Health insurance mandate looming, uninsured Wyomingites worry about federal exchange offerings

Sep 13, 2013

Credit jasleen_kaur / Creative Commons

Roughly a quarter of Teton County residents are living without health insurance. It's the worst rate of health coverage in the state. Beginning in October, those uninsured residents will have a new opportunity to get health insurance through a federally-operated exchange, or marketplace. Wyoming Public Radio's Rebecca Huntington has more.

REBECCA HUNTINGTON: Dana Gatt is a massage therapist. She's putting towels in a warmer to get ready for her next client.

DANA GATT: We sell feel-good here, so I have to make sure all of the products are nice... everybody is going to enjoy their experience.

HUNTINGTON: Gatt is self-employed and runs a massage business catering to Jackson's working class.

GATT: Spas are getting a little too gourmet for themselves, and I just kind of wanted to have fun and appeal more to the locals. 'Us working schmucks,' I like to say.

HUNTINGTON: Her shop sits along a busy highway leading north out of Jackson in a weathered, one-story strip-mall. Even when she worked for fancy, high-end spas, she says they didn't offer health benefits. Working as a massage therapist is much like other seasonal service jobs as far as benefits are concerned. People who cut lawns, clean houses and wait tables are often on their own to buy health insurance. And Gatt did that... for a while.

GATT: I think they start out really reasonable with the insurance program that I was with here.

HUNTINGTON: But the rates didn't stay that way.

GATT: The rates just kept going up and up and I think I had to stop maybe at around $530.

HUNTINGTON: That's per month. So Gatt dropped her private insurance in 2005. A single mom, she received Medicaid insurance, available to low-income individuals, for a few years. Her 7-year-old son still receives Medicaid, but Gatt herself no longer qualifies.

HOCHHEISER: She should be able to find something on the exchange and should get a subsidy on the exchange, depending on her income.

HUNTINGTON: That's Lou Hochheiser, CEO of St. John's Hospital in Jackson. He says that beginning October first, Gatt will be able to go online to see what health plans and subsidies she's eligible for. The exchange will offer tax subsidies to middle-income individuals, under age 65, who aren't eligible for insurance through their job, Medicaid or Medicare.

HOCHHEISER: The subsidies are really quite strong. But the hook is that there still will be a large deductible.

HUNTINGTON: He says the exchange will offer four different kinds of plans, which look promising.

HOCHHEISER: Around the country, despite predictions of a lot of people that these plans were not going to be affordable, it's looking like they are coming in at an affordable rate. 

HUNTINGTON: That's good news for Gatt, who says she'd like to buy health insurance for herself and her son instead of going without or depending on Medicaid. But she's still not sure how the exchange will work.

GATT: I need sort of a clear outline. I need somebody to say, 'Well, this is what you pay for and this is what you get.'

HUNTINGTON: Once the online exchange goes live next month, she'll be able to see specific plans and prices and to calculate what subsidies she may qualify for. Under the new health reform law, by January first, Gatt will have to buy some kind of insurance or pay a penalty.

GATT: If they're going to force us to get health insurance, it has to be affordable. Don't tell me I have to pay, you know, two car payments or an additional mortgage.

HUNTINGTON: Gatt says she'll the give exchange a try but she's not counting on it. In fact, she's already taking pre-requisites at a community college in order to apply for nursing school. She says she likes taking care of people, and it's a profession that will hopefully come with health benefits. For Wyoming Public Radio, I'm Rebecca Huntington in Jackson.