Lt. Gov. Sara Rodriguez speaks during a Wisconsin Technology Council forum featuring Democratic and Republican hopefuls in the 2026 governor's race Nov. 6, 2025. (Photo by Baylor Spears/Wisconsin Examiner)

The longest ever federal government shutdown that ended last week revolved around a top issue for Lt. Gov. Sara Rodriguez as she campaigns to be Wisconsin’s next governor: health and health care.

A registered nurse by training and former official at the Centers for Disease Control and Prevention, Rodriguez has been deeply involved in health care policy, first in her single term as a member of the Wisconsin Assembly and then, since 2023, as the No. 2 official in the state’s executive branch.

And, she says, it motivated her to declare her intention to succeed Gov. Tony Evers after Evers decided to stand down from the 2026 election.

“One of the reasons why I wanted to run is to make sure that we have somebody in a leadership position that, No. 1, understands health care, and No. 2, really gets how unaffordable and broken it is,” Rodriguez told the Wisconsin Examiner in an interview Monday.

She also sees a shift in the federal government away from established public health principles, forcing states to take the lead on setting public health standards. In the governor’s office, she said, her professional background would equip her to tackle  those issues.

As  a state representative, Rodriguez proposed a bill in the 2021-22 legislative term to accept the expansion of Medicaid — BadgerCare in Wisconsin — through the Affordable Care Act. Expansion would allow the state to enroll people with incomes between 100% and 138% of the federal poverty guidelines in Medicaid, with the federal government paying 90% of the additional cost.

When the ACA took effect, Gov. Scott Walker was in office and refused throughout his two terms as governor to accept the federal support and expand the program.

Evers defeated Walker in 2018 and promised to accept the federal expansion, but in the lame-duck session before he was sworn in, the Republican majority in the Legislature passed a bill that Walker signed, requiring the Legislature’s approval for expansion.

Since then, repeated attempts by Democrats to expand Medicaid, including the bill Rodriguez authored four years ago, have failed with Republican majorities in both houses of the Legislature.

Another form of Medicaid expansion — covering mothers for a year after they give birth — has the support of bipartisan majorities in the Senate and the Assembly, but Assembly Speaker Robin Vos (R-Rochester) has opposed bringing it to the floor. 

“We are one of two states that have not done that — us and Arkansas,” Rodriguez said. “And I think Arkansas may be working on it. So we may be the only one left at the end of the day.”

Rodriguez’s political career started with her Assembly race in 2020, flipping a Republican seat in the Milwaukee suburbs. She followed that with her race for lieutenant governor in 2022 and now her  campaign for the Democratic nomination to run for governor in 2026.

Throughout her political life, she said, she has been supported by 314 Action, a political organizing group seeking to elect more scientists and people in science-related professions, including health care.

During the recent federal government shutdown, Democrats in the U.S. Senate insisted that any resolution to fund the government also extend federal subsidies for health insurance under the ACA. The expiration of those subsidies at the end of this year will cause health insurance premiums to double, on average, participants in the ACA marketplace. 

Ultimately, a handful of Democratic senators voted with the Republicans to advance a GOP-authored spending bill that ended the shutdown without addressing the looming health insurance cost spike.

But the issue won’t go away, Rodriguez said.

“We’re looking at a doubling of premiums,” she said. “A 60-year-old couple are looking $1,500 to $2,000 more a month to be able to pay for their health insurance. That is absolutely unaffordable for most Wisconsinites.”

The problem extends beyond just people who buy their insurance through the federal marketplace, she warned.

“The larger amount of people who are uninsured in the state, the higher our health care costs are going to get, because they’re going to wait, they’re going to delay care, they’re going to be sicker when they get into care, and it’s going to cost hospital systems more in terms of uncompensated care,” Rodriguez said.

“If people will go uninsured, it’s going to raise costs,” she added. “And continuing to talk about it, continuing to let people know how that works, is something that I’m uniquely equipped to do as a nurse, as somebody who’s worked within the health care system. And it’s one of the reasons why I’m running for governor.”

Rodriguez said she has seen the benefits that the ACA has brought in the last decade and a half.

Before it was in place, “people delayed care,” she said. “They came in sicker to my emergency department and it cost a whole lot more dollars to be able to treat them and they were out of work because they had to be treated within a hospital system as opposed to going to their regular doctor and being able to get the care that they needed and be able to take care of their diabetes, to take care of their hypertension. Those are the kind of things that the Affordable Care Act has allowed us to do.”

She said she’s heard from small business owners who were able to start a business because they could get health insurance thanks to the ACA.

“Do we need to fix it? Absolutely. Do we need to get it better? Absolutely,” Rodriguez said. “But to get rid of it is going to have devastating effects on health care in Wisconsin.”

Rodriguez said she also brings the perspective of health and health care to other policy topics.

“The medicine we give you, the procedures that we do — it’s such a tiny fraction of how healthy we are,” she said.

Food, housing and “a good-paying job to put a roof over our heads and to pay for the food we eat and to pay for the medications we’re prescribed” are health issues, too, Rodriguez said. That’s why housing affordability, for example, is part of her platform, she said. 

“Tom Tiffany in the governor’s seat [is] not going to put a priority on lowering costs for Wisconsinites,” she said.

She also predicted that, if elected, Tiffany would sign laws restricting abortion in Wisconsin — “and that is going to be extraordinarily dangerous for people.”

Rodriguez views her science background as a strong selling point. “I think we want somebody who’s going to use data and science to make decisions,” she said.

Robert F. Kennedy Jr., President Donald Trump’s secretary of the federal Department of Health and Human Services, has been “using conspiracy theories as his underlying belief system, and that hurts real people,” Rodriguez said.

She cited surging measles cases in Wisconsin and nationally and the deaths of children in some states after the federal government weakened its support for vaccination.

“That hasn’t happened in a decade, and they’re continuing to feed this anti-science rhetoric that is going to harm our kids here in Wisconsin,” Rodriguez said. “I’ve been clear, I think RFK Jr. should resign. I don’t think he’s qualified for the job that he has and he’s actually a danger to public health across the country.”

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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.”

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