Article Summary –
Nancy Peske, a 63-year-old Milwaukee resident relying on the Affordable Care Act marketplace, experienced a significant increase in her health insurance premium from $370 to $1,164 after the expiration of enhanced tax credits, which, combined with high healthcare costs, has made it challenging for her to manage her freelance business. A University of Wisconsin-Madison report highlights that hospital costs in the U.S. have increased by 260% since 2000, far outpacing wage growth and contributing to Wisconsin hospitals charging prices that are 321% of what Medicare pays, the fourth-highest in the U.S. The report suggests improving affordability through price transparency, creating a price-comparison tool, establishing a mandatory all-payer claims database, and enhancing antitrust scrutiny of hospital mergers, while business leaders in Wisconsin advocate for making healthcare more affordable to alleviate economic pressures on businesses.
A few months after Nancy Peske’s health insurance rate tripled, a trip to the emergency room resulted in a $3,000 bill.
Residing in Milwaukee, Peske buys health insurance via the Affordable Care Act marketplace. When enhanced tax credits expired last year, her monthly premiums soared from $370 to $1,164. Recently, a herniated disc required an ER visit.
“I couldn’t sleep for days,” Peske shared. “I needed a diagnosis and strong painkillers to function. After seeing the doctor, they administered IV painkillers and a prescription, costing three grand.”
She later visited a chiropractor who suggested eight more visits, but Peske opted against it, hoping the issue would resolve independently.
As a 63-year-old working in book publishing, Peske finds it difficult to maintain her freelance business due to the high healthcare costs. “People don’t realize that small-business owners struggle to afford health insurance, harming the economy,” Peske explained.
Nationally, hospital service costs have risen almost three times faster than income in Wisconsin since 2000, according to a University of Wisconsin-Madison report.
The report by the Center for Research on the Wisconsin Economy highlights U.S. hospital costs rising 260% since 2000, with Wisconsin’s median household income only increasing 83%, and the Midwest Consumer Price Index rising 77% during the same period.
“While wages and overall prices have moved roughly in tandem, healthcare costs have far outpaced both,” the report notes.
Wisconsin hospitals charge 321% of what Medicare pays for identical services—the fourth-highest in the U.S. and the highest in the Midwest. Medical care services in the Midwest rose 140% from 2000 to 2025.
Wisconsin Hospital Association President and CEO Kyle O’Brien remarked that in 2024, a third of hospitals operated at a loss, and two hospitals closed in western Wisconsin.
O’Brien stated, “This report ignores the healthcare premium dollars absorbed by insurance industry middlemen, leaving patients to cover their own care.”
A 2024 survey by the Wisconsin Manufacturers & Commerce found 69% of businesses said healthcare costs forced them to cut hiring, reduce investments, lower employee compensation, or increase product prices.
Over half of businesses operating in multiple states paid more for healthcare in Wisconsin than elsewhere. Reducing healthcare costs was the top recommendation for state intervention.
The report suggests price transparency in hospitals as a key solution, noting the median rate for a diagnostic colonoscopy varied from $1,469 at Sanford Health’s Marshfield Clinic to over $4,600 at Froedtert Hospital in Milwaukee.
The authors argue hospital mergers, like the Marshfield Clinic’s merger with Sanford Health in 2025, can elevate prices. Wisconsin witnessed 19 rural hospital mergers between 2005 and 2016, ranking third among states.
To improve affordability, the report recommends creating a state-sponsored price-comparison tool, establishing a mandatory all-payer claims database, and enhancing antitrust scrutiny of hospital mergers.
Peske worries about her 27-year-old son’s career choices being dictated by healthcare affordability. She emphasized that current healthcare costs siphon funds from her retirement savings.
“What are you supposed to do if you’re in my situation?” Peske asked. “Should I have closed my business, found a job with insurance, and then restarted my business two years later?”
—
Read More Wisconsin News
