiums have nearly tripled and deductibles have doubled," Tiffany stated. "To hide this failure, Democrats supercharged pandemic-era subsidies, some for households making up to $500,000, that funneled billions to insurance companies."
Representative Derrick Van Orden (R) echoed these sentiments, pointing out that Democrats intentionally set an expiration date for these enhanced ACA subsidies. He called for long-term reforms to genuinely lower costs, rather than relying on temporary subsidies.
"If something is truly 'affordable,' it shouldn't require ever-increasing federal subsidies just to keep premiums within reach. That's why the Affordable Care Act should be called the 'Unaffordable Care Act'," Van Orden commented.
Both Republican representatives advocate for solutions that offer greater choice, transparency, and competition in the insurance market to provide truly affordable plans that fit individual needs.
As the deadline approaches, Central Wisconsin families and healthcare providers remain in a state of uncertainty, hoping for a resolution that ensures continued access to affordable health insurance.
