Health Insurance in Wisconsin: 2027 Marketplace, BadgerCare & Subsidy Guide

Updated for the 2027 plan year (October 2026)

When you shop for health insurance, Wisconsin offers something most states don’t: a crowded field of regional insurers, many of them tied to local health systems. That means more choice, and more homework on networks. If price is your main concern, start with our affordable health insurance in Wisconsin guide. Local pages for Milwaukee and Madison cover hospitals, clinics, and in-person help.

Health insurance Wisconsin 2027: at a glance

For individual health insurance, Wisconsin uses HealthCare.gov rather than a state-run exchange. Only about 5.3% of Wisconsinites were uninsured in 2024, one of the lower rates in the country, though up from 4.9% in 2023, according to the U.S. Census Bureau’s American Community Survey.

How and when to enroll in Wisconsin

Open Enrollment for 2027 Wisconsin Marketplace coverage runs November 1, 2026 through January 15, 2027. Choose a plan by December 15, 2026 and coverage starts January 1, 2027. Choose between December 16 and January 15 and it starts February 1. Our Open Enrollment 2027 guide has every date.

To buy health insurance, Wisconsin residents can enroll on HealthCare.gov themselves, with a free Navigator, or through a licensed agency such as Honesty that connects to the same federal system. The plans, prices, and subsidies are identical however you sign up.

Treat December 15 as the real deadline. CMS confirmed the January 15 end date after a federal court blocked a shorter season, but January enrollment means a month without coverage. Outside Open Enrollment, a move, job loss, marriage, a new child, or losing BadgerCare can open a Special Enrollment Period, usually for 60 days.

BadgerCare Plus: Wisconsin’s partial expansion

BadgerCare Plus is Wisconsin’s Medicaid program for people ages 0 to 64 with low incomes. Adults qualify with income up to 100% of the federal poverty level, which is $15,960 a year for one person under the 2026 guidelines. Children and pregnant people qualify up to 306% FPL, according to the Wisconsin Department of Health Services.

Wisconsin is unusual. It never adopted the ACA’s Medicaid expansion to 138% FPL, but it covers nearly all adults without dependent children up to 100% FPL under a federal waiver, with no enrollment cap. KFF calls this a partial expansion, and because it stops at 100%, the state does not receive the enhanced federal match that expansion states get.

You can apply any time of year at ACCESS Wisconsin, by phone, by mail, or through your county or tribal income maintenance agency. Children’s coverage, including Wisconsin’s CHIP, also runs through BadgerCare Plus, and some families above 201% FPL pay a monthly premium for children.

Why Wisconsin has no coverage gap

In most states that skipped Medicaid expansion, very low-income adults fall into a “coverage gap”: too poor for Marketplace subsidies, which begin at 100% FPL, but not eligible for Medicaid. Wisconsin avoids that because BadgerCare Plus covers adults right up to 100% FPL.

The handoff matters. A single adult earning just over $15,960 moves from BadgerCare to a subsidized Marketplace plan, where the benchmark silver plan costs no more than 2.15% of income for 2027. If your income rises above 100% FPL during the year, report the change to BadgerCare and you will usually get a Special Enrollment Period to pick a Marketplace plan. Going the other way, if your income drops below 100% FPL mid-year, apply for BadgerCare right away; Medicaid enrollment is open all year, and you can end your Marketplace plan once BadgerCare starts so you don’t keep paying premiums.

Wisconsin’s 2027 insurers and rate filings

For individual health insurance, Wisconsin has one of the most competitive markets in the Midwest. Twelve insurers proposed 2027 rates, all asking for increases ranging from about 11% to more than 30%, according to WisBusiness. The insurers named in the filings tracked by ACA Signups include:

• Anthem (Compcare), UnitedHealthcare, Medica, and HealthPartners
• Wisconsin-based Common Ground Healthcare Cooperative, Network Health, Security Health Plan, and Aspirus Health Plan
• Madison-area Dean Health Plan, Quartz, and Group Health Cooperative of South Central Wisconsin
• MercyCare Health Plans

Leaving: Molina Healthcare of Wisconsin is withdrawing from the individual market effective January 1, 2027. These filings were proposals; final rates and county service areas show on HealthCare.gov when window shopping opens. Many of these plans cover only part of the state, so your county may have far fewer choices.

The Wisconsin Healthcare Stability Plan

The Wisconsin Healthcare Stability Plan (WIHSP) is a state reinsurance program that has helped hold down individual-market premiums since 2019. It pays part of insurers’ highest-cost claims using federal funding under a Section 1332 waiver, according to the Office of the Commissioner of Insurance.

The waiver has been extended through December 31, 2028, and OCI has asked to extend it again through 2033. You don’t need to do anything to benefit: reinsurance lowers the sticker price of every individual plan, which matters most for people above the 400% FPL subsidy cliff who pay full price.

Rural, farm and self-employed Wisconsinites

Much of Wisconsin’s individual market is made up of people who don’t get coverage through a big employer: dairy and crop farmers, small-business owners, tradespeople, and seasonal workers in tourism up north. Their incomes rarely look the same two years in a row, and that makes subsidy planning the hardest part of health insurance. Wisconsin farm families in particular should plan around net farm income, not gross sales.

A few habits help. Base your 2027 estimate on your expected net self-employment income after business expenses, the figure that flows to your tax return. Update HealthCare.gov within 30 days if income changes, so your credit tracks reality instead of producing a surprise at tax time. If a strong year could push you past 400% FPL, retirement contributions such as a SEP-IRA can lower the income the Marketplace counts.

Network reach matters more in rural counties too. Some regional plans center on one system, such as a hospital network in the Fox Valley, the Northwoods, or western Wisconsin, and may have few in-network options elsewhere. If you travel for specialty care to Madison, Milwaukee, or out of state, check where your plan pays in-network before you pick it.

2027 subsidies for Wisconsin households

Premium tax credits still lower Marketplace premiums for 2027, but they are smaller than in 2021–2025 because the enhanced credits expired on December 31, 2025. The 400% FPL cliff is back: above about $63,840 for one person or $132,000 for a family of four, there is no credit.

Between 100% and 400% FPL, the credit caps your cost for the benchmark silver plan at 2.15% to 10.22% of income, under IRS Rev. Proc. 2026-26. Silver plans add cost-sharing reductions up to 250% FPL. KFF found insurers proposed a median 15% increase nationally for 2027, after subsidized enrollees’ net payments more than doubled in 2026. See our 2027 subsidy guide for worked examples.

From January 1, 2027, only certain immigration statuses, such as green card holders, Cuban and Haitian entrants, and COFA migrants, still qualify for Marketplace savings, per HealthCare.gov.

How to choose a Wisconsin plan

When choosing health insurance, Wisconsin shoppers should put the network first. Many plans here are built around one health system, so two silver plans at similar prices can include completely different hospitals and doctors. Confirm your doctors, nearest hospital, and prescriptions before comparing price.

• Bronze pays about 60% of covered costs: lowest premium, highest deductible.
• Silver pays about 70% and is the only tier with cost-sharing reductions.
• Gold pays about 80%: worth a look for regular prescriptions or planned care.
• Catastrophic is for people under 30 or with a hardship exemption.

The 2027 out-of-pocket maximum is $12,000 for one person and $24,000 for a family. Our how to choose a health plan checklist and health insurance Marketplace explainer go deeper. Honesty compares ACA plans alongside alternative and ancillary coverage like dental and vision for your family’s needs.

Free help and consumer protection

Covering Wisconsin, based at UW–Madison, provides free Navigator help with HealthCare.gov and BadgerCare applications statewide; call (877) 942-6837 or visit coveringwi.org. You can also search localhelp.healthcare.gov by ZIP code.

For a denied claim, a billing dispute, or a problem with an agent, contact the Office of the Commissioner of Insurance at 1-800-236-8517. Honesty® Insurance Services, LLC (NPN 21094885) is a private agency licensed in Wisconsin and 48 other states plus DC, not a government agency. Pages are reviewed by a licensed agent.

Frequently asked questions

Keep learning: compare costs in affordable health insurance in Wisconsin, see local guides for Milwaukee and Madison, and review Open Enrollment 2027 and 2027 subsidies.