Wisconsin health insurance enrollment under the ACA again sets a record

by Erik Gunn, Wisconsin Examiner
January 31, 2025

For the second year in a row, a record number of Wisconsinites signed up for health insurance through the Affordable Care Act, state officials announced Friday.

The federal Centers for Medicare & Medicaid Services (CMS), which tracks enrollment in health plans through the ACA, reported that 313,579 Wisconsin residents enrolled in insurance through the federal insurance marketplace during the open enrollment period from Nov. 1, 2024, to Jan. 15, 2025.

This year’s enrollment includes 47,250 more people than the 2024 open enrollment period, which set the previous record — an 18% increase, according to the Wisconsin Office of the Commissioner of Insurance (OCI).

The marketplace, Healthcare.gov, was created under the ACA for people to purchase individual or family health insurance policies if they don’t have health insurance coverage through an employer or other group and don’t qualify for Medicaid or Medicare.

Marketplace plans are sold by private insurance companies and must meet standards set under the ACA for comprehensive coverage. One of those is that people with a preexisting health condition cannot be denied coverage, charged higher rates or have their insurance coverage canceled.

For people who are currently enrolled, health insurance premium costs for ACA plans have been offset by federal subsidies, tied to a person’s income. The subsidies were expanded under the 2021 American Rescue Plan Act and the 2022 Inflation Reduction Act. The increased subsidies will expire after this year unless Congress agrees to extend them.

A majority of Wisconsinites signing up for ACA plans have qualified for the subsidies and saved an average of $573 on their monthly insurance premiums, according to the office of Gov. Tony Evers.

Before Evers and Attorney General Josh Kaul, both Democrats, took office in 2019, Wisconsin had been part of a multi-state lawsuit that sought to overturn the ACA. The health care law was enacted in 2010 under then-President Barack Obama.

Evers and Kaul withdrew Wisconsin from the lawsuit fighting the ACA, and the Evers administration has instead heavily promoted the program, including the creation of a health coverage information program and website, WisCovered, a joint project of the state’s insurance and health departments.

With President Donald Trump returning to the White House, however, the ACA’s future has been uncertain. Trump tried unsuccessfully to abolish the program in his first term in office, and during the 2024 campaign said he would replace it, but has never offered a clear alternative plan.

In a statement, Evers cited the increased popularity of the ACA as a reason to ensure it remains intact.

“Health care should not be a privilege only afforded to the healthy and the wealthy, and the Affordable Care Act has been transformational for millions, including Wisconsinites who have pre-existing conditions,” Evers said. “This record enrollment proves just how important it is that we continue to defend and protect access to healthcare, close our uninsured gap, and support programs that help make a real difference in the lives of folks and families across our state.”

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