Wisconsin Affordable Care Act Guide
In this informative article, you will learn about the Affordable Care Act health care reform laws in Wisconsin. You will learn how the new health care reform law, Affordable Care Act, also known as Obamacare or ACA, impacts you as a citizen of the state. Learn how to sign-up for Wisconsin Affordable Care Act, the Affordable Care Act penalty, and subsidies.
What is Wisconsin Affordable Care Act?
Affordable Care Act, also know as ObamaCare or Health Care Reform was signed into law in March 2010. There are four main goals of the Affordable Care Act:
- Expanding Health Care Insurance Coverage
- Providing New Consumer Insurance Protections
- Offering New Insurance Choices via Marketplace Exchanges
- Making Health Insurance more affordable
When can I apply for the Affordable Care Act in Wisconsin?
You can only apply for Wisconsin Affordable Care Act during Open Enrollment. The open enrollment for Wisconsin Affordable Care Act is usually from November 1 to December 15.
If you qualify for Wisconsin Medicaid health insurance, then you can sign-up for Medicaid any time of the year.
If there are life-changing events, then you can apply for the Affordable Care Act Special Enrollment Period.
When is the Wisconsin Affordable Care Act deadline?
The WI Affordable Care Act Open Enrollment is only open for 6 weeks around November and December. There are two important dates for the Wisconsin Affordable Care Act:
- November 1: First day to enroll or change plans for new coverage
- December 15: Last day to enroll in or change plans for new coverage to start the following year
How do I apply for Affordable Care Act Wisconsin (WI ACA)?
Wisconsin Affordable Care Act Health Insurance Marketplace is run by the Federal government. Click on HealthCare.gov to access Wisconsin Affordable Care Act Marketplace. You can preview the different insurance plans and see participating doctors before selecting the final health insurance plan.
How much is the Affordable Care Act Wisconsin?
The cost of Wisconsin Affordable Care Act health insurance depends on the metal plan you choose and the number of people in the household.
There are four different health insurance plans within the Wisconsin Obamacare Marketplace. All of the plans cover the Essential Health Benefits. The metal plans represent the various levels of coverage you receive and what the plan pays on average. The plan levels DO NOT represent the quality of the health coverage/doctors you receive.
- Bronze Plan: The plan pays 60% of the cost, you pay 40% of the cost
- Silver Plan: The plan pays 70% of the cost, you pay 30% of the cost
- Gold Plan: The plan pays 80% of the cost, you pay 20% of the cost
- Platinum Plan: The plan pays 90% of the cost, you pay 10% of the cost
Platinum plans have the highest insurance premiums (monthly cost) and Bronze plans have the lowest insurance premiums.
How much is Wisconsin Affordable Care Act Penalty?
The penalty (or also called individual shared responsibility payment) is calculated in two ways.
Starting in the 2019 tax year, there is no longer a penalty for not having health insurance.
From 2016-2018, the ACA penalty is as follows:
- By percentage of income (2.5% of household income or a maximum of National Average Bronze plan premium)
- By number of people in the household ($695 per adult, $347.50 per child, or maximum $2085)
You’ll pay whichever penalty is higher.
How much are Wisconsin Affordable Care Act Subsidies? What are the requirements?
If your gross income is between 133% to 400% of the Federal Poverty Level, you can qualify for Affordable Care Act Subsidies if you purchased the health insurance from the Federal/State Marketplace. Affordable Care Act Subsidies are also called, “Premium Tax Credits or PTC.” If your income is above 400% of the Federal Poverty Level, you do not qualify for any Affordable Care Act Premium Subsidy.
ACA subsidy lowers your premium – the amount you pay each month to your insurance plan. The amount of your ACA Subsidy depends on the estimated household income that you put on your ACA Marketplace application.[table "0" not found /]
Do I need to get the Affordable Care Act Wisconsin?
Yes, every individual in Wisconsin needs to have health insurance. One of the hallmarks of the Affordable Care Act health care reform law is the Individual Mandate. The Individual Mandate of Affordable Care Act health care law requires US Citizens and legal residents to enroll in a health insurance plan or pay a penalty.
You can choose not to have health insurance, but you will have to pay the penalty in addition to the hospital/doctors medical fee if you do get sick.
You might be able to qualify for health coverage exemptions and be waived from paying the Affordable Care Act penalty.
What is the Requirement for Affordable Care Act Wisconsin?
To qualify for Wisconsin Affordable Care Act, you must meet the following requirements:
- Must live in Wisconsin
- Must be a US citizen, national, or lawfully present, immigrant
- Cannot be currently incarcerated (be in jailed)
- Have a valid Social Security Number
Medicaid Expansion Relating to Affordable Care Act Wisconsin
Wisconsin did not expand the Medicaid program as of 2015/2016.
Wisconsin Affordable Care Act Frequently Asked Questions:
- Who runs the Affordable Care Act Wisconsin Marketplace? Federal
- Where can I sign up for the Affordable Care Act Wisconsin? Click here
- How much is the health insurance premium for Wisconsin Affordable Care Act? It depends on your income and the number of households/family.
- Which insurance companies are offering Affordable Care Act Plans in the state of Wisconsin? Click here to see the insurance companies
Click here for more Frequently Asked Questions on ACA / Affordable Care Act.
For additional information on Wisconsin Affordable Care Act / Obamacare:
Wisconsin Office of the Commissioner of Insurance
125 South Webster Street
Madison, WI 53703
Toll-Free: (800) 236-8517
TDD: Dial 711 and ask for (608) 266-3586
If you have a hard time affording health coverage and have questions about Medicaid eligibility or benefits, go to:
Wisconsin Department of Health Services
1 West Wilson Street
Madison, WI 53703
Toll-Free: (800) 362-3002
Federal HealthGov Marketplace
Wisconsin’s five largest cities in terms of population: Milwaukee, Madison, Green Bay, Kenosha, and Racine.