Wisconsin Unpaid Hospital Care Tops $2 Billion
Hospital operators should plan for an 18 percent bad debt increase in 2026 as enrollment and coverage decline.
Updated on Nov. 2, 2026 in Healthcare
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Wisconsin hospitals reported more than $2 billion in unpaid care in 2025, split nearly evenly between charity care and bad debt, with unpaid care rising 15 percent over 2024. Hospital leaders project bad debt for 2026 will rise 18 percent further.
Why it matters
Patients facing higher housing, food, and gas costs may find it harder to pay medical bills, and insurance coverage denials can shift already-performed services into the charity care category. Congress's decision to let pandemic-era premium tax credits expire at the end of 2025 is a backdrop to the enrollment decline that accompanies these rising costs.
Wisconsin hospitals reported more than $2 billion in unpaid care in 2025, up 15 percent from 2024, across more than 2 million patient visits. Unpaid care represented about 2 percent of total patient charges, with charity care up nearly 29 percent and bad debt up 4 percent over the prior year.
The players
Wisconsin Hospital Association
A trade association representing Wisconsin hospitals that publishes the annual Uncompensated Health Care Report on charity care and bad debt across the state's hospital system.
U.S. Congress
The federal legislature whose decision to let pandemic-era premium tax credits expire at the end of 2025 affected marketplace insurance costs for Wisconsin residents.
The details
Unpaid care is the combined total of charity care, which hospitals provide to patients who qualify, and bad debt, which is the amount patients owe but do not pay. The Wisconsin Hospital Association's annual Uncompensated Health Care Report surveys hospitals on these categories. Coverage denials from private insurers, including Medicare Advantage plans, can push services already rendered into the charity care category when the patient qualifies. Marketplace enrollment for 2026 fell 7 percent from 2025 after pandemic-era premium tax credits expired.
Timeline
2024: baseline year for the 2025 unpaid care comparison.
End of 2025: Congress let the pandemic-era premium tax credit increase expire.
2026: Wisconsin marketplace enrollment fell 7 percent and bad debt is projected 18 percent higher.
Dec. 15: current marketplace open enrollment ends.
Next year (2027): Medicaid work requirement takes effect.
Market Landscape
The expiration of the pandemic-era enhanced premium tax credits at the end of 2025 reduced affordability for marketplace enrollees, and Wisconsin's 7 percent enrollment drop for 2026 follows that policy change. The same period's rising charity care and bad debt show how coverage shifts translate into hospital finances.
Healthcare operators should plan for higher bad debt and charity care in 2026, with the projected 18 percent bad debt increase as a planning baseline. Revenue cycle and patient financial counseling teams should prepare for more patients with unpaid balances and more coverage denials to appeal.
The takeaway
Hospital finances in Wisconsin are absorbing the effects of coverage losses, and bad debt projections for 2026 point to continued pressure. Operators should track next year's Medicaid work requirement implementation and the 2026 bad debt figures as they are reported.
What happens next
Wisconsin's Medicaid work requirement takes effect next year and could cause coverage to expire for tens of thousands of residents.
Further reading
For broader context on how coverage changes shape hospital finances, explore more Healthcare coverage.
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