The Covering Wisconsin webpage. The nonprofit, housed at the University of Wisconsin Extension, is a navigator agency to help people understand their options when buying health insurance through the HealthCare.gov marketplace. (Screenshot)

About 4,000 fewer people in Wisconsin signed up at the federal HealthCare.gov marketplace in November for a health plan for next year than did in November 2024 for coverage this year, recently released numbers from the federal government show.

It’s too soon to tell for sure whether that will forecast a significant drop in health coverage through the marketplace, according to William Parke-Sutherland of the Wisconsin family policy research and advocacy group Kids Forward.

Parke-Sutherland and others who pay close attention to health care access in Wisconsin are watching those numbers closely, however.

Monday, Dec. 15, marks a critical deadline — the last day that people who purchase a health plan through the marketplace can sign up for coverage that starts Jan. 1, 2026.

The Healthcare.gov marketplace was created as part of the Affordable Care Act. Enacted in 2010 to drive down the ranks of Americans without access to health care, the ACA established the marketplace to make it easier and cheaper for people without coverage from an employer or through government programs such as Medicaid to buy health insurance.

Enhanced tax credit subsidies first enacted in 2021 on health plans sold through the marketplace have helped boost enrollment to new records over the last four years nationally and in Wisconsin. More than 300,000 state residents received their health coverage for 2025 through the marketplace.

Those enhanced subsidies expire at the end of this year, however, leading to forecasts that enrollment will decline in 2026 as the cost of insurance climbs.

“Many Wisconsinites will see their premiums double, and some will see staggering increases of over $30,000 a year,” Gov. Tony Evers said Wednesday during a press call with the ACA advocacy groups Protect Our Care and Main Street Alliance. “That’s ridiculous and unattainable for many.”

The event was held both to alert people about Monday’s open enrollment deadline and to urge voters to lobby Congress to extend the subsidies.

“Each year, the Affordable Care Act and open enrollment has ensured hundreds of thousands of Wisconsinites having life-saving health care coverage,” Evers said. “These tax credits are not luxuries — they are lifelines that make the difference between kids and families and communities getting care or going without it.”

This year, 88% of Wisconsin residents who enrolled at HealthCare.gov qualified for the enhanced subsidies and saved $644 a month on average, Evers said.

Thad Schumacher, a Fitchburg pharmacist who also joined the call, said losing coverage would lead people to forgo “their primary care visits, their medications, for chronic conditions like diabetes and hypertension, and preventative care that keeps people healthy.”

Early numbers send mixed signals

The federal Centers for Medicare & Medicaid reported that from Nov. 1 to 29 this year, 84,398 Wisconsinites enrolled in coverage through the marketplace. From Nov. 1 to Nov. 30, 2024, Dairy State enrollment totaled 88,189, according to CMS.

Nationally numbers are up, however — 5.76 million in November this year, compared with 5.36 million in November last year, according to CMS.

While Wisconsin’s decrease of less than 4,000 people signing up may look small, “It’s just hard to know what this means,” Parke-Sutherland told the Wisconsin Examiner.

In the years going back to 2022, the first month of open enrollment saw anywhere from 29% to 42% of that year’s total HealthCare.gov sign-ups, he said.

At Covering Wisconsin — a federally licensed navigator that helps guide people through the process of enrolling in HealthCare.gov plans — the volume of November calls and contacts through the navigator’s web-based chat portal have been about even with the same month last year, said Allison Espeseth, the Covering Wisconsin director.

In 2024, however, there was “a pretty big spike” in contacts in the first two weeks of December leading up to the Dec. 15 deadline for coverage to start Jan. 1.

“This year, we are definitely continuing to have people call us, but we haven’t seen that spike,” Espeseth said.

She offered several possible reasons for that. Some people may have seen higher premiums for their plans and decided to go without. Others may think that there won’t be any subsidies, despite the fact that smaller subsidies that were part of HealthCare.gov plans from the beginning remain in place.

And some have wondered whether they should hold off on signing up in case Congress does reach a deal and extend the subsidies, Espeseth noted.

“We’ve been encouraging people to please sign up regardless,” Espeseth said. “Don’t wait.”