Major Changes Ahead for Affordable Care Act Coverage in Wisconsin
Appleton, Wisconsin – Significant adjustments are on the horizon that may lead to increased healthcare premiums for those seeking coverage through the Affordable Care Act market.
One provider, Common Ground Health Care Cooperative, has informed customers across 11 Wisconsin counties that it will not be offering coverage starting next year.
This announcement coincides with ongoing discussions in Congress about whether to extend premium grants that were previously enacted during the pandemic.
The affected counties include Outagamie and Winnebago, which together serve nearly 7,000 customers of Common Ground.
These individuals will need to seek alternative providers starting November 1st, but the options will be quite limited.
Mike Ohlinger, who relies on the ACA market for health insurance, expresses concern about potential premium hikes if Congress does not extend the grants. “We’re currently paying almost $900 a month for insurance through the market. That’s just not acceptable. If these subsidies end at the year’s close, the potential for rising premiums is really daunting,” he shares.
While Ohlinger may not represent the typical customer, it’s clear that dwindling options affect many. Some state lawmakers are also cautioning that it’s not just low-income individuals who are impacted by these changes.
“The biggest worry I have is that people don’t realize this affects everyone. There’s often a mindset that assumes only certain people will be left without options,” one lawmaker notes.
In a communication to customers, Common Ground explained, “Our decision to withdraw health insurance offerings in your region next year stems from rising healthcare costs and unexpected changes in the demand for services. These trends are occurring both in our state and nationwide, making sustainable operations difficult.”
Alongside Outagamie and Winnebago, counties such as Calumet, Fond du Lac, Sheboygan, Waupaca, and Waushara are also included in this announcement.
Ohlinger remarks, “I think this serves as a wake-up call—seeing all those counties in the Common Ground memo is just alarming. Even insurance providers are struggling to keep pace with the changes.”
State Senator Christine Dusler Alfheim emphasizes the turbulence within the insurance industry, noting that many lawmakers themselves find it hard to comprehend the current landscape.
Common Ground provided a statement indicating, “Common Ground Healthcare Cooperative (CGHC) has made the tough decision to exit 11 Wisconsin market products. Current members in these areas will continue to receive quality care through the end of 2025 and will have the opportunity to select a new health plan during the upcoming open enrollment period starting November 1st.”
