Rising ACA Premiums Spur Concern Among Wisconsin Small Businesses and Lawmakers

The Affordable Care Act (ACA) continues to play a critical role in providing health insurance coverage to nearly 300,000 residents in Wisconsin. Milwaukee chef Dan Jacobs, who lives with Kennedy’s Disease, a rare neuromuscular disorder, credits the ACA marketplace for making health insurance affordable and stable enough to allow him to operate two restaurants while managing his condition effectively. The ACA prevents insurance companies from denying coverage or excluding treatment for preexisting conditions, which is essential for individuals like Jacobs. However, insurance premiums for ACA marketplace plans in Wisconsin are projected to rise significantly in 2026. This increase is partly attributed to the expiration of enhanced ACA tax credits at the end of 2025. Jacobs and his wife expect their premiums to increase by about $550 per month, a nearly $7,000 annual rise. Unlike many beneficiaries, Jacobs does not currently receive subsidies, highlighting concerns about the financial strain on those both with and without aid. In Washington, Jacobs testified before a Senate subcommittee deliberating on healthcare policy, advocating for the protection and strengthening of the ACA. The subcommittee is led by Senator Ron Johnson, who emphasized a need to reintroduce consumerism and market competition into healthcare to reduce costs, expressing skepticism about the ACA's impact on affordability. Legislative options to address rising healthcare costs include two competing Senate bills: one from Democrats proposing a three-year extension of enhanced subsidies, and a Republican bill focused on expanding health savings accounts without subsidy extensions. Both bills face uncertain prospects for passage due to partisan divides. Senator Richard Blumenthal, ranking committee member, argued for immediate extension of subsidies to prevent sharp premium increases while broader healthcare reforms are negotiated. The debate underscores ongoing challenges in balancing regulatory frameworks and market mechanisms to ensure affordable coverage. Jacobs expressed additional concern about the effect of rising premiums on his employees who also rely on ACA coverage. Increased insurance costs may force workers to seek alternative employment or result in business closures, a trend already impacting the restaurant industry. This situation illustrates the broader economic repercussions of healthcare premium volatility on small businesses and workforce stability. Overall, Wisconsin's ACA marketplace faces key uncertainties related to subsidy policies and premium affordability, with significant implications for consumers, providers, and insurers. Upcoming legislative decisions and regulatory adjustments will be pivotal in shaping the accessibility and cost-effectiveness of healthcare coverage under the ACA framework in the state and potentially nationwide.