Insurers seeking ACA plan premium increases in Wisconsin for 2027 say rising medical costs and greater use are driving their double-digit requests, while advocates raise concerns about affordability.
Health insurers in the state are requesting an average premium increase of 20.9% for next year, according to rate review filings posted online. All 12 of the insurers that proposed rates for the state’s Affordable Care Act marketplace are requesting increases, ranging from about 11% to more than 30%.
These proposals reflect the insurers’ experience in the prior year, including how many people were enrolled, what was spent on their medical care and other factors, including broader economic trends such as the impact of tariffs. That’s according to Natasha Murphy, director of health policy for the Center for American Progress, which advocates for progressive policies.
“This year, among some of the filings I’ve seen elements like, you know, even the fact that people are losing coverage, we expect the risk pool to be sicker and therefore cost us as the insurer more moving forward,” Murphy said in a recent interview.
While the regulated review process for these proposals is underway, she expects decisions to be made by the end of August on final rates for next year. Then by late September or early October, commissioners and other regulators around the country will release final lists of which insurers are operating in their marketplaces, Murphy explained.
Wisconsin’s Office of the Commissioner of Insurance confirmed information about participating insurers, service areas and rates is typically available in October.
Of the 12 insurers that requested rate increases in the state, five responded to requests for comment on their proposals.
Common Ground Healthcare Cooperative, which is proposing the largest increase across its plan categories at 30.88%, said its proposal reflects the expected cost of providing coverage in the coming year and aims to “ensure we can continue to provide high-quality coverage” for its customers.
“Like most Marketplace insurers, CareSource is navigating rising medical and pharmacy costs, a changing regulatory environment and increased market uncertainty,” a spokesperson wrote in an email, referring to the insurer’s parent company.
Compcare Health Services Insurance Corporation, which operates as Anthem Blue Cross and Blue Shield in Wisconsin, is requesting a 16.48% rate increase. Spokesperson Emily Snooks says the company’s proposed rates are “a direct reflection of local healthcare costs,” arguing Wisconsin has some of the highest costs in the country.
“Anthem has served Wisconsinites for more than 80 years and we remain committed to lowering health care costs by negotiating reasonable rates for care and ensuring health benefits and services are designed to prioritize high-quality care,” Snooks said in a statement.
Meanwhile, Healthpartners Insurance Company is requesting a 15.59% increase, based on anticipated changes in healthcare utilization and benefits. A spokesperson for the insurer said the increase accounted for expected “future medical inflation” and benefit changes between this year and next, based on shifting state and federal regulations.
Medica Community Health Plan, which is requesting a 24.56% increase, says the request “reflects a priority on high value plan offerings and provider partnerships” along with ensuring rates cover the cost of care.
“Rate requests for 2027 were not tied to any single factor but did account for these things: utilization continues to increase in intensity, pharmacy pricing has shown little relief in drug costs, and provider cost inflation as their cost of delivering care has gone up,” a spokesperson wrote in an email.
Security Health Plan — which is proposing the smallest increase of the bunch with 10.72% — points to rising healthcare and prescription drug costs as well as greater use of medical services as key factors.
“These changes, along with targeted service area updates, will help us continue providing high-quality, affordable coverage and care for the members and communities we serve,” said Nate Ovenden, Security Health Plan’s senior director of product and risk strategy.
The proposed increases follow the loss of enhanced premium tax credits for ACA plans, resulting in millions of Americans facing affordability challenges, Murphy said. That includes some losing coverage altogether, and others “buying down” and switching to lower-coverage plans.
“With the fact that everything else is doing up, whether that’s housing costs, utility costs, folks are really feeling the budget squeeze everywhere and it’s forcing them to make incredibly difficult decisions,” she said. “My concern is, as we look to 2027, to see likely even additional reductions in the number of uninsured in the state of Wisconsin.”
The state’s ACA plan enrollment total dropped by nearly 46,000 earlier this year as the enhanced subsidies went away, falling from 291,336 at the end of open enrollment to 245,753 in February. That decline of 16% matched the national trend.
