In Lisa Nerenhausen’s house, the consequences of the state of Wisconsin’s approach to the Affordable Care Act are mixed.

For Nerenhausen, her husband and 18-year-old son, it will mean being kicked off of Medicaid and sent to the new federal exchanges where they will face higher medical costs.

But her 21-year-old son, Parker Sorensen, could become newly eligible for Medicaid coverage. For now, though, he remains without: His ability to enroll has been pushed back, to April 1.

“It’s stressful for us, who are just above the poverty level, to try to figure this out,” said Nerenhausen, 53, of Appleton.

Nerenhausen’s family of five first enrolled for BadgerCare in 2003 when her husband, Brian Sorensen, was laid off from his job as custodial and maintenance supervisor with the city of Appleton. When he started working again, part time, his income remained low enough to maintain their eligibility.

The couple has occasionally paid premiums for BadgerCare coverage, depending on income, and are sorry to see it go. “It’s a good insurance plan,” Nerenhausen said. “It’s been there for us.”

Sorensen, 56, suffers painful neuropathy — a consequence of successful treatments for neck cancer a few years ago. Even with BadgerCare and Social Security, the couple still has a hard time covering his medications and occasional hospital visits.

After April 1, that may prove even harder, as the couple and their 18-year son will have to rely on what coverage they can get through the exchanges. (The couple’s daughter, age 15, has a mitochondrial disease, Nerenhausen said, and will continue to be covered under a special state program for children with complex medical needs.)

Nerenhausen is most concerned about the impact of an anticipated $2,000 deductible on the household budget. Under Medicaid, there was no deductible. She and her husband would likely qualify for stipends to minimize the burden of monthly premiums, though she admits she is still confused about what her options may cost.

The family’s income lies somewhere between 100 and 133 percent of the federal poverty level. This bracket will lose eligibility in Wisconsin and gain it in Minnesota and some other states that accepted the federal expansion dollars.

While her family will qualify for federal health care subsides, Nerenhausen is confused by the new marketplace and worried about the deductible she may have to pay with a new plan. She has called hotlines and talked to state health officials and health care advocates, but Nerenhausen still has questions.

“I don’t know where to go,” she said. “The information isn’t out there.”

Shelby Jensen, economic support manager for the Department of Human Services in Green Lake County, said this is a common concern.

“One of the biggest obstacles we’ve had to face here is the communication of the marketplace,” she said. “Getting the word out has been an issue, especially in the smaller counties.”

Nerenhausen is frustrated with the politics behind Wisconsin’s health care decisions.  “We’re not just crying wolf, trying to get some sort of entitlements,” she said.

Nora G. Hertel is a reporter for the Wisconsin Center for Investigative Journalism.