Why Your Premium Went Up in January

If you buy your health insurance on the marketplace, your premium went up in January. For people who get help paying, the amount they owe more than doubled on average.

Here's what happened. Extra marketplace subsidies passed in 2021 expired December thirty-first. Congress fought over them for months — the dispute drove the longest government shutdown in American history — and then let them lapse.

Wisconsin is more exposed than most states. Because Wisconsin never expanded Medicaid, BadgerCare covers adults up to the poverty line and everyone above it buys on the marketplace. In expansion states, many of those people would be on a program like BadgerCare instead.

Wisconsin enrollment dropped by seventeen thousand.

In January, the House voted to restore the subsidies for three years — two hundred thirty to a hundred ninety-six, seventeen Republicans joining. The Senate hasn't taken it up.

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What expired. The Affordable Care Act's original premium tax credits, created in 2010 and first available in 2014, applied to households between 100% and 400% of the federal poverty level. The American Rescue Plan Act of 2021 temporarily expanded them — removing the 400% income ceiling entirely and lowering the share of income households had to pay toward premiums. The Inflation Reduction Act extended that expansion through the end of 2025.

Those enhanced credits expired December 31, 2025. The original credits remain in place. This distinction matters: subsidies did not disappear, they reverted. What returned is the "subsidy cliff" at 400% FPL — above that line, no assistance at all. (Ballotpedia; ASTHO)

"More than doubled" — what the figure measures. KFF estimated that premium payments would increase 114% on average for subsidized ACA Marketplace enrollees to keep the same plan in 2026 — roughly $1,016 more per year. Note this measures the increase in what enrollees pay out of pocket, not the increase in the underlying premium. The script says "the amount they owe" for this reason. An earlier draft said "rose about a hundred and fourteen percent"; "more than doubled" was substituted as clearer on air and harder to mishear than a percentage above 100.

Underlying premiums also rose independently. Analysts attribute part of that to insurers anticipating that higher costs would drive healthier enrollees out of the market, leaving a sicker and more expensive risk pool. (KFF; Wisconsin Examiner)

Why the script says "on the marketplace" and not "your own insurance." Employer-sponsored premiums also rose in 2026, for reasons unrelated to the subsidy expiration. The claim here is specific to subsidized marketplace enrollees, and the script is worded to say so.

Wisconsin's unusual structure — the reason this is a Wisconsin script. Wisconsin did not expand Medicaid under the ACA. But through a Section 1115 waiver, BadgerCare Plus covers childless adults with incomes up to 100% of the federal poverty level. The result: Wisconsin is the only non-expansion state without a coverage gap.

• Under 100% FPL → BadgerCare Plus
• 100% to 400% FPL → Marketplace with premium tax credits
• Above 400% FPL → Marketplace at full price (the cliff, restored in 2026)

In full-expansion states, Medicaid reaches 138% FPL, and marketplace subsidies begin there. So Wisconsinites between 100% and 138% of poverty are on the marketplace when in most states they would be on Medicaid — meaning the subsidy expiration reached a lower-income population here that expansion states largely shielded. This is the structural point the script's third paragraph makes, and it is the strongest reason to localize this story rather than run a national version. (healthinsurance.org; BenefitsUSA)

Wisconsin numbers. 2025 enrollment set a state record at over 310,000. As of January 3, 2026, enrollment stood at 289,213 — a drop of more than 17,000. Roughly 277,000 Wisconsin enrollees had been receiving a subsidy. In 2025, more than 86% of Wisconsin marketplace enrollees received premium tax credits, reducing premiums by an average of $585 per month. Twelve insurers offer individual and family plans in Wisconsin for 2026.

Nationally, 2026 enrollment came in at 22.77 million, down about 1.5 million from 2025. KFF found the drop concentrated above the subsidy cliff: enrollees between 400% and 500% FPL were just 3% of 2025 sign-ups but accounted for 27% of the decline, with sign-ups in that band falling 44% — over 321,000 people. (Wisconsin Examiner; FOX6; KFF)

What it looks like to a household. Mike Ohlinger of Neenah told WBAY his family faced roughly a $150 monthly increase: "which brings us almost to the cost of our mortgage each month. It's been a very difficult cost to absorb." (WBAY)

The legislative sequence. The dispute over these credits was a major contributor to the 43-day federal government shutdown in fall 2025, the longest in U.S. history. The continuing resolution that reopened the government secured a Senate vote on preserving them.

• December 2025: The Senate voted on the Lower Health Care Costs Act (S 3385), which would have extended the enhanced credits through 2028. It failed to reach the 60 votes needed to proceed. The Senate also considered competing approaches — reverting to original credit levels paired with expanded health savings accounts (S 3386, S 3362), association health plans, and fraud-oversight provisions (HR 6703). None advanced.
• December 17, 2025: The House passed the Lower Health Care Premiums for All Americans Act, 216-211. It did not extend the enhanced credits, instead advancing association health plans and related measures. Moderate House Republicans expected an opportunity to vote on an extension amendment; Speaker Mike Johnson and the Rules Committee denied it.
• December 31, 2025: The enhanced credits expired.
• January 8, 2026: The House passed a three-year restoration, 230-196, with 17 Republicans joining Democrats. Speaker Johnson, who opposed it: "I think it's a really bad policy, and I wish they hadn't, but everybody had a vote." Rep. Rob Bresnahan (R), who voted yes: "The Senate could put together a product that could ultimately get sent back over to the House that we can then conference on."
• Since: The Senate has not passed the House bill or any alternative. Negotiations remain unresolved as of mid-2026.

(ASTHO; Health Affairs; Ballotpedia; Fierce Healthcare via HMP)

A clarification on the One Big Beautiful Bill Act. OBBBA did not expire the enhanced premium tax credits. They lapsed on the schedule the Inflation Reduction Act had already set. OBBBA made separate and significant health policy changes — roughly $911 billion in Medicaid reductions over ten years, and an estimated 10 million more uninsured by 2034 — but the marketplace subsidy expiration is a distinct event with a distinct legislative history. Do not conflate them. The relevant decision points on the credits were the December 2025 Senate vote and the House's choice of bill, not OBBBA.

The case against extension, stated fairly. Opponents have not generally argued that premiums should rise. Their objections: the enhanced credits removed the income ceiling entirely, extending assistance to households well into the upper middle class; a "clean" extension does nothing to address underlying cost growth; and the structure invites fraud, including enrollment of ineligible or nonexistent beneficiaries by brokers paid per sign-up. Alternative proposals emphasized consumer-directed health savings accounts, association health plans, and regulatory flexibility rather than premium subsidies. Supporters counter that record enrollment, historically low uninsured rates, and improved market stability argue for continuation, and that the alternatives do not reach the same populations.

Related Civic Minute segments: the Medicaid and rural hospitals material on OBBBA's health provisions; the Education series on the state budget's role in local costs.