Wyoming can expect highest premiums in the country from its health care marketplace

Sep 25, 2013

Credit Oklahoma Policy Institute

Starting October first, Wyomingites will be able to go online and shop for medical insurance coverage from the participating providers in the state’s insurance marketplace.

Under the healthcare marketplace established by the Affordable Care Act, Wyomingites will be able to choose from about 16 plans, according to the US Department of Health and Human Services. The average premium for the cheapest, medium-coverage plan will be $489 per month. That’s the most expensive in the country.

Wyoming Insurance Commissioner Tom Hirsig says insurance premiums are driven by the cost of care, so states with large metropolitan centers are likely to have more doctors, more competition, and lower premiums.

“Wyoming has always been toward the top of health insurance costs. You know, we’re a very rural population. You know, we have towns where there might be one or two doctors.”

However, Hirsig says that the amount a person or family actually pays will depend on their income, and many American families will qualify for subsidies that will lower their payments. For example, a family of four making $50,000 per year would pay about $282 per month for mid-range coverage. A family with higher income would pay much more.

Hirsig says the only way for Wyomingites to know their individual rates is to log in to the state’s healthcare marketplace.

“It’s just gonna be so specific to each individual as far as cost, subsidies. Get in the exchange and take a look. See what you qualify for, and see if it makes sense for you.”

Although health care marketplaces go online in October 1, coverage won’t go into effect until January first. Wyomingites have until March 15 to obtain health coverage – if not through the marketplace, then through work or private purchase. Marketplace enrollment will close on March 15 until a new period in autumn. Anyone without health insurance after March 15 will pay a penalty to the Internal Revenue Service.

Hirsig says an enrollment deadline will keep people from gaming the new health care system.

“If there was no open enrollment period, why wouldn’t you just wait until you got sick, and then enroll in health insurance? Since it’s guarantee-issue, they can’t deny you for health conditions, everybody would just wait until they had to go to the hospital and then they’d enroll in the health insurance.”

Hirsig says IRS penalties in 2015 will be $95 per uninsured person for the year, or onepercent of their income, whichever is higher. Hirsig adds that those penalties will increase each year.

Hirsig says people interested in shopping around Wyoming’s marketplace should be sure to go to the https://www.healthcare.gov/ to avoid scams, not other web sites.