Why Do We Need a Local Healthcare Action Plan?
Community Action Wisconsin is a non-partisan organization. This guide presents factual information about healthcare costs in western Wisconsin, the votes that made things worse, and what a Local Healthcare Action Plan would do about it.
Healthcare in western Wisconsin was already under strain. Now, decisions made in Washington are making it significantly worse — and Reps. Derrick Van Orden and Tom Tiffany — the representatives voters sent to fix it — voted to cut coverage instead.
The costs are rising. Fast.
Wisconsin ACA marketplace premiums are already up an average of 23% in 2026 — and in some parts of the state, families are seeing increases of 45% or more. The average Wisconsin household on a marketplace plan is paying roughly $1,400 more per year than they were last year. Those costs are going up because Congress let the enhanced subsidies expire — a deliberate policy choice, not an accident.
These aren't abstract statistics. In La Crosse County, the Aging and Disability Resource Center is facing a potential 50% cut to its revenue. Across western Wisconsin, families are already delaying care, skipping prescriptions, and working extra shifts just to keep their coverage. A nonpartisan analysis projects that federal Medicaid changes will cut $7 billion from Wisconsin's program over the next decade — eliminating services, closing maternity wards, and straining rural hospitals that were already struggling to stay open.
Sources: News 8000 La Crosse · Wisconsin Public Radio · Cap Times · Wisconsin Examiner · ACA Signups (WI rate data)
They promised to protect you. Then they voted for cuts.
In 2025, Congress passed H.R. 1 — the One Big Beautiful Bill Act — enacting the largest cuts to Medicaid in a generation and allowing enhanced ACA Marketplace subsidies to expire. Both of western Wisconsin's congressional representatives voted yes.
Rep. Derrick Van Orden (WI-3 — La Crosse area)
Van Orden voted for the One Big Beautiful Bill Act despite having previously promised constituents he would not cut Medicaid. When the cuts passed, Van Orden claimed he had "secured" $1 billion for Wisconsin's rural hospitals — a claim multiple news outlets fact-checked and found to be inaccurate. The funding came from a bipartisan state budget deal that Van Orden had no role in.
Rep. Tom Tiffany (WI-7 — Eau Claire area)
Tiffany also voted for the One Big Beautiful Bill Act, calling it a "game changer." Like Van Orden, his vote helped deliver over $1 trillion in tax cuts that primarily benefit the wealthiest Americans and their donors — paid for by cutting the Medicaid and ACA coverage that western Wisconsin families depend on.
Local government can't undo Washington — but it can respond.
Cities in La Crosse and Eau Claire don't have the power to reverse federal Medicaid cuts or restore ACA subsidies. But local government can do something Washington seems unwilling to: listen to residents, document the harm, and put formal recommendations on the record for the officials who have the authority to act.
That's what a Local Healthcare Action Plan is built to do. More than 8,000 Eau Claire residents signed petitions supporting one. Now the question is whether voters will make it official.
Source: Volume One
What Is a Local Healthcare Action Plan?
A Local Healthcare Action Plan is a community-based process — driven by residents, healthcare experts, and local leaders — for assessing healthcare affordability and access in La Crosse or Eau Claire, evaluating the policy decisions that affect it, and developing a published set of recommendations for action.
Diagnosis
Public testimony and local data are used to assess healthcare access and affordability in the community.
Assessment
The committee reviews relevant policy decisions — local, state, and federal — and evaluates their real effects on residents.
Recommendations
A published Action Plan lays out specific recommendations for decision-makers, covering the next two years.
The plan repeats on a two-year cycle, keeping the process ongoing rather than a one-time event. For issues that require state or federal action — most of them — the plan creates a formal public record: what the problem is, who has the power to fix it, and what the community is asking them to do. That accountability function is the point.
The process is not a substitute for state and federal action. It is a mechanism for demanding it.
What Voters Will Decide
Voters in La Crosse and Eau Claire will each see a municipal question on their November 2026 ballot asking whether their city should establish a Citizens' Advisory Healthcare Action Committee. The two measures are separate — one for each city — but both ask the same fundamental question: should our community have a formal, ongoing process for addressing healthcare affordability and access?
You can find your city's sample ballot at MyVote.wi.gov.
La Crosse Ballot Question
"Shall the City establish a Citizens' Advisory Healthcare Action Committee to develop a biennial Healthcare Action Plan and provide a public process for community input on healthcare?"
YES — The City of La Crosse would establish a Citizens' Advisory Healthcare Action Committee, charged with developing a biennial Healthcare Action Plan and creating a public process for community input on healthcare.
NO — The measure would not pass and the Committee would not be established.
Eau Claire Ballot Question
"Shall an ordinance be enacted creating Chapter 2.53 of the Code of Ordinances of the City of Eau Claire creating the Citizens' Advisory Healthcare Action Committee?"
YES — The ordinance would be enacted, creating Chapter 2.53 of the City of Eau Claire's Code of Ordinances and formally establishing the Citizens' Advisory Healthcare Action Committee.
NO — The ordinance would not be enacted and the Committee would not be established.