Wisconsin Free Clinics Face Growing Demand Amid ACA Premium Increases and Tax Credit Expirations

Free and charitable health clinics in Wisconsin are preparing for increased patient demand due to rising Affordable Care Act (ACA) premium costs and the impending expiration of enhanced premium tax credits. These tax credits have helped over 270,000 Wisconsinites afford their marketplace health insurance plans. The expiration of these subsidies, coupled with an average 17.4% increase in ACA premiums in Wisconsin for 2026, is expected to significantly impact health coverage affordability. Clinics like Milwaukee’s Bread of Healing and Walworth County’s Open Arms Free Clinic, which primarily serve uninsured or underinsured individuals, report growing patient numbers and anticipate further increases. These clinics provide vital preventive and chronic care services to reduce emergency room overuse and help manage community health needs. Leaders at these clinics emphasize the challenge of meeting rising demand amid limited resources and variable funding. The enhanced premium tax credits, initially expanded during the COVID-19 pandemic to broaden income eligibility and reduce out-of-pocket premiums, are set to expire without Congressional intervention. This policy shift is expected to result in premium payments more than doubling on average nationally for subsidized marketplace enrollees. KFF research indicates a quarter of affected enrollees may choose to forgo insurance if premiums double. Legislative efforts in the U.S. Senate include a Democratic proposal to extend these subsidies, while a Republican alternative focuses on high-deductible plans and health savings account funding without renewing enhanced subsidies. Meanwhile, free clinics are proactively adjusting operations, including insurance arrangements for staff, expanding volunteer recruitment, and exploring additional service hours to accommodate increased patient volumes. Wisconsin’s free clinic sector, led by organizations such as the Wisconsin Association of Free and Charitable Clinics, continues to adapt to evolving healthcare policy changes, including post-pandemic service modifications and Medicaid policy adjustments. Collaboration through initiatives like Wisconsin Owns Wellbeing aims to strengthen statewide safety net services. State government has allocated some funding to free clinics recently, but private grants and donations have declined, intensifying financial challenges. Despite these constraints, clinics affirm their commitment to maintaining access and service for uninsured and underinsured populations. Historical context reflects sustained demand for free health services predating ACA implementation, highlighting persistent systemic gaps in healthcare coverage. This dynamic underscores ongoing pressure on safety net providers as federal healthcare policies evolve, affecting access, affordability, and the operational capacity of free and charitable clinics serving vulnerable populations in Wisconsin.