Wyomingites may be skeptical of Obamacare, but many are using it for health insurance

For Madelyn Beck

Wyoming leaders have repeatedly rejected Medicaid expansion, but a new study shows many residents here trust another component of the Affordable Care Act: the health insurance marketplace.

Among the 10 states with the highest share of farmers, Wyoming uses the federal health insurance marketplace the most, according to a new analysis by the Robert Wood Johnson Foundation. This marketplace is a virtual space to compare plans and find insurance that is often more affordable than elsewhere thanks to federal subsidies.

More than 42,000 Wyomingites made Marketplace plan selections during the 2024 open enrollment period, comprising more than 7% of the state’s population.

The analysis also showed Wyoming benefited the most from advanced premium tax credits, bringing the average monthly market premium in the state from $937 to $118.

Health care is actually more expensive in many rural states than in urban states because there is a shortage of providers, said Katherine Hempstead, the report’s author and senior policy adviser at the foundation, which focuses on health issues public and health care. It’s not very competitive, there are long distances, and Wyoming is a particularly expensive state for health care.

Wyoming has the third-highest average rates in the nation, according to the Centers for Medicare and Medicaid Services.

Premium costs vary by zip code and personal situations, but these tax credits are often crucial for Wyoming families, said Caleb Smith with Enroll Wyoming, a free tool to help people navigate the market.

They’re make or break for most people, Smith said.

According to the analysis, 95% of people using the Wyoming marketplace receive these tax credits. Others may not have filled out the paperwork or may not be eligible.

Without renewal, the tax credits will expire in 2026. And without the credits, self-employed groups like farmers could have a harder time affording health care, Hempstead said, and going uninsured in a higher-risk occupation it can be expensive.

Although tens of thousands of Wyomingites use the market, there is still a stigma associated with it. The marketplace was created through the Affordable Care Act, often called Obamacare. The name alone can be polarizing in conservative Wyoming.

But there’s also concern about looking like you need help, Smith said.

Some people still see a stigma in using these programs, even if it means improving the quality of care, he said. This is not just the market, I have worked with our local soup kitchen and know people who would rather go hungry than be seen in person at the soup kitchen.

The marketplace is primarily to help people find health insurance options at a time when costs have risen across the country. This can include self-employed people, jobs that don’t provide insurance, and those who don’t qualify for Medicaid.

Smith and Enroll Wyoming work with people to help them navigate the market and other insurance options in Wyoming. And while most people sign up during open enrollment from November to mid-January, Smith said there are plenty of reasons to sign up at other times.

That can include, having a new child in the house, maybe adopted, maybe taking care of foster children, she said. You may have gotten married, divorced, the person who provided health insurance no longer provides health insurance.

Still, after the passage of the Affordable Care Act, the opposition in Wyoming was clear. A UW poll conducted last decade found that roughly three-quarters of residents disapproved of the law.

Lawmakers then worked to change the state constitution in response to the outcry. The language voters later approved reads: Every competent adult shall have the right to make his or her own health care decisions.

That wording has become a key legal argument against Wyoming’s two abortion bans, which are currently tied up in Teton County District Court.

The Robert Wood Johnson analysis also showed Wyoming had the lowest rate of Medicaid use among the 10 farm states with about 73,000 or 12.6 percent of the state using it.

Both Wyoming and Kansas on this list have not passed Medicaid expansion.

Wyoming is one of 10 states that have not passed the Medicaid expansion, which faces strong opposition from the right. After several failed attempts, many suspect it will never happen here, but they still hope for some way to cover more people who fall into a gap: making too much to qualify for Medicaid, but not enough to pay for the insurance plans of the market

The state estimates the Medicaid expansion could cover about 19,000 more residents over two years.

Meanwhile, about 17,600 Wyoming Medicaid and Kid Care CHIP enrollees lost coverage over the past year as the state reassessed who qualified. This is after a hiatus of several years from reviews during the pandemic.

Some people lost coverage when their incomes increased, but most are children whose guardians failed to provide the required paperwork.

Enroll Wyoming has been working with the health department to publicize the Medicaid renewal process, but Smith said it can be difficult: Many who signed up for Medicaid or Kid Care during the pandemic had never gone through it before. before.

They didn’t even know it was an annual thing, he said. Or some of these people had moved in that time and therefore didn’t know they needed to update their contact information.

Since the Medicaid opt-out began last April, Smith has also seen more people contact Enroll Wyoming for help finding insurance coverage. It’s something he encourages others to do because it can be risky not to take particularly preventative care.

Most importantly, we just want people to have health coverage so they can take care of their health, so they can live a long happy life with their friends and family, he said.

According to a KFF survey, nearly one in four adults who disenrolled from Medicaid in the past year are uninsured.

Those who lost coverage for procedural reasons during this last year’s process have 90 days to provide the necessary information and regain backdated coverage.

People who have already received their renewal notices can update their contact information and renew coverage at www.wesystem.wyo.gov or by calling 1-855-294-2127.

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This article was originally published by WyoFile and is republished here with permission. WyoFile is an independent, nonprofit news organization focused on the people, places and politics of Wyoming.

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