Health Insurance Concerns in Central Wisconsin

Residents of Central Wisconsin who depend on health insurance from the federal marketplace are facing tough decisions as the premium tax credit from the Affordable Care Act will end at the close of this year.

Dawn Russ, a former teacher from Stevens Point, expressed her anxiety over the potential increase in her family’s monthly premiums. If the credit isn’t extended, she anticipates that their premium could soar from $500 (with a $14,400 deductible) to $2,475 (with a $20,000 deductible). “I honestly have no idea what I’m going to do,” Russ admitted. “We really didn’t see this coming, and now we’re trying to figure out how to manage it.”

Russ and her husband, both retired educators, find themselves within the “sandwich” generation, balancing care for their aging parents and their granddaughter. After taking early retirement to assist her parents, one of whom has passed away, Russ might have to return to work due to the new premium rates. “I wanted to be there for my mom, and now it seems I won’t be as available. Plus, I enjoy spending time with my granddaughter, and that might have to change,” she shared.

A Widow’s Struggles

Julia Giannakopoulos, a resident of Coloma, is also navigating tough circumstances after recently losing her husband. She is looking for coverage for herself and her 14-year-old daughter under the ACA, where the current tax credits have kept her insurance costs about 20% of her income. However, she’s worried that her tax obligation will more than double next year.

Giannakopoulos is considering a catastrophic plan while paying out of pocket for most treatments. “There’s no way I can give up my care. My child has already lost one parent, so I need to focus on my health to remain here for her as long as I can,” she stated.

Surge in ACA Enrollment

By 2025, it is expected that over 300,000 Wisconsinites will sign up for health insurance through the Affordable Care Act, marking about a 60% increase in enrollment compared to the period before the tax credits were introduced. In 2021, eligibility for these credits expanded to include more middle-income families.

Both Giannakopoulos and Russ, along with others, have approached legislators, including Senator Tammy Baldwin, to voice their concerns. Baldwin invited them to share their stories at a news conference in Wausau, which took place at the Bridge Community Health Clinic, an organization committed to offering care regardless of insurance status.

“We hear these stories daily, and listening to their experiences was profoundly moving. It’s heartbreaking to realize the choices people face,” the clinic’s executive director, Jennifer Smith, remarked.

Challenges for Clinics

The clinic provides services to around 4,000 patients each year across multiple locations in Central Wisconsin. Smith has indicated that if the tax credit expires, more people may seek adjustments for uninsured medical expenses, adding strain to the clinic’s operating budget, which already relies on about 25% of its revenue from subsidies. Community services like food banks also depend on specific donations, and without adequate funding, these programs could struggle to operate.

The clinic is gearing up for various scenarios if the tax credit isn’t renewed, which might lead to cutbacks in other service areas that have seen growth. “Our main worry is that individuals might start avoiding necessary treatments and preventive care, which could lead to serious issues down the road,” Smith noted.

Bipartisan Support Needed

Senator Baldwin mentioned the need for healthcare reform but emphasized the urgent nature of the December 31 deadline. To pass the necessary legislation, 13 Republicans need to join the Senate Democrats, and while some Republicans share similar concerns, she feels that Senator Ron Johnson might not be one of them. “I haven’t invested much time in persuading him, but I hope other individuals will step up and take action,” Baldwin said.

Senator Johnson did not provide any comments when questioned.

Republican Views on ACA Subsidies

Representative Tom Tiffany criticized the ACA as the cause of rising premiums and deductibles, arguing that Democrats’ tax credits merely cover a failure. “Since Obamacare took effect, my insurance premiums nearly tripled, and my deductible doubled. To compensate for this failure, Democrats have significantly increased subsidies, even for families making up to $500,000, funneling money to insurance companies. The focus should be on providing real choices and transparency to help families find affordable plans,” Tiffany stated.

Representative Derrick Van Orden echoed concerns about the temporary nature of these enhanced subsidies, emphasizing the need for long-term reforms. “Affordable healthcare is crucial for Wisconsin families, but these enhancements were intentionally designed to expire,” he mentioned. “If it were truly ‘affordable,’ there wouldn’t be a need for constant increases in federal subsidies.” He reaffirmed his commitment to bipartisan solutions that genuinely reduce costs and enhance access for hardworking Americans.