Wisconsin had an uninsured population of around 327,000 people as of 2019, representing about 5.8% of the state’s population overall. That data comes from the Kaiser Family Foundation (KFF), a nonprofit that studies healthcare. KFF looked at the data again in 2021 and found that of the people without health insurance in Wisconsin, nearly 206,000 of them would qualify for a marketplace health plan.
Marketplace coverage is comprehensive. It covers a set of 10 essential health benefits that includes, among other things, preventive care, maternity care, prescription drugs and mental health care. These plans, regulated by the Affordable Care Act (ACA), must accept people with pre-existing conditions regardless of medical history as well.
The ACA also created cost subsidies to lower the price of health insurance for people with low to moderate incomes. Available to people earning 100% to 400% of the federal poverty level, these subsidies — officially known as advance premium tax credits — can offset monthly premium costs, sometimes by a lot.
In fact, Kaiser Family Foundation estimates that over a quarter (27%) of the uninsured, marketplace-eligible people in Wisconsin could get a bronze plan for free thanks to premium tax credits. Most people qualify for a tax credit to some degree.
The nonprofit also calculated premium averages for Wisconsin in 2021. They found that the average lowest cost for bronze plans is $338 a month this year. Silver plans had an average lowest cost of $443 a month while gold plans had an average low of $480 a month.
These averages don’t take into account any premium tax credits.
When we looked for health insurance in Wisconsin using our own marketplace, we found that a 40-year-old living in Milwaukee and earning $37,000 a year could buy a bronze plan for just over $217 a month. That estimate does include subsidies.
Of course, coverage options and pricing depend on where you live. There are at least 13 insurers offering marketplace health plans in Wisconsin in 2021. Among them are Anthem, Molina, Medica, and Mercy Alliance.
Sources
Kaiser Family Foundation, “Health Insurance Coverage of the Total Population”
Kaiser Family Foundation, “Marketplace Eligibility Among the Uninsured: Implications for a Broadened Enrollment Period and ACA Outreach” (January 27, 2021)
Kaiser Family Foundation, “Average Marketplace Premiums by Metal Tier, 2018-2021”
Kaiser Family Foundation, “Insurer Participation on the ACA Marketplaces, 2014-2021” (November 23, 2020)