Health insurance in Wyoming
- Wyoming uses the federally facilitated marketplace so residents enroll through HealthCare.gov.
- Open enrollment for 2020 health plans has ended, although residents with qualifying events can still enroll or make changes to their coverage for 2020. The next open enrollment period, for plans effective in 2021, will begin November 1, 2020.
- Short-term health insurance is also available in Wyoming, and plans can be sold with initial terms of up to 364 days.
- Blue Cross Blue Shield of Wyoming is the only insurer in the state’s exchange.
- Individual-market health insurance rates increased slightly in 2020.
- Wyoming’s lawmakers have been generally opposed to the ACA, including Medicaid expansion.
- Wyoming’s uninsured rate is higher than the national average, although it was lower than the national average pre-ACA.
- A little more than 111,000 Wyoming residents are Medicare enrollees.
Wyoming tends to be more conservative and hasn’t embraced the Affordable Care Act – opting for a federally facilitated exchange 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.
Wyoming does not run its own health insurance exchange, so residents enroll in coverage using HealthCare.gov.
Open enrollment for 2020 health plans has ended, although Wyoming residents with qualifying events can still enroll or make changes to their coverage for 2020. The next open enrollment period, for plans effective in 2021, will begin November 1, 2020.
24,574 people enrolled in private plans through Wyoming’s exchange during the open enrollment period for 2020 coverage.
Read more about Wyoming’s health insurance marketplace.
2020 rates and plans
As has been the case since 2015, Blue Cross Blue Shield of Wyoming is the only insurer offering plans in the state’s health insurance exchange. For 2020 coverage, Blue Cross Blue Shield of Wyoming increased their average premiums for individual ACA-compliant plans by 1.6 percent.
For 2020, average premiums nationwide were mostly flat, so Wyoming’s average rates continue to be very similar to what they were in 2019, but they also continue to be among the highest in the country (but no longer the highest, as West Virginia has taken over that spot).
Wyoming defers to the federal government for the rate review process, so BCBSWY’s rate filings were reviewed by federal regulators rather than the state insurance department.
Wyoming and the Affordable Care Act
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 has remained in place. Although opposition to the ACA has been a mainstay for Republicans in Congress, Barrasso and Enzi have been even more opposed than most. In October 2014, they were among 14 senators who called for an opposition to 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 he was 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 that 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.
How did Obamacare help Wyoming residents?
Wyoming is the least populated and the second-least densely populated state, both of which 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 health insurance premiums in Wyoming 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.
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.
Short-term health plans in Wyoming
Wyoming defaults to the federal limits for the duration of short-term plans. The Trump Administration relaxed those rules in 2018, so short-term plans in Wyoming can have initial terms of up to 364 days, and total duration, including renewals, of up to three years.
Wyoming Medicaid/CHIP enrollment
Although former Governor Mead pushed for Medicaid expansion, Wyoming is currently one of 14 states that have not yet expanded Medicaid or made progress towards expansion. [Nebraska is expanding coverage in October 2020.] 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 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.
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. 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.
Medicare enrollment in Wyoming
As of the end of 2019, there were 111,413 Wyoming residents enrolled in Medicare. Read more about Medicare in Wyoming, including details about Medicare Advantage, Part D, and the state’s rules for Medigap plans.
State-based health reform legislation
Scroll to the bottom of the page for a summary of other recent Wyoming bills related to healthcare reform.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.