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Sunday is deadline for Affordable Care Act insurance enrollment for coverage to start Jan. 1

By: Erik Gunn

The Healthcare.gov website, where people can sign up for health insurance coverage under the Affordable Care Act (ACA). Sunday, Dec. 15, is the deadline to enroll for people who want coverage to start Jan. 1. (Screenshot | Healthcare.gov website)

People who want to sign up for health insurance coverage under the Affordable Care Act in 2025 must do so by the end of the day Sunday, Dec. 15, if they want coverage to start on New Year’s Day.

“For accidents or injuries or when illness strikes, the last thing that anyone should have to worry about is how they’re going to pay for that, or whether they’re going to fall into some sort of medical debt,” said Milwaukee County Executive David Crowley during an online press conference Friday to draw attention to the Sunday deadline.

The Affordable Care Act (ACA) imposed new consumer protection provisions for health insurance plans, among them a requirement that people cannot be denied coverage or charged higher premiums because of their personal health history.

The act also led to the creation of a federal health care marketplace Healthcare.gov, where people can purchase individual health insurance plans if they don’t have health coverage through an employer or some other group source, including Medicaid or Medicare. Healthcare.gov provides information about the plans available in a person’s geographic area.

The ACA open enrollment period for individual plans started Nov. 1. Whether people are enrolling for the first time — because they’ve lost their coverage through work, for example — or renewing their insurance after enrolling previously in 2023 or before, “you should take advantage of this time right now,” said Joe Zepecki of Protect Our Care, a national campaign to support and strengthen the ACA. Protect Our Care organized Friday’s news conference.

People who sign up for a plan at Healthcare.gov must do so by Sunday, Dec. 15, to get coverage that starts Jan. 1.  For people who enroll after Sunday, 2025 coverage won’t start until Feb. 1. The final deadline for enrolling is Jan. 15.

People can get guidance in assessing their choices of plans through the statewide health insurance navigator, Covering Wisconsin (coveringwi.org).  In addition to the website, Wisconsin residents can call 414-400-9489 in the Milwaukee area or 608-261-1455 in the Madison area to reach a navigator with the organization. Both telephone numbers are available to residents anywhere in the state.

As of Dec. 1, 88,189 Wisconsin residents have enrolled in coverage during the current open enrollment period, according to the federal Centers for Medicare & Medicaid Services (CMS). That’s slightly short of the pace at the same time last year, when 99,950 people enrolled by Dec. 2, the Wisconsin Office of the Commissioner of Insurance reported.

Almost 250,000 Wisconsin residents — a record number — have been covered in 2024 under plans provided through the ACA website, Zepecki said Friday.

Expanded federal tax credit subsidies tied to the income of an applicant have reduced the cost of plans purchased through the ACA dramatically. Those subsidies have reduced the cost for about 61,000 Wisconsin residents, Zepecki said, and will remain in effect through 2025, making health plans much more affordable for people.

The enhanced insurance premium tax credit subsidies were first instituted with the enactment in 2021 of the American Rescue Plan Act (ARPA) in the first year of President Joe Biden’s term, and they were extended in the 2022 Inflation Reduction Act.

Zepecki said that for a 45-year-old Wisconsinite making $60,000 a year, the enhanced subsidy would save about $1,442 a year. For a 60-year-old couple with a combined income of $82,000 a year, “the difference in having the premium tax credits and losing them is more than $18,000 a year,” he added. And for a family of four with a household income of 125,000 a year, the premium tax credits would save more than $8,200.

“This helps almost everybody who’s in the [federal health insurance] marketplace,” Zepecki said.

Sen. Tammy Baldwin (D-Wis.) said making the subsidies permanent “will be at the top of my list as something that helps working families across Wisconsin and across the United States” in the 2025 Congress. She said they will be part of “a very robust debate” about the tax code as Republican lawmakers seek to extend tax cuts enacted in 2017 during Donald Trump’s first term as president.

“I know we have some folks who are more focused, sadly, on tax breaks for the wealthy and big corporations,” Baldwin said. “I’m going to be fighting for working Wisconsinites.”

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