Federal refund checks are going to marketplace enrollees who paid full price this year, a small slice of the market. Wisconsin insurers want about 21% more for 2027, and open enrollment starts Nov. 1.
The Trump administration has started mailing $500 checks to Affordable Care Act enrollees, Wisconsin among them, but the money is aimed at a narrow group: people who bought a HealthCare.gov plan this year and paid full price without a subsidy.1,2,5 For the much larger share of Wisconsin's marketplace that does get help, the bigger number this fall is the one insurers filed with the state. They've asked for an average increase of about 21% on 2027 individual plans.3
Open enrollment for 2027 coverage begins Nov. 1. To have a plan start Jan. 1, enrollees need to pick one and pay by Dec. 15, and the final deadline is Jan. 15.4
The refunds go to people in the 30 states that use the federal HealthCare.gov exchange, including Wisconsin, who enrolled for 2026 without premium tax credits.5 Most of them earn more than 400% of the federal poverty line, the cutoff that came back this year when the enhanced subsidies expired in December.1,5 ABC News puts the number of recipients at about 950,000 nationally,6 out of a marketplace that KFF estimates will average about 17.5 million paying enrollees this year.7 Households get $500 per eligible person.5 The federal government hasn't released a state-by-state count, so there's no public figure for how many Wisconsinites qualify.
The administration says the money comes from surplus HealthCare.gov user fees that the Biden administration built into premiums. Trump has called those fees an overcharge and said the money belongs to "hard-working Americans."2 The refunds don't reach people in states that run their own exchanges, or the roughly 90% of HealthCare.gov enrollees who still qualify for a subsidy, according to an analysis by healthinsurance.org.5 Gerard Anderson of the Johns Hopkins Bloomberg School of Public Health told ABC News the checks don't target the people most likely to have been hurt by the policy changes.6
Nationally, what enrollees actually pay each month rose from an average of $113 to $178 this year, a 58% jump, after the enhanced tax credits ended in December, according to KFF.7 CBS News put the average increase at about $780 for the year, well above the $500 check.1 KFF's Cynthia Cox told CBS the check won't cover the full increase for most people who get it.1 Average deductibles also rose by $1,027, to $3,786, the steepest increase KFF has seen in the marketplace.7 The share of enrollees getting any tax credit fell from 92% to 87%.7
Wisconsin's market shrank with it. WisBusiness reported enrollment fell 16%, from 291,336 to 245,753, after the subsidies ended.8 WPR reported in January that sign-ups had dropped to just under 290,000 from nearly 307,000 the year before, with experts warning the paid enrollment numbers would come in lower.9 Sarah Smith of the state Office of the Commissioner of Insurance told WPR the marketplace serves people who work for and own small businesses, along with barbers and farmers.9
Twelve insurers have filed 2027 rates in Wisconsin, with proposed increases ranging from about 11% to more than 30%, according to WisBusiness.8 The weighted average comes to 21.1% in the individual market and 13.3% for small employers, according to rate filings compiled by ACASignups.net.3
Molina Healthcare is leaving Wisconsin's individual market on Jan. 1, so its enrollees will have to choose a new plan.3 Insurers blamed rising medical and pharmacy prices, more intense use of care and provider cost inflation.8 Several also cited the subsidy expiration itself, saying the healthier customers dropped coverage and left a sicker, costlier pool behind.3
The Pentagon used an emergency process to remove a checkbox for Americans abroad who've never lived in the U.S. Democrats have sued. Wisconsin told its clerks the change doesn't affect who can vote here.
First-term Democrat Ryan Spaude wants to phase out Wisconsin's voucher program. Republican challenger Bobby Lindsey wants to keep it. Here's where the 89th Assembly District candidates stand.
Incumbent Tammy Weckler-Sternard, Republican Curt Vandertie and independent Randy Wagner agree Door County shouldn't sign a 287(g) agreement. The campaign has turned on a union no-confidence vote and released personnel files.
Federal prosecutors have charged three Wisconsin residents with illegal voting since Sept. 2, part of a midterm-season push by the Justice Department. State records show how rare the crime is here.
Join for free and unsubscribe at anyime
