It’s March madness that the ACA isn’t getting a sweet 16

Wisconsin Republicans have helped President Donald Trump undermine the Affordable Care Act and ramp up health insurance costs.

For small business owners like Dan Jacobs, a Milwaukee chef with a national TV presence, the Republican assault on the Affordable Care Act goes against any notion of small business growth.

“The ACA leveled the playing field that has long been tilted towards large corporations,” Jacobs said. “Small businesses like mine depend on it.”

For Wisconsinites with life-threatening chronic illnesses like Emma Widmar of Mount Pleasant, it’s a perplexing attack on people when they’re most vulnerable.

“Everyone needs healthcare,” said Widmar, 26, whose health relies on the Medicaid IRIS program for adults with disabilities. “Republicas have cut Medicare, Medicaid, and the ACA. Why? Things happen every day that are unexpected. We know that things happen to people, why are we taking an axe to the safety net?”

For lawmakers like US Rep. Gwen Moore (D-Milwaukee), the GOP’s ongoing mission to torpedo the ACA shows their promises about addressing affordability issues were never sincere.

“Instead of lowering costs for working families, my Republican colleagues made the largest cuts to health care in American history with the poorly named One Big Beautiful Bill,” Moore said at a press event for the health advocacy group Protect Our Care. “They gutted Medicaid, ripping coverage from nearly 33,000 of my constituents. And of course, they allowed insurance premiums for Affordable Care Act plans to skyrocket.”

The current political environment has created a very sour “Sweet 16” for the ACA, signed into law on March 23, 2010. Republicans and President Donald Trump refused to continue tax credits that helped consumers be able to afford private sector health insurance plans sold in the ACA marketplace. The credits expired at the end of 2025, leaving 20 million Americans — including 275,000 in Wisconsin — facing higher insurance premiums.

A new national survey by KFF, a nonpartisan health policy research group, found nearly 10% of respondents elected to drop their healthcare coverage because they could not afford the higher costs for the same level of coverage. Nearly three out of four (73%) of marketplace consumers worry they won’t be able to afford the cost of emergency care or a hospital stay. Anxieties grew more sharply with those who have chronic conditions — like Widmar who has debilitating allergies, requires two caretakers, and needs medications that would cost more than $1 million annually without assistance, all while reliant on a disability income of about $12,000 per year.

“I’m lucky that I have these state programs to cover that,” Widmar said. “But why do I have to be lucky? If Medicaid didn’t have my back, I wouldn’t be able to afford these healthcare costs that keep me alive. It is a never-ending circus of appointments, infusions, medications, just to have some quality of life.”

Americans are facing multiple barriers because of the Republican assault on the ACA, according to a new Protect Our Care report. Beyond financial obstacles, there are geographical challenges as people have to travel farther for basic care, emergency care, getting surgery, or having a baby. Taxes are going up in communities that are trying to keep local hospitals from closing. And the group says Trump’s claims of making prescription medicines more affordable don’t stand up to scrutiny, as any discounts pharmaceutical companies offer are more than offset with decreased regulations and tariff exemptions.

Despite all evidence to the contrary, Trump and Republicans insist the cuts to Medicaid and other programs are necessary reforms. US Rep. Derrick Van Orden (R-Prairie du Chien), a vulnerable Republican running in a swing district, voted with Democrats in their unsuccessful effort to renew ACA tax credits; but the politically expedient vote did not change his core opposition to the law that he describes as “failed.”

But because Republicans have not offered a credible replacement plan after 16 years of opposition, patients like Widmar say they feel the need to repeatedly remind voters that the GP obstruction isn’t a political game — it’s a life or death matter to people like her.

“Simply stated, I would die without these services,” Widmar said. “And if that makes you uncomfortable, then that’s a signal that you need to do more.”