The number of people enrolling in health plans through the Affordable Care Act's HealthCare.gov website has fallen in 2026, according to the federal government. (Getty Images)

After a record number of Wisconsin residents signed up for health insurance through the federal health care marketplace in 2025,  enrollment for 2026 is down by 7%, according to the federal government.

Enrollment could fall farther, if people who have signed up decide they can’t afford the cost when the first bill for insurance arrives, an independent analyst warns.

Health insurance — whether purchased through the federal marketplace or elsewhere — is costing people more in 2026. The price of plans purchased through the HealthCare.gov marketplace has gone up. In addition, enhanced federal tax subsidies that became available in 2021 and dramatically lowered the cost for most marketplace customers have expired.

The Affordable Care Act, enacted in 2010, created HealthCare.gov to help reduce the number of Americans without health insurance. The marketplace was designed to make it easier and more affordable for people without health coverage through an employer or through government programs to purchase a health plan for themselves and their families.

After enhanced tax-credit-based subsidies were enacted in 2021, enrollment through the marketplace began setting new records each year, nationally and in Wisconsin. Several efforts by Democrats in Congress last year to extend the subsidies past their Dec. 31, 2025, expiration date failed when the Republican majorities in both houses of Congress declined to take up the proposals.

Legislation that would revive the enhanced subsidies for another three years has now passed the U.S. House, but its future in the U.S. Senate remains uncertain.

“Without the subsidies — that’s what makes it really affordable — many small business owners and others would not have access to health care,” U.S. Rep. Mark Pocan (D-Black Earth) said during a media call in January with Protect Our Care and Main Street Alliance.

Protect Our Care campaigns for preserving and improving the Affordable Care Act and other federal health care programs. Main Street Alliance is a small business organizing group that supports the ACA along with the act’s provision to expand Medicaid by raising the income cap to 138% of the federal poverty guideline.

“We need to keep the Affordable Care Act in place, and the only way you keep it in place so it’s affordable for small business owners and many others is by having those credits,” Pocan said.

Data released last week by the Centers for Medicare & Medicaid Services showed that 291,336 Wisconsin residents had enrolled in plans through HealthCare.gov by Jan. 15, the final open enrollment deadline. That is about 7.1% below 2025 enrollment of 313,579 for the state.

Nationally, 2026 enrollment fell by 1.3 million from 2025, a drop of more than 5%.

Difficult choices for HealthCare.gov customers

For Sydney Badeau, an advocate for people with disabilities, affordable insurance through HealthCare.gov made it possible for her to work part-time for two different Wisconsin advocacy groups. In 2026, that has changed.

Badeau calculated that her 2026 premium would cost her around $450 a month — more than she could afford. She told the Wisconsin Examiner she was able to shift her work arrangement, taking a full-time position with one of her employers, The Arc Wisconsin, which now provides her health benefits, while remaining as a part-timer for her other employer, People First Wisconsin.

Most health plans sold at HealthCare.gov are classified Gold, Silver or Bronze based on a combination of their coverage, premium cost and the out-of-pocket costs that patients incur.

Nancy Peske, a Milwaukee-area freelance writer, editor and consultant, said she has always purchased a bronze plan with a $7,500 deductible. Thanks to the enhanced subsidy, her insurance cost her $370 a month in 2025, she said, instead of about $900 a month.

For 2026, her premium has risen to $1,164 a month — with no subsidy any more.

Peske has stopped contributing to her retirement account. “It will probably push back retirement for a couple of years for me,” she said.

Amanda Sherman, a Mequon real estate broker’s assistant, purchased a mid-level Silver plan in 2025 with a $7,500 deductible. Enhanced subsidies reduced her monthly premium by about $250, to $222 a month.

The health plan also helped cover some expensive medications for her complex autoimmune disorder, Sherman said.  

For 2026 she wound up with a Bronze plan that has a $9,500 deductible. Although she no longer has an enhanced subsidy, she does qualify for a smaller subsidy that still exists, of about $185 dollars — lowering her premium that would have been $538 a month to $353 a month — $120 more than she was paying in 2025.

When she went to enroll for 2026, Sherman’s previous insurer had left the HealthCare.gov marketplace where she lived. In picking a replacement plan, she said, she found herself having to choose between an option with better coverage for her medications — or one that included the same providers and specialists she had grown to trust.

Making that choice was a struggle, but keeping that care team was important, she decided. “I feel like that’s invaluable,” Sherman said.

Enrollment could fall off further

Nationally and in Wisconsin, the total HealthCare.gov enrollment numbers could still shrink further, according to Charles Gaba, an independent researcher who monitors enrollment and coverage under the Affordable Care Act.

In addition to monitoring open enrollment data at his website, acasignups.net, Gaba regularly posts information on a number of other data points. One of those is “effectuated enrollment” — active coverage for which the person enrolling has paid the monthly premium. Effectuated enrollment data lags by several months.

In a post Jan. 29, Gaba wrote that “it’s important to remember that up to 10 MILLION of the [approximately] 19.6M enrollees who re-enrolled did so by passively auto-renewing, which means millions of them received massive sticker shock when they received their January invoice.”

Gaba told the Wisconsin Examiner that for Wisconsin — which uses the federal HealthCare.gov marketplace rather than standing up its own state marketplace — the first batch of effectuated enrollment data might not be available until July at the earliest.

In the Jan. 29 post, however, Gaba wrote that in states with their own marketplaces, “at least a half-dozen of the state-based exchanges have warned that they’re already seeing much higher cancellations than they usually do, and that they expect this trend to continue as people are no longer able to keep up with the dramatically higher premium payments.”

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