Wyoming health insurance
A look at the Cowboy State – and what health reform could mean to coverage
By Louise Norris
August 1, 2014
If you live in Wyoming – or you’re considering living there – you’re probably interested in issues that impact the overall health of the state’s residents. There are numerous factors that might affect your own perception of the state’s attitudes toward providing health coverage and health care.
We’ve put together a list of resources to help you get a clearer picture of the overall public health and attitudes towards reform in Wyoming.
Wyoming health ratings
The Commonwealth Fund’s Scorecard on State Health System Performance 2014 rated Wyoming 29th among the 50 states and District of Columbia – up one place from 30th in 2009. Wyoming’s Scorecard includes details on how the rankings are determined.
The most recent edition of America’s Health Rankings (2013) also measured the state’s “healthiness” and ranked Wyoming number 33 of the 50 states. Wyoming’s rating is helped by low rates of poverty, violent crime, and air pollution. But it’s lowered by factors that include few health care providers, low immunization rates among adolescents, and high rates of tobacco use.
For more details on overall public health in Wyoming, check out the 2014 listing of Key Health Data About Wyoming, compiled by Trust for America’s Health. Interested in how your county ranks? Check out health rankings for Wyoming counties, from the Robert Wood Johnson Foundation and the Population Health Institute at the University of Wisconsin.
Wyoming and the Affordable Care Act
In 2010, Wyoming’s U.S. Senators, John Barrasso and Mike Enzi, both voted against the ACA. Cynthia Lummis, Wyoming’s single member of the House, also voted no. All three are still in Congress.
Gov. Matt Mead is also opposed to the ACA, but is considering possible ways that Wyoming might be able to implement a state-based approach to Medicaid expansion under the ACA. Mead has said that although he continues to believe the ACA is bad for Americans, “there is no approach that will extricate us from the ACA. It is upon us and we must act.”
How did the ACA help Wyoming Residents?
Before the ACA was implemented, the uninsured rate in Wyoming was 18.92 percent. In large part because the state has not yet expanded Medicaid, there will be only a very small reduction in that number in 2014. Various studies have projected an average post-Obamacare uninsured rate of 18.29 percent – a reduction of just 0.63 percentage points. This puts Wyoming 36th among the 50 states and District of Columbia in terms of overall uninsured rate after ACA implementation, and one of only two states projected to have less than one percentage point reduction in the uninsured rate.
Wyoming enrollment in QHPs
In November 2013, the Kaiser Family Foundation estimated that the potential market for the exchange in Wyoming was 80,000 residents, and that 47,000 of them would qualify for premium subsidies to lower the cost of their coverage. By mid-April 2014, when the first open enrollment period ended, 11,970 people had finalized their enrollment in the Wyoming exchange, and HHS reported that 93 percent of them received subsidies to lower their premiums – the second highest percentage in the country (nationwide, an average of 87 percent of enrollees received premium subsidies)..
Only two carriers are offering health insurance plans through the Wyoming exchange: Blue Cross Blue Shield of Wyoming, and WINhealth Partners. Rates are significantly higher in Wyoming than in most other parts of the United States. Excluding Natrona and Laramie counties (Casper and Cheyenne), the state of Wyoming is the sixth most expensive region in the US for individual health insurance premiums.
Wyoming Medicaid/CHIP enrollment
Although Governor Mead is reportedly considering options for Medicaid expansion, Wyoming is currently one of 24 states that has not yet expanded Medicaid. This means that the state has 17,390 people – about 23 percent of the state’s uninsured population – in the coverage gap, with no access to financial assistance with their health insurance. They would be eligible for Medicaid if the state were to accept federal funds to expand coverage under the ACA.
But for now, there is no financial assistance available for people with incomes below the poverty level who do not qualify for Medicaid under the state’s existing guidelines (Medicaid is not available in Wyoming for non-disabled adults without dependent children, and is only available for parents of dependent children if their household income is under 56 percent of poverty).
The ACA would have provided Medicaid for all Wyoming residents with incomes up to 138 percent of poverty, but a Supreme Court ruling in 2012 allowed states to opt out of Medicaid expansion, which Wyoming has done. As a result, only 2,216 Wyoming residents had enrolled in Medicaid through the exchange by mid-April, qualifying under the existing guidelines. More information on Wyoming’s Medicaid and CHIP coverage and eligibility is available here.
Does Wyoming have a high-risk pool?
Before the ACA, individual health insurance was underwritten in nearly every state – including Wyoming – which meant that pre-existing conditions could prevent a person from obtaining a policy, or could result in significantly higher premiums or policy exclusions. The Wyoming Health Insurance Pool (WHIP) was created in 1990 to give people an alternative if they were unable to obtain individual health insurance because of their medical history.
Now that all health insurance plans are guaranteed issue, high-risk pools largely obsolete. But WHIP is still operational, and could remain in existence until the middle of 2015. WHIP can be reached at 800-442-2376.
State-based health reform legislation
Here’s a summary of recent Wyoming bills related to healthcare reform: