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Wyoming health insurance exchange

Subsidized premiums low in Wyoming, but coverage gap is harsh

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Although Wyoming has the most expensive pre-subsidy health insurance premiums in the US, an HHS study released on June 18th demonstrates the power of the Obamacare tax credits, which are more substantial in Wyoming than in any of the other 35 states where HHS is running the exchange.  Although Wyoming’s average pre-subsidy rates come in at a whopping $536 per person, the average after-subsidy premiums paid by the 93% of Wyoming enrollees who qualify for subsidies is just $113.  Two other states (Arizona and West Virginia) also have average after-subsidy premiums of $113, despite the fact that their “retail” rates are considerably lower than Wyoming’s ($272 and $415, respectively).  $113 is higher than the HHS-run marketplace average of $82, but it’s certainly far more affordable than the $536 that residents in sparsely-populated Wyoming would be paying without the Obamacare tax credits.

Unfortunately for Wyoming residents living below the poverty line, the high cost of unsubsidized coverage means that the coverage gap is particularly harsh in Wyoming.  Since the state has not expanded Medicaid under Obamacare, residents with incomes below 100% of poverty are not eligible for subsidies, and Medicaid is not available for most of them either.  Their only alternative is to pay full price for private insurance, which is particularly unrealistic in a state where the average premium is more than five hundred dollars a month.

Enrollment in the Wyoming exchange has continued during May and June thanks to qualifying events that trigger special open enrollment periods;  HHS will be releasing the off-season enrollment numbers in November.  But by April 19, 11,970 people had enrolled in private plans in the Wyoming exchange – an increase of more than five thousand people since the beginning of March.  The total includes people who enrolled after March 31 using a special open enrollment window due to qualifying events or extenuating circumstances that prevented enrollment by the end of March.  An additional 2,216 exchange applicants had been found to be eligible for existing Medicaid or CHIP (Wyoming has not yet expanded Medicaid under the ACA).  The total private plan enrollment was the fourth lowest in the country, but Wyoming has the smallest population in the US.

Originally, the federal projection was that Wyoming would have 13,000 private plan enrollees by March 31.  That was revised to around 10,000, and officials were optimistic that a March surge in application volume would put total enrollment into the five figure range.  That projection proved to be correct, and the exchange far surpassed the 10,000 mark by the end of the 2014 open enrollment window.

The federally-run Wyoming health insurance exchange has 18 plans available from two health insurance carriers:  Blue Cross Blue Shield of Wyoming and WINhealth Partners.  Rates in Wyoming are higher than anywhere else in the country, due to a variety of factors including a small number of insurers and a sparse, mostly rural population.  The national average for the lowest cost Bronze plan is $249/month, but in Wyoming, it’s $425/month.  Excluding Natrona and Laramie counties (home to Casper and Cheyenne), the rest of Wyoming ranks as the sixth most expensive region in the US for health insurance plans.

Gov. Matt Mead announced in late 2012 that Wyoming would default to the federal health insurance exchange for 2014, with the possibility of moving to a state-run exchange at some unspecified future date.

In 2012, the Wyoming legislature passed a bill requiring a small committee to study the federal government’s implementation and operation of the exchange. The committee will monitor how many state residents use the federal exchange, what problems they encounter, operating costs, and other factors in deciding whether to recommend the state eventually take over operations of the exchange. The committee held its first meeting in April 2013, and the study may take more than two years according to the committee co-chair.  This round of study continues the evaluation process started by the Wyoming Health Insurance Exchange Steering Committee, which Mead appointed in 2011.

Gov. Mead has also refused to expand Medicaid, but there’s a possibility that the state will reconsider that decision.  Two bills that would expand Medicaid passed out of committee in January by a small margin.  Both failed introduction during the budget session in mid-February, and there is little chance for an expansion vote in the current legislative session.  But some lawmakers are continuing to push for Medicaid expansion, and Governor Mead is keeping an eye on neighboring Utah to see how they do with their proposed alternative to Medicaid expansion.  Although Mead has said that he’s opposed to Medicaid expansion as it’s written in the ACA, he may be open to the possibility of a state-designed alternative.

Wyoming health insurance exchange links

HealthCare.gov
800-318-2596

Wyoming Insurance Department
Provides consumer protection and support to Wyoming residents by investigating consumer complaints and resolving issues on insurance matters.
(307) 777-7401 / Toll Free: 1-800-438-5768 / wyinsdep@state.wy.us

State Exchange Profile: Wyoming
The Henry J. Kaiser Family Foundation overview of Wyoming’s progress toward creating a state health insurance exchange.