HealthCare.gov insurance rates to ‘skyrocket’ for 2026 without enhanced subsidies, Evers announces
Gov. Tony Evers, shown here in a press gaggle in March, said Monday that health insurance rates on the ACA market are set to skyrocket in Wisconsin. (Photo by Baylor Spears/Wisconsin Examiner)
This report has been updated.
The cost for health care coverage purchased on HealthCare.gov in Wisconsin will rise for some insurance policies by anywhere from 45% to 800% for 2026, depending on where a person lives, Gov. Tony Evers announced Monday.
The increased rates will be made worse with the end of enhanced federal subsidies, provided in the form of tax credits, that have lowered insurance costs through the marketplace since 2021, Evers and Sen. Tammy Baldwin (D-Wisconsin) said during a virtual press conference Monday morning. The enhanced subsidies expire at the end of December.

“In 2025, 88% of Wisconsinites [who] enrolled in coverage on HealthCare.gov qualify for tax credits, saving an average of $664 a month,” Evers said. “And without these enhanced tax credits, health care premiums for Wisconsinites are going to skyrocket, period. Many Wisconsinites will see their premiums double, and some of them will see staggering increases.”
HealthCare.gov is the federal insurance marketplace, created under the 2010 Affordable Care Act (ACA) to improve health insurance access for people without health coverage from an employer or from government programs.
More than 310,000 Wisconsinites purchased health insurance through the marketplace for 2025, according to the Wisconsin Office of the Commissioner of Insurance (OCI). HealthCare.gov open enrollment for 2026 starts Nov. 1.
OCI released a list Monday with examples of rate increases for patients of various ages and under selected scenarios based on age, family size and incomes. The examples compared rate increases across eight counties.
Evers said a statewide average increase wasn’t available “because it’s going to impact lots of people in a lot of different ways.”
The comparisons made by OCI all reflected health plans in the Silver category on HealthCare.gov. Silver plans have a “moderate” deductible and require patients to pay 30% of the cost of care (see sidebar, HealthCare.gov insurance plan categories).
In a few scenarios and locations, rate increases will be lower than 10%. Those are exceptions, however. Most scenarios and locations showed premium increases ranging from more than 30% on up. Some increases were well over 100%, and one example showed an increase of more than 800% in one county.
All the comparisons assume the buyers are nonsmokers.
According to OCI’s report 2026 premiums will increase:
- Between 39% in Waukesha County and 85% in Barron County for a 26-year-old with an income of $48,000.
- Between 16% in Marathon County and 43% in Barron County for a 26-year-old with an income of $65,000.
- Between 18% in Brown County and 84% in Barron County for a 40-year-old with an income of $65,000.
- Between 132% in Waukesha County and 391% in Barron County for a 60-year-old with an income of $63,383.
- Between 221% in Waukesha County and 812% in Barron County for a 60-year-old couple with an income of $85,658.
- Between 2% in Waukesha County and 57% in Barron County for a family of four with a household income of $128,000.
- Between 102% in both Waukesha and Dane counties and 312% in Barron County for a family of four with a household income of $130,000.
In both family examples, the parents are ages 48 and 47 and children ages 8 and 12.
Nationwide, some 22 million Americans will see their premiums double on average, Baldwin said. She cited projections that 4 million Americans “will look at that price tag and decide to drop their insurance altogether because it’s simply too expensive. It’s more than they can afford.”
KFF, a nonpartisan, nonprofit health policy news and analysis organization, reported Oct. 3 that seven out of 10 people nationally who buy health coverage through the federal marketplace said they would not be able to afford insurance without the enhanced subsidies.
Democrats in Congress have named extending the subsidies as one of their conditions for Democratic support of the Republican majority’s legislation to end the current federal shutdown.
In response, GOP leaders in Congress have called on Democratic lawmakers to sign on to their spending bill to restart the government and then negotiate to extend the subsidies.
Baldwin said Democrats won’t accept “a wink and a nod” that the tax credit talks should come after the government reopens. She said she’s heard privately from Republicans in the Senate who agree that Congress should extend the subsidies.
With 78% of Americans, according to one poll, “who believe we need to address this, and many of my Republican colleagues want to do so, then we need to have an agreement to extend the tax credits as we reopen the government,” Baldwin said.

Later Monday in Milwaukee, Evers held a round table with business owners, advocates and lawmakers to discuss the HealthCare.gov rate increases.
“If you’re seeing these jumps in 26-year-olds, across the board, I don’t know how we afford this,” said Dan Jacobs, owner of the Milwaukee restaurant DanDan. Jacobs said about two-thirds of his employees have health insurance, most of them probably purchasing it through the marketplace.
His business subsidized the insurance premiums that full-time employees and managers bought through HealthCare.gov for 2025, he said, but with the premium increases, reported Monday, “we’re not going to be able to afford to do that,” Jacobs told Evers.
Kara Pitt-D’Andrea, who operates a nonprofit child care facility in Milwaukee with about 25 employees, told Evers, “100% of us are on the ACA or Medicaid.”
She called health coverage a moral imperative rather than an act of charity. “To say to people, ‘We refuse to come to the table to create a sustainable option for you’ is the equivalent of saying, ‘You are unimportant in the game of business that we are playing,’” Pitt-D’Andrea said.
HealthCare.gov insurance plan categories
Health plans sold through the marketplace are assigned to one of four categories, nicknamed “metal levels”: Bronze, Silver, Gold and Platinum.
A page at HealthCare.gov on the metal levels explains that the categories do not reflect the quality of care provided. The categories are based on how much a patient shares in the cost of care covered by a plan.
Regardless of their metal level, all plans must cover the same 10 essential health benefits, including preventive services.
Gold and Platinum plans have low deductibles, with patients paying 20% of the cost of care out of pocket with a Gold plan and 10% of the cost with a Platinum plan.
Bronze plans have a high deductible and patients pay 40% of the cost of care.
Silver plans have a “moderate” deductible and patients pay 30% of the cost of care out of pocket.
Patients who qualify for cost-sharing reductions with a Silver plan based on their income have a low deductible and pay 6% to 27% of the cost of care out of pocket rather than the regular Silver plan share of 30%.