Last day of health insurance enrollment during record-breaking year

With just over one day left of open enrollment on the health insurance marketplace, Wisconsin has already surpassed the previous record high for signups.

Data from the Centers for Medicare and Medicaid Services shows 306,470 Wisconsin residents signed up for an insurance plan as of Jan. 4. That’s just over 40,000 more people, or 15 percent higher, than the record high set last year.

Gov. Tony Evers celebrated the enrollment increase in a press release last Friday, saying he was “proud” of his administration’s efforts to get more Wisconsinites enrolled in health care coverage.

“The (Affordable Care Act) has never been more important, with a record number of Wisconsinites now signed up for affordable, high-quality health insurance through the federal marketplace, ensuring they can access preventive care, vaccinations, life-saving prescriptions, and more,” Evers said in the press release.

Residents can still participate in open enrollment before midnight on Jan. 15 for coverage that will start on Feb. 1.

Lower costs, increased outreach leading to enrollment growth

Enrollment in the health insurance marketplace has been on the rise in Wisconsin since 2021. Data from nonprofit policy group KFF shows enrollment grew by nearly 75,000 people, or 39 percent, over the last three years.

Justin Rivas, manager of the Milwaukee Enrollment Network, said federal subsidies that can reduce insurance premiums have helped drive growth. His organization has seen a significant increase in people age 18 to 25 signing up for plans in recent years.

“If we’re kind of cross-cutting that age group by socioeconomic status, lower income folks are also picking up in that age group,” Rivas said. “So the appeal of the affordability of the health insurance, I think, is really hitting the groups that we would like to pick it up and get covered.”

The American Rescue Plan, signed by President Joe Biden in March of 2021, expanded eligibility for subsidies and increased tax credits that help low- to moderate-income people purchase marketplace coverage. Those premium subsidies, which were set to expire in 2023, were continued through the end of 2025 by the Inflation Reduction Act.

Federal data shows 89 percent of Wisconsinites who signed up for coverage in 2023 received a premium tax credit, reducing their premium by an average of $573.11 per month.

Bobby Peterson, executive director of public interest law firm ABC for Health in Madison, said increased awareness about what’s available on the federal marketplace has also helped drive enrollment growth.

“It’s been around longer, and people have been able to secure pretty good coverage through it,” Peterson said. “People talk, they share it with their neighbors. There’s also a lot more outreach and advertising related to it.”

Advocates warn against unauthorized sign-ups, junk plans

This year’s enrollment period included new restrictions on insurance agents and brokers to help cut down on unauthorized sign-ups. Last year, more than 200,000 people reported that they were either enrolled in health insurance plans or switched from one plan to another without their permission. 

Peterson said the new restrictions seem to have curtailed the fraudulent behavior, but he encouraged residents to still be on their guard when getting signed up for a plan.

“Signing up for plans that sound too good to be true, that you heard about on TV or someone texted you about,” Peterson pointed to as examples. “It doesn’t have essential health benefits, it’s got pre-existing condition limitations, and you’re paying premiums for not a very good plan.”

The federal health insurance marketplace faces several headwinds in the coming year, including the potential end of premium subsidies if Congress does not move to expand them.

Rivas said much of the increased outreach that has helped drive enrollment has been through federal pandemic-era funding that will also come to an end.

“We always say that the amount of work we can do on the ground is proportionate to the dollar that we have,” he said. “We’re forecasting a future in which we’re going to have tighter budgets and not be able to do as much outreach and awareness building.”

Peterson also predicted less federal funding for outreach in the future. He said former President Donald Trump’s previous administration chose to cut funding for enrollment efforts, and he thinks sign-up numbers will decline if Trump takes a similar approach when he returns to office.

If that happens, Peterson said he hopes to see state officials step in to continue funding for these efforts.

“I think it’s an appropriate role for the state to make sure we invest in the workforce, we invest in the outreach, we invest in the education, and we make sure that people get connected to the services they need and deserve,” he said.