Affordable Care Act

Matt Laslo

Wyoming’s senators are supporting a massive bill to overhaul the nation’s health care system next week.

The new GOP health bill eliminates the mandate that every American must have health insurance and it ends the Obamacare subsidies that help many Wyomingites afford insurance. The new proposal does maintain some taxes under the Affordable Care Act but then sends that money back to the states as a block grant, which Wyoming Senator John Barrasso likes. 

Bob Beck / Wyoming Public Radio

Blue Cross Blue Shield of Wyoming is proposing to raise health insurance rates by 48 percent in the coming year. That would mainly impact the 28,000 Wyomingites who get their coverage via the Federal Health Insurance Exchange.  

Those off the exchange and who get group insurance through Blue Cross Blue Shield could also see a substantial increase. Spokeswoman Wendy Curran explained that Blue Cross Blue Shield is nervous about proposed changes in the current health care law. She said they are particularly concerned about threats to remove cost shared reduction subsidies.

Bob Beck

As the Senate health insurance reform effort remains on life support, Wyoming’s two senators are pushing their Republican colleagues to get on board with the effort.

Senator John Barrasso literally burned the midnight oil on Wednesday when he invited a large group of Republican senators into his office for last minute negotiations on their party’s health insurance reform plan. Barrasso emerged late and was the last to address the thirty or so reporters who huddled outside for hours.  

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Wyoming’s two U.S. Senators have been at the center of their party’s effort to overhaul the nation’s healthcare system, and they’re still optimistic they can pass a bill when they return to Washington after their July Fourth recess. Some have been critical of their work, mostly because Republicans have been negotiating their health insurance bill behind closed doors after holding no hearings on it this year. 

More healthcare providers around Wyoming are expressing worry over the Senate’s healthcare bill released last week.

The Downtown Clinic in Laramie provides primary care and emergency dental services to people without any healthcare coverage.

Pete Gosar, the clinic’s executive director, said the bill may make it more difficult to provide coverage there. The clinic recently had to extend its operating hours, staying open two days a week instead of one, to accommodate all 700 patients.

Wyoming Congresswoman Liz Cheney helped her party pass a historic bill to unwind Obamacare, but its chances of passage in the Senate remain far from certain.

After House Republicans passed their bill to overturn Obamacare they walked out of the Capitol and were greeted with a few hundred protestors who were chanting shame.

But Wyoming Congresswoman Liz Cheney was undeterred.

Bob Beck / Wyoming Public Radio

Wyoming U.S. Representative Liz Cheney was among those who voted to support the Republican overhaul of the Affordable Care Act. Cheney says the passage of the American Health Care Act by the House of Representatives will help Wyomingites purchase affordable care.  

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Despite some recent setbacks, Congress will eventually move to either replace or make serious changes to the affordable care act. Wyoming’s congressional delegation says that should help reduce insurance premiums in the state, but that may not be the case. Wyoming saw a growth in those who have insurance under the affordable care act and current congressional fixes could do more harm than good. 

Bob Beck

The Republican Party hates so-called Obamacare, but when it comes to replacing the bill the party is divided over how to change the health care system.

You’ve heard about the angry protests at Republican town halls across the nation, but you may not know there’s also a heated debate happening inside closed door Republican meetings on Capitol Hill. The thirty or so member House Freedom Caucus voted as a block to fully repeal the Affordable Care Act before the party even has a replacement in hand.

Senator Mike Enzi (R)

Wyoming's two senators are set to play a key role in the Republican effort to repeal and replace Obamacare. Senate Republicans, led by Senator Mike Enzi took their first steps towards repealing the Affordable Care Act in a late night session.

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As the January 31 deadline approaches to sign up for health insurance under the government’s health care marketplace, Senate Republicans are beginning plans to repeal the law that created that program.

It’s still unclear how lawmakers will replace the Affordable Care Act if it is repealed, and experts around the country are unsure what a reformed health care system should look like.

healthcare.gov

On November 1, people will be able to sign up for this year’s round of health insurance coverage under the Affordable Care Act. Wyoming’s rates are expected to increase by roughly seven percent, and while the increase will be less than some other states, Wyoming’s insurance prices are typically among the highest in the country.

Following the adoption of the Affordable Care Act, Wyoming’s Northern Arapahoe tribal members signed up in high numbers for fully subsidized health insurance, many of whom had never received any before.

Now, a federal judge in Casper says it’s not the responsibility of the federal government to pay for tribal health care. It’s the responsibly of the tribe. U.S. District Judge Scott Skavdahl ruled against the tribe in its lawsuit with the IRS, arguing that under the ACA the Northern Arapaho tribe qualifies as a large employer.

Wyoming's Governor and Congressional delegation have been fighting to dismantle the Affordable Care Act for years.

But with Thursday’s Supreme Court ruling ruling “Obamacare” looks stronger than ever.

Wyoming Minority Floor Leader Mary Throne of Cheyenne says that might force state legislators to finally start talking about how they could work with federal healthcare policy.

Wyoming’s decision to not set up a set health care marketplace could haunt it if the United States Supreme Court rules that federal marketplaces or exchanges cannot receive federal subsidies. The King vs. Burwell case could impact close to 20 thousand Wyoming residents, especially the 17 thousand who would lose subsidies to purchase insurance. 

Bob Beck / Wyoming Public Radio

A U.S. Supreme Court decision this summer could affect health coverage for nearly 21,000 Wyoming residents. The court will decide if subsidies can be provided to low-income individuals in states that don’t have their own health insurance exchange under the Affordable Care Act.

Wyoming is one of more than 30 states without its own insurance marketplace.

Of the 21,000 citizens enrolled in a health care plan under the federal government run marketplace, 91% receive the premium tax credit, which on average pays for more than 70% of their monthly premiums.

The number of people in Wyoming who have purchased health insurance through the federal health insurance marketplace has nearly doubled since last year. More than 21,000 consumers signed up for plans in 2015 as part of the Affordable Care Act. Last year, nearly 12,000 people signed up for a plan.

Monica Jennings is a Marketplace Navigator with Enroll Wyoming. She says despite many Wyomingites enrolling, there are still many in the state without health coverage who would have benefited from Medicaid expansion.

One of the biggest Supreme Court cases of this term could wipe away the insurance subsidies that tens of thousands of Wyoming residents now rely on under so-called Obamacare. Matt Laslo has the story from Washington on how Wyoming Senator John Barrasso is now scrambling to find a Plan B for a law he's staked his name as a doctor opposing.  

The Northern Arapaho tribe recently lost a lawsuit against the Internal Revenue Service. The tribe sued the IRS because it classified the Northern Arapaho as a large employer, requiring them to pay for employee health insurance under the Affordable Care Act. The tribe argued that a long-standing treaty requires the federal government to pay for Native American health care, and that the federally-run Indian Health Services isn’t doing good enough to fulfill that agreement.

Bob Beck

For the last few years Wyoming has considered taking advantage of part of the Federal Affordable Care Act which pays states to expand Medicaid services to the so called working poor. While states have some up-front costs, the federal government pays for 100  initially and 90 percent after that. In Wyoming it would pay for close to 18,000 additional low income people to get health care coverage. Despite the federal money, lawmakers have consistently refused to adopt expansion. Why? The answer is varied.

Bob Beck / Wyoming Public Radio

  

Last week, Governor Mead appointed a new commissioner at the Department of Insurance. Paul Thomas Glause was previously the vice chairman of the Wyoming Board of Equalization. Tom Hersig recently left the position to become CEO of Cheyenne Frontier Days. Looking forward, Glause says the question is whether a new Republican lawsuit will succeed in dismantling parts of the Affordable Care Act, leaving states to fulfill subsidies to help pay for health insurance.  

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The federal government has provided millions of dollars to states to offer Medicaid Health Insurance to what’s known as the working poor. Last week, after months of discussion, the Wyoming Department of Health unveiled its plan for expanding Medicaid in the state. 

Low income people who do not currently qualify for Medicaid and do not make enough money to be able to get insurance via the Affordable Care Act would be eligible. Governor Matt Mead and several health care organizations support the plan, but it still has the difficult task of getting through the legislature.

The open enrollment period to sign up for health insurance starts November 15 and runs through February 15. That gives customers a short three-month window to sign up. There will not be another chance to enroll again until next November. Wyoming Insurance Commissioner Tom Hirsig says a wide range of Wyoming residents qualify for government aid to help pay for the health insurance.

“That’s kind of the range,” he says. “A single person making $12,000 to, say, a family of four making $100,000. So as you can well imagine that encompasses a vast majority of the population of Wyoming.”

While Wyoming residents strongly oppose the Affordable Care Act, residents are supportive of expanding Medicaid to provide health care to those who cannot afford it. A University of Wyoming election year survey conducted in mid - August found that only 24 percent of state residents approve of the Affordable Care Act, while 70 percent oppose it.  

University of Wyoming Political Scientist Jim King says people have a different opinion about Medicaid expansion.

Senator Mike Enzi (R)

U.S. Senator Mike Enzi is facing Charlie Hardy in the upcoming General Election.  In his time in office Senator Enzi has been a key player on issues such as No Child Left Behind and the Affordable Care Act. We begin our conversation by discussing the ACA.

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St. John’s Medical Center in Jackson is hiring several new surgeons and doctors to join the public hospital’s physician group.  It will be the first time the hospital has directly employed surgeons. 

St. John’s CEO Lou Hochheiser says the new hires are needed to meet demand in the area.

“A year and a half ago, we had 4 and a half surgeons in this community,” Hochheiser said. “We have lost two and a half of those surgeons, leaving us with two. Therefore, it was the hospital’s responsibility to make sure that gap was filled.”

Rebecca Huntington

With the deadline looming to sign up for health insurance under the Affordable Care Act, healthcare-dot-gov navigators are seeing a surge in people seeking help. Wyoming Public Radio's Rebecca Huntington has more.

"Thanks for your patience, you'll have our undivided attention shortly. Your access to quality, affordable coverage is just a few minutes away."

Bob Beck

For over a decade the state has struggled with making sure all citizens had access to health care.  Much of this had to do with the fact that many Wyoming citizens can’t afford health insurance.  The federal affordable care act was supposed to help.

clker.com

A central mandate of the Affordable Care Act is getting health care professionals to communicate across disciplines.  A conference Thursday at the University of Wyoming brought health care leaders together to talk about how to better train students for doing that.

Brenda Zierler with the Center for Health Sciences at the University of Washington was one of the conference leaders.  She says it’s time to move past the old paradigm in which nurses, social workers and psychologists all learn their crafts in isolation. 

Wyoming Democratic Party leaders have criticized Governor Matt Mead for opposing a full Medicaid expansion under the Affordable Care Act. There are over 17,000 low-income adults in the state and State Democratic Party Chairman Pete Gosar says it's not right to oppose the expansion, since Mead isn’t proposing another option.

At a press conference last week, Mead said that on that count, Gosar is right.

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