ACA makes coverage affordable in Wyoming
Although Wyoming had the most expensive pre-subsidy health insurance premiums in the US in 2014, 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.
Even though Wyoming’s average pre-subsidy rates in 2014 came 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.
Wyoming carriers and rates
Although rates are decreasing in many areas of the country for people willing to switch plans in 2015, that’s not the case in Wyoming. The NY Times Upshot pegs the increase in benchmark plan premiums in Wyoming at 7 percent or more, although the Kaiser Family Foundation shows the average benchmark plan in Wyoming increasing by just 1.6 percent for 2015.
For people who qualify for subsidies however (which was 93 percent of the exchange enrollees in Wyoming in 2014), the state’s high health insurance premiums are dramatically offset by the premium tax credits, and that will continue to be the case in 2015. The average after-subsidy premium for the benchmark plans in Wyoming is expected to be $208 in 2015, a dollar less than it was in 2014.
The federally-run Wyoming health insurance exchange has 40 plans available (up from 18 last year) from two health insurance carriers: Blue Cross Blue Shield of Wyoming and WINhealth Partners, both of which participated in the exchange in 2014.
No longer the highest rates in the country
Rates in Wyoming were higher than anywhere else in the country in 2014, due to a variety of factors including a small number of insurers and a sparse, mostly rural population. Excluding Natrona and Laramie counties (home to Casper and Cheyenne), the rest of Wyoming ranked as the sixth most expensive region in the US for health insurance plans in 2014.
But a Kaiser Family Foundation analysis in November 2014 found that Burlington, Vermont and Anchorage, Alaska both have higher average pre-subsidy premiums for 2015 Bronze and Silver plans than Cheyenne, Wyoming (rates in the study were based on a 40 year old non-smoker).
No Medicaid expansion yet
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.
It’s possible that the state could be moving towards expanding Medicaid though. Governor Matt Mead has been discussing the issue with the federal government, and he noted in early November that HHS is “more open” to modified Medicaid expansion than they were in the past. Then in late November, the Governor released the details of his Medicaid expansion proposal, which would include modest premiums for enrollees with incomes between 100 percent and 138 percent of poverty, and along with small copays for many newly-eligible enrollees.
HHS has not yet approved Wyoming’s proposal, and the state legislature would still have to agree to it before it could be implemented. But it’s possible that Wyoming could join the list of states with expanded Medicaid by 2016.
And while 70 percent of Wyoming residents disapprove of the ACA in general, 55 percent support Medicaid expansion according to a recent poll conducted by the University of Wyoming.
2014 enrollment numbers
The total private plan enrollment was the fourth lowest in the country, but Wyoming has the smallest population in the US.
An additional 2,216 exchange applicants had been found to be eligible for the state’s existing (not expanded) Medicaid or CHIP.
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.
Wyoming exchange history
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 the 2014 legislative session did not result in any further legislation on the issue.
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. As far as Medicaid expansion goes, a lot hinges on the will of the state’s voters, as Mead is up for re-election in November.
Wyoming health insurance exchange links
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 / email@example.com
State Exchange Profile: Wyoming
The Henry J. Kaiser Family Foundation overview of Wyoming’s progress toward creating a state health insurance exchange.