Sen. Tammy Baldwin (D-Wisconsin) speaks Wednesday about the effort to extend enhanced Affordable Care Act insurance premium tax credits that will expire at the end of 2025. Nancy Peske, left, and Julia Harris-Robinson, center also joined the press conference. (Photo by Erik Gunn/Wisconsin Examiner)

With the loss of enhanced subsidies for the health insurance she has bought on the federal marketplace HealthCare.gov, Nancy Peske’s health plan will cost $1,163.50 a month in 2026.

That’s more than three times what she paid this year — $372 a month, Peske said Wednesday.

But if there’s one thing she wants everyone to know, it’s this: The higher prices for health insurance aren’t just something that she and other people who buy their coverage on the federal marketplace are facing.

Long before the ACA, Peske learned about “the premium death spiral,” she said.

“The more you raise the price, the more people drop out of the pool. This means you have to raise the price, which means more people drop out of the pool. And it goes on and on and on,” Peske said.

“It’s not just my health insurance that’s going to go up. It’s everybody’s — right?” she said. “We’re all in this together.”

Peske was one of two people who have relied on HealthCare.gov, created as part of the Affordable Care Act, who spoke Wednesday at a press conference in Milwaukee with Sen. Tammy Baldwin (D-Wisconsin).

Baldwin called the press conference  to draw attention anew to the skyrocketing cost of health insurance — and to the failure of Congress to address it in the stopgap spending bill that passed the U.S. Senate Monday, the U.S. House Wednesday evening and was signed by President Donald Trump.

“This is a health and wellness issue,” Baldwin said. “This is an affordability and cost-of-living issue, and this is a quality of life and dignity issue. And it touches every single one of us right now.”

A success amid ‘a broken system’

Health care in the U.S. is “a broken system that prioritizes profits over patients,” Baldwin said. Despite that, she said, the 2010 Affordable Care Act was an important advance for expanding health care access.

She said that was improved by enhanced federal subsidies enacted in 2021 to offset the cost of health insurance for people who must buy their own policies on the federal HealthCare.gov marketplace that was created by the ACA — making insurance more affordable and drawing record numbers of people to the marketplace to get health coverage.

The enhanced subsidies expire at the end of 2025, however, and until this week a Republican stopgap spending bill that passed the U.S. House in September stalled in the U.S. Senate as Democrats pushed unsuccessfully to extend the subsidies.  

“That is what is at the center of the government shutdown and debate in Washington, D.C.,” Baldwin said. “We know the impact of taking away these tax breaks. For 275,000 Wisconsinites, their health care [insurance] costs will double, triple or even more. For 30,000 Wisconsinites, they predict the price will be too high, and that those Wisconsinites will go without insurance altogether.”

A handful of Democratic Senators changed their votes Monday to advance the spending bill in return for a promise of a future vote on the subsidies, with the House taking up the revised bill Wednesday. Baldwin didn’t join them.

“I said the entire time that a handshake deal with my Republican colleagues to reopen the government and no real action to lower health care costs was simply not good enough,” said Baldwin of her vote against the bill.

She also forced an amendment to extend the tax credits for a year — a compromise, she said, because she wants them extended permanently, but one she offered “to avoid catastrophe for families across Wisconsin and give folks breathing room while we negotiate longer-term solutions.”

The amendment failed on a party-line vote.

“Every single Republican voted no on my amendment,” Baldwin said. “They chose to send a clear, unmistakable message that they are OK with jacking up health care costs on 22 million Americans.”

Early retirement, then sticker shock

HealthCare.gov user Erica Topps also joined Baldwin’s news conference. Topps took early retirement in April and bought a health insurance policy through the federal marketplace for herself and her college-age daughter that started in June.

At the marketplace open enrollment for 2026 that started Nov. 1, that plan’s premium increased by $1,200 a month and the deductible went from $6,700 per person to $10,600 per person, Topps told reporters She found another plan via the marketplace and is enrolling, but she’s concerned about the future beyond that.

“Part of my plan is to go back to work” so she can get health insurance, Topps told the Wisconsin Examiner, because it will be 10 years before she can qualify for Medicare.

Before taking early retirement, “I did my due diligence,” she said. “I feel like the rug was pulled out from under me.”

Peske is a freelance writer, editor and consultant. She is also a cancer survivor, whose diagnosis two years ago was covered thanks to her HealthCare.gov policy. Going without health insurance is unthinkable, but at the age of 63, she must wait another two years before she can go on Medicare, she said.

Peske told the Wisconsin Examiner that she will scrape together the money to afford her new premium. “I’ll not put a dime into my underfunded retirement account,” she said. She expects to “tighten the belt” on household expenses, “and I will probably cut into my savings.”

Freelancers and small businesses account for 40% of the U.S. economy, Peske told reporters.

“Do you want everyone to go out of business?” she asked. “Should I just do what so many people do and get a much lower paying job at a company? Because I’m desperate for health care. I don’t think that’s the solution. I think you want to keep people like me in business, generating money, adding to the economy, and being able to live, to not die of cancer.”

Seeking inroads with GOP lawmakers

Baldwin said she has been talking with Republicans about finding common ground in increased transparency in the health care system, from insurance companies, pharmacy benefit managers and providers.

In addition, she told the Wisconsin Examiner after the press conference, she continues to have conversations with GOP Senate colleagues who have expressed interest in continuing the subsidies to avert the sharp hike in premiums.

None of them were willing to break ranks and vote for her amendment this week, however.

“Those discussions were happening informally, in quiet, not in the public spotlight,” Baldwin said. “But they were afraid to vote on something that they, probably, some of them want, because Donald Trump said you can’t talk about this before the government reopens.”

Baldwin said that the next step will be for the Democrats to settle on the bill that Republican Senate Majority Leader John Thune has promised they could bring to the upper chamber for a vote.

As much as she favors a permanent extension of the enhanced credits, if the Democrats go that route, “we know it will go down, and it will be on a pretty much a partisan vote,” Baldwin said.

“I want results, so that probably dictates towards supporting something that conceivably does respond to some of the concerns Republicans have raised,” she said. “I’d like to pick the path most reasonably likely to succeed on behalf of the people who sent me to Washington to fight for them.”

American Family Children's Hospital in Madison. An annual report from the Wisconsin Hospital Association says hospitals in the state are doing better financially, but face uncertainty. (Photo by Erik Gunn/Wisconsin Examiner)

Uncompensated health care at Wisconsin hospitals rose more then 30% in 2024 from the year before, according to a new report from the Wisconsin Hospital Association.

People without health insurance or regular health providers are using emergency rooms more, the report also finds.

The association annually assesses the state of Wisconsin hospitals, including their finances, utilization and staffing. The 2024 report was released Thursday.

“We are seeing a modest improvement in hospital financials across the state,” said Kyle O’Brien, president of the Wisconsin Hospital Association, in an interview. Nevertheless, he added, “there’s a lot of uncertainty in the health care market right now.”

While the state’s hospitals were doing better in 2024 than in the previous two years, 40 hospitals had a negative operating margin, O’Brien said, and many hospitals across the state where margins were positive, but narrow.

Uncompensated care includes charity care — provided by the hospital with the full knowledge that the cost won’t be covered — as well as bad debt: care for which the hospital expected to be paid but wasn’t.

In 2024, uncompensated care in both categories added up to $1.77 billion — a 30.5% increase over the 1.36 billion in uncompensated care in 2023.

O’Brien said several factors are responsible for that increase. One of those is generally higher deductibles on health insurance plans, requiring patients to spend more out of pocket before their insurance coverage kicks in.

“If that patient can’t pay for that higher out-of-pocket [expense], hospitals are the ones that either have to try to collect those dollars, or they are the ones that provide relief through charity care, bad debt policies, or things like that,” O’Brien said.

For hospitals, another top concern is how much Medicaid pays to cover the cost of care.

State budgets over the last decade have been increasing Medicaid hospital payments, O’Brien said, with the 2025-27 budget having the largest increases to date. Even so, he said, hospital Medicaid reimbursements fall short of fully covering the cost of the care that Medicaid is supposed to cover.

Decisions by health insurance to deny coverage are a source of “general consternation” for hospitals, O’Brien said — both with group health insurance policies but also for Medicare Advantage policies. Medicare Advantage policies are sold to people eligible for the federal Medicare program but are instead provided by private insurance companies.

O’Brien said the hospital association is also concerned about projected increases in people without health insurance as a result of higher premiums paid by people who buy their own insurance at the federal marketplace, HealthCare.gov, created under the Affordable Care Act.

Enhanced subsidies for HealthCare.gov policies enacted in 2021 will expire at the end of this year unless they are renewed. The subsidies are provided in the form of federal income tax credits for consumers who purchase insurance through HealthCare.gov

This week the state Office of the Commissioner of Insurance released projected rates for 2026 that reflected the loss of those enhanced subsidies.

Those higher costs have prompted widespread predictions that, after years in which enrollment in the marketplace plans has set new records, enrollment will drop off and more people with go without health insurance instead.

“We are certainly concerned anytime there’s a potential that somebody might lose coverage,” O’Brien said. Federal law requires hospitals to treat patients whether or not they are able to pay.

“We have been advocating with the congressional delegation to reauthorize those enhanced premium tax credits,” O’Brien said. He said members of Congress have been focused on “issues that are playing out right now [that] may be even bigger than hospital-related issues, but I think that they understand our concerns.”

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)

Last updated 10/28/2025, 1:51 p.m. 

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.

The comparisons reflect the premium cost after any subsidies are applied. 

The ACA included subsidies on the cost of insurance from the beginning for people with incomes up to 400% of the federal poverty guideline.

The enhancements that were put in place in 2021 and expire at the end of December included increases in the subsidies for the original group. They also extended subsidies to people with incomes above 400% of the poverty guideline, to avoid an “eligibility cliff” at those higher incomes. 

In the comparisons, the 2025 premiums include the effect of the enhanced subsidies, while the 2026 premiums reflect the return to the original subsidy formula.

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 (subsidy continues, but reduced).
• Between 16% in Marathon County and 43% in Barron County for a 26-year-old with an income of $65,000 (subsidy ended).
• Between 18% in Brown County and 84% in Barron County for a 40-year-old with an income of $65,000  (subsidy ended).
• Between 132% in Waukesha County and 391% in Barron County for a 60-year-old with an income of $63,383  (subsidy ended).
• Between 221% in Waukesha County and 812% in Barron County for a 60-year-old couple with an income of $85,658  (subsidy ended).
• Between 2% in Waukesha County and 57% in Barron County for a family  of four with a household income of $128,000 (subsidy continues, but reduced).
• 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  (subsidy ended).

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.

U.S. Rep. Mark Pocan (D-Black Earth) speaks about impending insurance price increases due to the sunset of enhance subsidies for health insurance policies purchased at HealthCare.gov. (Photo by Erik Gunn/Wisconsin Examiner)

Sometime in the next 10 days, Wisconsin residents will see directly what the stakes are in the ongoing standoff in Washington over the federal shutdown, U.S. Rep. Mark Pocan (D-Black Earth) said Wednesday.

That’s when people who buy health insurance through the federal HealthCare.gov marketplace under the Affordable Care Act (ACA) will find out their likely premiums for 2026.

“In the next probably 10 days, we’re going to have a lot more information,” Pocan said at a press conference in the state Capitol along with small business owners and state lawmakers. “Health care is going to start getting very expensive for everyone beyond what it costs now — but for some people it’s going to be so cost prohibitive that they’re going to actually wind up losing their health insurance.”

Most Democrats in the U.S. Senate have refused to vote to advance a Republican continuing resolution to keep the federal government funded and have said they won’t do so if Republicans won’t negotiate with them on the bill.

In demanding changes to the stopgap spending bill, Democrats have focused on enhanced premium tax credits that provide subsidies for most people who buy health insurance on the federal marketplace.

The enhanced subsidies, enacted in 2021 and extended in 2022, will expire at the end of this year, driving up the premium cost for health insurance policies sold on the marketplace.

Pocan said that with the premiums on ACA policies going up and losing the additional subsidies, “a couple 60 years old making $85,000 in my district could see somewhere between a $16,000 and $17,000 increase next year in their premiums.” The projections are the product of KFF, the independent health research, policy and news organization.

Macy Buhler owns a child care center. She said her own health insurance comes through her husband’s job, but some of her employees have relied on the ACA and HealthCare.gov to buy insurance. With the possibility that they won’t be able to afford those plans any more, she said, she’s been inquiring with insurance companies about their potential options.

“I’m doing the best I can,” Buhler said. “But when people don’t see that this is going to affect our workforce, it frustrates me. It will absolutely affect our workforce. It will absolutely affect families who are middle class and lower. It will affect our farmers.”

Kyle LaFond, who  owns a custom manufacturing business, said he and his team of eight employees have relied on the ACA for health insurance.

“The ACA really leveled the playing field in terms of being able to provide coverage,” LaFond said.

Among his employees, the projected increases for health insurance will range from $2,000 to about $12,000. “For a growing family, those price hikes are almost insurmountable. It’s unconscionable,” La Fond said.

With the increased subsidies expiring, “I might lose some good people,” he added. “So I’m talking about the future of my business.”

Democrats tried to make extending the subsidies part of the tax- and spending-cut megabill that President Donald Trump signed in July, but the procedure Republicans used to pass that legislation allowed them to move it through the process without Democratic votes.

Pocan said the Democrats are not willing to trust the Republican majority to  negotiate on the ACA subsidies if the Democrats first agree on the GOP bill and simply reopen the government.

Previous deals in December and in March on stopgap spending bills fell apart, he said. “Then Donald Trump did recissions, which are against the law, and started taking away funding that we did. Article 1 of the Constitution gives the power of the purse to Congress and he took it away. So they get all of that.”

Pocan said the recurring Republican claim that Democrats are holding out “because they want to give hundreds of billions of dollars of health benefits to illegal aliens — PolitiFact gave that an outright false.”

Pocan refrained from using a barnyard epithet for the claim. “Manure is what it is,” he said, glancing around at the ornately decorated Assembly parlor. “It’s a pretty room. I got to talk pretty.”

But, he said, “by federal law, not one dime can go directly to someone who’s an undocumented person — I’m going to use that terminology — from Medicare, Medicaid, or the Affordable Care Act. So, nothing. So, it’s not true.”

Public awareness about the shutdown could be lagging. Pocan said his office had 85 calls last week about the shutdown.

By contrast, in the last nine months, his office has taken 14,435 calls about health care. “So this is something that people really care about.”

Rachel LaCasse-Ford, right talks to Sen. Tammy Baldwin about her use of the Affordable Care Act marketplace to buy insurance during a meeting Baldwin held with small business owners and others in Mount Horeb, Wisconsin, on Sept. 25. (Photo by Erik Gunn/Wisconsin Examiner)

Matt Raboin owns Brix Cider, a farm-to-table restaurant, and brews apple cider in the Dane County village of Mount Horeb.

His wife’s full-time job with benefits provides the family with health insurance, but for Raboin, the Affordable Care Act (ACA) has made an important difference for some of his employees.

“We don’t offer insurance ourselves,” Raboin said during a recent round table discussion set up by Sen. Tammy Baldwin (D-Wisconsin). “A lot of small businesses in small towns aren’t in a financial place to do that.”

Like Raboin, some of his employees get their coverage through a spouse or because they also work another full-time job that provides benefits. But over the years, the ACA and the HealthCare.gov marketplace created under the law have been a critical source of health coverage for many of his employees, Raboin said.

Recently he polled a number of them. One memorable response came from a part-time employee who also has a part-time job with a local church. She buys her health insurance on HealthCare.gov. Thanks to an increase enacted in 2021 in tax credit subsidies, she’s been able to afford the premiums, Raboin said she told him.

“So without it, she’s like, ‘I can’t keep working for you. And I don’t think I keep working for my church. I think I have to find a different job,’” Raboin recalled.

The ACA and HealthCare.gov have made it possible for millions more Americans and thousands more Wisconsin residents to obtain health insurance.

But less visibly, the health care marketplace that the ACA created has also helped support many small businesses. If the enhanced tax credit subsidies that lowered the cost of health insurance for millions over the last three years aren’t renewed, small business owners and employees say they could be especially hard hit.

Nearly half of people who get their health insurance through the HealthCare.gov marketplace are self-employed or small business owners, or else work for small businesses, according to KFF, an independent nonprofit that researches and reports on health policy.

To expand access to health care, the ACA created the HealthCare.gov marketplace to make buying health insurance easier for people whose jobs don’t provide coverage and who don’t qualify for government programs such as Medicaid.

To make coverage more affordable, the law provides tax credit subsidies for people with incomes up to 400% of the federal poverty guideline. Those subsidies were increased in 2021 and expanded to people with higher incomes.

The enhanced subsidies will expire at the end of 2025 unless Congress extends them — driving up the cost of health insurance for millions.

The enhanced subsidy “saves more than 230,000 Wisconsinites an average of $500 every single month,” Baldwin said during a Zoom press conference Tuesday.

For Chrysa Ostenso and her late husband, the enhanced subsidies lowered their premiums from nearly $2,000 a month to about $300 a month, Ostenso said.

Ostenso lives in Ladysmith, Wisconsin, where she and her husband operated an optometry clinic for more than three decades, raising four children along the way.

“We always struggled to afford health insurance but of course we had to buy it,” Ostenso said in an interview. “As a family of four kids with a small business, you can’t go without health insurance.”

The family’s high deductible plans required them to pay $6,000 a year out of pocket before insurance would cover their health care. By 2020, when the children were grown and the health plan just covered Ostenso and her husband, they were paying $1,979 a month, she said.

They hadn’t qualified for the original ACA subsidies. When the enhanced subsidies were enacted in 2021, however, Ostenso said their premiums went down to $300 a month, increasing to $500 a month in subsequent years.

“It actually meant freedom to go to the doctor, because we were spending so much money on our premiums [previously] that we actually couldn’t afford to go to the doctor,” she said.

Standoff over extending subsidies

In the weeks leading up to Tuesday night’s federal shutdown, Democrats in Congress demanded that Republicans rescind sweeping changes to Medicaid that were part of the major tax- and spending-cuts megabill that President Donald Trump signed July 4.

They also demanded an extension of the enhanced ACA subsidies.

Baldwin has coauthored legislation that would make the enhanced subsidies permanent. She spent part of the just-concluded congressional recess traveling Wisconsin and meeting with people who expect to see their health costs go up sharply if the increased subsidies end.

During Tuesday’s press conference, Baldwin related a conversation with a  bakery owner who worried about how she and her family will afford health insurance, “but also that increased costs on the [HealthCare.gov] exchange will mean that her employees at her bakery may have to quit to work for big companies that offer insurance.”

During Baldwin’s press conference, Gigi Gastevich, an artist who owns a retail space in Stoughton, said the ACA and the enhanced subsidies had made it possible for her to launch and grow her business.

Gastevich is a 15-year cancer survivor. When starting her business, she qualified for BadgerCare — Wisconsin’s main Medicaid program — which covered the ongoing medical monitoring she requires as a cancer survivor.

In 2025, with her income above the limit for BadgerCare, she found an insurance plan on HealthCare.gov that included her existing health care professionals in its network and had an affordable deductible.

The plan’s premium was $481 a month, Gastevich said, but the enhanced subsidy  brought it down to about $100 a month.

Without the subsidy, she said, she will have to switch plans — possibly losing her long-standing group of providers if they aren’t in the network. She said her choices include taking a high-deductible plan that would put some of the regular care she’s been recommended as a cancer survivor out of reach financially; or closing down her business. 

“[That] would mean not only abandoning my dream of entrepreneurship and being a self-employed artist, but taking away an income source for the dozens of artists and artisans whose American-made work I sell here,” Gastevich said.

It would also forestall her plans to scale up her business to sell her own line of textiles and employ others. “I won’t be able to do that if my health and well-being is tied to being on an employer-based health care plan,” she added.

Uncertain future

During her tour of the state, Baldwin stopped in Mount Horeb on Thursday, Sept. 25, where she spoke with Brix owner Matt Raboin and four other business owners as well as local health care providers.

The round table took place at the Upland Hills Health Mount Horeb clinic. The urgent care clinic is part of a broader system that includes a hospital in Dodgeville and clinics in surrounding communities.

Dr. Mark Thompson, Upland Hills CEO, said system executives expect to see about $400,000 a year in additional uncompensated care based on projections of people leaving the insurance rolls because they don’t think they can afford the new ACA premiums.

Jay Goninen sat in as a board member of the Upland Hills system, but he’s also an employer for whom the ACA has made it possible to provide health benefits.

Goninen owns a business that helps connect the auto repair industry with high schools and technical schools. For the last few years, he’s opted to have employees of the firm purchase health insurance on the ACA.

The company pays a portion of the cost. Goninen likens the arrangement to a common practice of employers who offer a group health plan and split the cost with their employees.

“I do really worry about just the individual person and their ability to afford to live right now, in general,” he told Baldwin. “It is tough.”

In addition to worrying about what will happen to employees who bought coverage at HealthCare.gov if they lose their subsidies, Raboin said he’s also concerned about the broader ripple effect in the community.

“Our clients aren’t rich,” Raboin said. “Not everybody can go out to eat all the time, and if you start taking away that expendable income, that’s less people coming out to eat. So I think it would depress the whole economy.”

Rachel LaCasse-Ford owns a campground with her husband and also heads the Mount Horeb Chamber of Commerce.

“I’ve never really had a job that offers health care,” LaCasse-Ford told Baldwin. “I’ve always worked in small business, so we have always used health care from the ACA.”

The enhanced tax credits “definitely benefited” the couple, she said. “And if those go away, that will make our budgets tighter, and it will make things more challenging for us.”

With every new job, LaCasse-Ford said, she considers its impact on their health coverage and whether she can stay with a nonprofit employer such as the chamber, work for a small business, “or if I need to look for a larger employer that offers benefits.”