Wisconsin Cliff Calculator — 2026 ACA Subsidy

By Severance Calculator Editorial · Updated

Wisconsin Marketplace: HealthCare.gov

Wisconsin uses a federally-facilitated marketplace (FFM) called HealthCare.gov. Wisconsin residents enroll at HealthCare.gov.

Medicaid in Wisconsin: BadgerCare Plus

Wisconsin provides partial Medicaid expansion via a §1115 waiver. BadgerCare Plus offers coverage but may not reach the standard 138% FPL threshold in the same way as full expansion states.

2026 SLCSP Benchmark Premiums (Wisconsin)

Statewide average monthly second-lowest-cost Silver plan (SLCSP) premiums by age. Actual premiums vary by rating area.

Age2130405060
Monthly SLCSP$400$453$511$714$1,085

2026 ACA Cliff Thresholds by Household Size (Wisconsin)

MAGI above these amounts zeros out the federal Premium Tax Credit. FPL region: contiguous48.

Household size12345
400% FPL cliff$62,600$84,600$106,600$128,600$150,600

Key Facts: Wisconsin ACA

Wisconsin occupies a unique position in ACA Medicaid policy: it has NOT formally accepted the ACA Medicaid expansion, yet it has no coverage gap — a combination found in no other state.

BadgerCare Plus, Wisconsin's Medicaid program, covers adults to 100% FPL (not the standard 138% expansion ceiling) through a §1115 demonstration waiver. This was not a small tweak: Wisconsin made a deliberate policy choice to cover nearly all non-elderly adults below the poverty line while declining to accept the additional enhanced federal matching funds available under full ACA expansion. As KFF's analysis of Wisconsin's approach notes: 'Because coverage is limited to 100% FPL this is considered a partial expansion and is not eligible for enhanced federal matching funds provided in the ACA.'

Why no coverage gap? In most non-expansion states, adults earning 0–100% FPL cannot access Medicaid and are also ineligible for marketplace PTCs (which begin at 100% FPL) — leaving them uninsured. Wisconsin's waiver closes this gap from the Medicaid side: adults below 100% FPL get BadgerCare Plus, and adults at 100–138% FPL are eligible for marketplace PTCs. As healthinsurance.org explains: 'Wisconsin is the only non-expansion state that doesn't have a coverage gap.'

This no-gap design was built into the ACA engine in Plan 1: Wisconsin residents in the 100–138% FPL band are directed to marketplace plans with PTCs, not flagged as being in a coverage gap. No other state requires this treatment.

Wisconsin uses HealthCare.gov (FFM) for marketplace enrollment and has no state-funded premium subsidy backfill for 2026.

Calculate your Wisconsin ACA cliff

Inputs default to Wisconsin; adjust to your household specifics. Cliff = $62,600 (HH=1) / $128,600 (HH=4).

Your situation

Member ages
self

Coverage

Income

You're under the cliff

100%138%200%300%400%

You are at 319% of the federal poverty level.

Annual PTC
$1,764
$147 / month
MAGI headroom before cliff
$12,600
until you hit 400% FPL

PTC dollar values use a state-level SLCSP estimate; verify your exact second-lowest-cost Silver plan on healthcare.gov for your zip.

Primary Sources

  1. healthinsurance.org — Wisconsin Marketplace
    “Wisconsin is the only non-expansion state that doesn't have a coverage gap.”
  2. healthinsurance.org — Wisconsin BadgerCare Coverage Gap
    “Wisconsin has not expanded Medicaid under the ACA, but also does not have a coverage gap.”
  3. KFF — Wisconsin's BadgerCare Program and the ACA
    “Because coverage is limited to 100% FPL this is considered a partial expansion and is not eligible for enhanced federal matching funds provided in the ACA.”
  4. KFF — Wisconsin no coverage gap
    “There is no gap in coverage that is typical in other states not implementing the Medicaid expansion because individuals with incomes above 100% are eligible for tax credits to purchase coverage in the Marketplaces.”

FAQ — Wisconsin ACA Cliff

What is the 2026 ACA subsidy cliff in Wisconsin?
For a household of 1, MAGI above $62,600 (400% of the 2025 FPL contiguous-48 base) zeros out the federal Premium Tax Credit under IRS Rev. Proc. 2025-25. Household of 4: $128,600. Wisconsin has no state subsidy backfill, so crossing this threshold eliminates all premium assistance.
Did Wisconsin expand Medicaid under the ACA?
No — Wisconsin did not formally accept the ACA Medicaid expansion and is not eligible for the enhanced federal matching funds associated with it. However, Wisconsin did extend BadgerCare Plus coverage to nearly all adults below 100% FPL through a §1115 waiver. This is described as a 'partial-via-waiver' expansion: more coverage than pre-ACA, but not the full 138% FPL threshold standard expansion states achieved.
Does Wisconsin have a coverage gap?
No — Wisconsin is the only non-expansion state without a coverage gap. Adults below 100% FPL are covered by BadgerCare Plus (§1115 waiver). Adults at 100–138% FPL are eligible for marketplace premium tax credits (PTCs begin at 100% FPL). There is no income band where a Wisconsin adult is too rich for Medicaid and too poor for marketplace subsidies.
What is BadgerCare Plus?
BadgerCare Plus is Wisconsin's Medicaid program, administered by the Wisconsin Department of Health Services. It covers nearly all adults below 100% FPL through a §1115 demonstration waiver. BadgerCare was originally created in 1999; BadgerCare Plus expanded coverage significantly in 2008 and again under the current waiver structure. Apply at access.wisconsin.gov year-round.
How do I enroll in 2026 marketplace coverage in Wisconsin?
Wisconsin uses HealthCare.gov (the federal FFM marketplace). Open enrollment runs November 1 through January 15. Adults at 100% FPL and above may qualify for marketplace PTCs. Adults below 100% FPL should apply for BadgerCare Plus at access.wisconsin.gov year-round.
How is SLCSP calculated for Wisconsin?
The 2026 statewide SLCSP age-band averages for Wisconsin are: Age 21: $400/mo, Age 30: $453/mo, Age 40: $511/mo, Age 50: $714/mo, Age 60: $1,085/mo. These are statewide averages; Milwaukee metro vs. rural Wisconsin counties may vary. The federal cliff distance (income vs. 400% FPL) is exact regardless of SLCSP precision.
Can I reduce my MAGI to stay below the 2026 cliff in Wisconsin?
Yes — common strategies include maximizing HSA contributions, deductible IRA or SEP-IRA/Solo 401(k) contributions if self-employed, harvesting capital losses, and deferring Roth conversions. Because Wisconsin has no state subsidy above 400% FPL, staying below the federal cliff has full dollar impact.

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