Frequently asked questions about health insurance
coverage options in Wyoming
Wyoming does not run its own health insurance marketplace, so Wyoming residents use the federally run marketplace, HealthCare.gov, to enroll in individual/family health plans.
The insurance marketplace is used by people who need to buy their own health insurance. This includes early retirees, the self-employed, and people employed by small businesses that don’t offer health benefits. People who are eligible for Medicare do not use the marketplace, nor do people who are employed by a company that provides them with health insurance (unless they choose to reject the employer’s coverage offer and buy their own plan instead, although financial assistance with the premiums would not likely be available in that case).
Learn about the history of Wyoming’s health insurance marketplace.
Although individual/family health insurance enrollment and plan changes are normally only available during the annual open enrollment period and during special events triggered by qualifying life events, there’s a one-time enrollment window in 2021, which continues through August 15.
This enrollment period is designed to help people obtain coverage during the ongoing COVID pandemic and to allow people to access the additional premium subsidies created by the American Rescue Plan. Wyoming residents do not need a qualifying event to use this enrollment window, and coverage will take effect the first of the month following enrollment.
The 2021 enrollment window allows people to newly enroll through the Wyoming marketplace/exchange, and also allows existing enrollees to switch plans, as some enrollees might be better served by switching to a different plan now that the subsidies are larger as a result of the American Rescue Plan.
After August 15, a qualifying event will be necessary in order to enroll or make a plan change for 2021. Open enrollment for 2022 coverage will start on November 1, 2021, for plans effective January 1, 2022.
For five years, from 2016 through 2020, Blue Cross Blue Shield of Wyoming was the only insurer offering plans in the state’s health insurance marketplace. But Mountain Health CO-OP has joined Wyoming’s exchange for 2021, and is offering coverage statewide.
For five years, from 2016 through 2020, Blue Cross Blue Shield of Wyoming was the only insurer offering plans in the state’s health insurance marketplace. But Mountain Health CO-OP joined Wyoming’s exchange as of 2021, and is offering coverage statewide. Blue Cross Blue Shield of Wyoming implemented an average rate decrease of 10% for 2021, and CMS confirmed that average benchmark premiums dropped by 10% in Wyoming.
For 2020, average premiums nationwide were mostly flat, and Wyoming’s average premiums were no longer the highest in the nation, as West Virginia took over that spot. For 2021, Blue Cross Blue Shield of Wyoming reduced their average premiums by 10%, and Mountain Health CO-OP added new coverage options for Wyoming residents.
Wyoming defers to the federal government for the rate review process, so rate filings are authorized and approved by federal regulators rather than the state insurance department (Oklahoma and Texas are the only other states that do not have their own rate review process).
Read more about Wyoming marketplace health insurance premiums.
During the open enrollment period that ended in mid-2020, 26,728 Wyoming residents enrolled in coverage through the exchange. This was a record-high for Wyoming’s exchange. This year, almost 3,000 more Wyoming residents enrolled between February 15 and April 30, during the first 2.5 months of the COVID/American Rescue Plan enrollment window.
This enrollment window runs through August 15, 2021, and people can sign up for coverage — which is entirely premium-free in some cases — regardless of whether they experience a qualifying event.
Wyoming is the least populated and the second-least densely populated state, both factors that contribute to higher-than-average health insurance premiums. According to US Census data, the uninsured rate in Wyoming was 13.4 percent in 2013, which was lower than the 14.5 percent national average at that point. But by 2018, the state’s uninsured rate stood at 10.5 percent, which was higher than the 8.9 percent national average.
Wyoming’s decision not to accept federal funding to expand Medicaid is largely to blame for the smaller-than-average reduction in the uninsured rate. An estimated 20,000 people would become eligible for Medicaid if the state were to expand coverage. That’s nearly 3.5 percent of the state’s population, and would make a considerable dent in the uninsured rate.
Average individual market premiums for Wyoming health insurance are the second-highest in the country in 2020, but that’s calculated before premium subsidies are applied. The subsidies in Wyoming are particularly large due to the high premiums, and after the subsidies are applied, people in many areas can get bronze and even gold plans at no charge, depending on their income.
But for some people who don’t qualify for premium subsidies, coverage can be unaffordable in Wyoming. Subsidies are not available to people in the coverage gap (which would be eliminated if Wyoming were to accept federal funding to expand Medicaid), people impacted by the family glitch, and people who earn more than 400 percent of the poverty level. [The Democratic Party’s 2020 platform calls for the removal of the income cap on subsidy eligibility; instead, it calls for enrollees to receive a subsidy if they would have to pay more than 8.5 percent of their income for health coverage, regardless of how high their income is; this sort of rule change would be particularly helpful in a place like Wyoming, where health insurance premiums are so much more costly than average.]
Wyoming tends to be more conservative and hasn’t embraced the Affordable Care Act – opting for a federally facilitated exchange (HealthCare.gov) and refusing to expand Medicaid.
Former Governor Matt Mead, a Republican, pushed for Medicaid expansion for several years, and regrets the fact that the state still hasn’t expanded Medicaid — a decision that has cost Wyoming hundreds of millions of dollars in missed federal funding and left its poorest residents without any realistic access to health coverage or help with their medical expenses.
Wyoming’s U.S. congressional delegation is comprised entirely of Republicans: Senators Mike Enzi and John Barrasso, and Representative Liz Cheney. All three are opposed to the ACA.
In 2017, Cheney voted in favor of the American Health Care Act, which was House Republicans’ effort to repeal the ACA. Barrasso and Enzi both voted in favor of all three pieces of legislation that GOP senators introduced in an effort to pass ACA repeal in that chamber. None of those bills was successful, however, and the ACA still remains in place. Although opposition to the ACA has been a mainstay for Republicans in Congress, Barrasso and Enzi’s degree of opposition is greater than most. In October 2014, they were both among 14 senators who opposed spending related to the temporary risk corridor program that was built into the ACA in an effort to stabilize the individual markets.
Cheney and Barrasso both won re-election in 2018, and both have been elevated to the third-highest-ranking positions for Republicans in their respective chambers. Cheney is the House GOP Conference Chair, and Barrasso is the Chair of the Republican Conference in the Senate.
Former Governor Matt Mead was also generally opposed to the ACA, but has been in favor of Medicaid expansion since 2013, after initially opposing it before that, when states were first considering expansion. 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.”
Mead was term-limited and did not run again in 2018. But Governor Mark Gordon, also a Republican, is opposed to Medicaid expansion — a position he continues to hold, despite the fact that three neighboring states (Idaho, Nebraska, and Utah) passed ballot measures to expand Medicaid in the 2018 election.
Although former Governor Mead pushed for Medicaid expansion, Wyoming is currently one of 12 states that have not yet expanded Medicaid eligibility or made progress towards expansion.
A legislative committee approved a Medicaid expansion bill in late 2019, but it died in committee on the first day of the 2020 legislative session, dashing Medicaid expansion hopes for another year.
Because Wyoming has not expanded Medicaid (and is thus missing out on hundreds of millions of dollars in federal funding) the state has 12,000 people in the coverage gap, with no access to financial assistance with their health insurance. They would be eligible for Medicaid coverage if Wyoming were to accept federal funds to expand coverage under the ACA. In all, about 20,000 people would become newly-eligible for Medicaid if the state were to expand coverage, including people with income between 100 percent and 138 percent of the poverty level, who are currently eligible for premium subsidies in the exchange.
Learn more about Wyoming’s Medicaid and CHIP coverage and eligibility.
Wyoming defaults to the federal limits for the duration of short-term plans so short-term health insurance in Wyoming can have initial terms of up to 364 days, and total duration, including renewals, of up to three years.
Learn more about the rules for short-term health insurance in Wyoming.
As of early 2021, there were 115,184 Wyoming residents enrolled in Medicare. Most of these people – 88% – are eligible for Medicare due to their age (at least 65 years old). But the other 12% are eligible for Medicare due to a disability, and are not yet 65 years of age.
Read more about Medicare in Wyoming, including details about Medicare Advantage, Part D, and the state’s rules for Medigap plans.
- Wyoming Department of Insurance — Oversees, licenses, and regulates health insurance companies, insurance agents, and brokers
- Wyoming State Health Insurance Information Program — A local resource that provides information and assistance for Medicare beneficiaries
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. During the 2015 Wyoming Legislature, SF0064 was passed, allowing the Commissioner to dis-enroll risk-pool members who could obtain reasonable coverage elsewhere. This became effective December 31, 2015.