Rising ACA Premiums Leave Wyoming Residents Concerned

Elizabeth Aranow and her husband are facing a tough decision as their Affordable Care Act premiums are projected to jump from $600 to an alarming $3,000 monthly starting next year.

“I haven’t picked a plan yet because, to be honest, the prices are shocking,” Aranow explained. While residents of Lander Island can opt for less expensive marketplace plans, the cheapest alternative is still $1,800 a month, which is significantly more costly and offers less coverage. This situation has pushed them to think about major life changes, like taking a new job with benefits or risking life without insurance. But for Aranow, going without coverage isn’t really an option—she’s had surgeries due to injuries in recent years.

Approximately 45,000 people in Wyoming rely on health insurance via the Affordable Care Act marketplace, and they are now experiencing some of the steepest premium hikes in the country. Factors such as changing health care policies, market shifts, and the expiration of tax credits are contributing to these increases.

In Wyoming, a 60-year-old making around $63,000 could see a staggering 421% rise in average monthly premiums. This increase dwarfs those in neighboring states, where the hikes are comparatively lower—231% in Montana, 166% in Colorado, and so on.

“It’s quite frightening,” Aranow added.

Not all individuals are facing such extreme increases, as costs can vary based on age and income. However, health advocates are worried that the high prices will force many to seek out cheaper private plans that typically offer poorer coverage—or even to go without insurance altogether.

“Many will likely opt to go uninsured, thinking they can manage any unexpected medical bills later,” noted Jen Lowe, executive director of Healthy Wyoming, which promotes affordable health care.

Lowe fears that this could escalate medical debt, lead to increasing unpaid hospital bills, raise premiums for everyone, and worsen health outcomes as individuals might skip necessary preventive care due to cost concerns.

“It’s alarming to see how many people may be affected in the state,” she said. “Now, as people are seeing the real costs unfold, the reality is hitting harder.”

Background on ACA Changes

Established in 2010, the Affordable Care Act Marketplace is designed for those who don’t qualify for Medicaid and lack employer-provided insurance.

In response to the COVID-19 pandemic, Congress introduced enhanced premium tax credits in 2020 to make insurance more affordable, which significantly lowered some monthly payments. For a segment of low-income individuals, premiums dropped to $0.

This initiative, according to health advocates, contributed to the lowest uninsured rate in the U.S. history. However, critics argued the subsidies were financially unsustainable, and Congress did not extend them this year. This deadlock around tax credits was a significant factor in the recent government shutdown.

A report from 2020 projected that expanding these credits would lead to a $212 billion deficit over the next decade.

Ultimately, Congress reached a consensus that left tax credits unchanged; the enrollment period began on November 1. Participants recently gained access to view new options for their plans. This annual window allows individuals to sign up for ACA insurance, adjust their existing plans, or cancel coverage.

Due to rising costs of basic plans this year—and the reduced subsidies—many options have sharply increased in price. Notably, Mountain Health Corp. has exited the Wyoming market, leaving only two insurance providers in the state.

To help residents understand these changes, Lowe’s organization is organizing forums, the most recent of which saw a record turnout in Casper, likely fueled by the newfound awareness of rising premiums.

“I’ve heard from numerous people who are weighing choices between paying for rent or food and their insurance,” she shared. “It’s definitely a troubling time.”

Complexities of Enrollment

The Lander Free Medical Clinic is fielding calls from patients it previously assisted in obtaining ACA plans. Medical assistant Audrey Zanetti mentioned a patient who had a plan costing $0, but now faces a rise to $650, which is a substantial portion of their income and doesn’t even account for other costs such as copays or deductibles.

“If they hadn’t come in, they would have been stuck with the higher premium without realizing it,” Zanetti warned. “They could have ended up uninsured.”

Insurance intricacies can be daunting, and not everyone understands the implications of automatic renewals.

Until recently, federally funded medical navigators—trained to guide consumers through the enrollment process—were widely available, but funding saw a drastic cut this year, leading to staff reductions in organizations like Enroll Wyoming.

In response, they have formed a network of trained health counselors to fill the gap.

“We aimed to set up a system where people can still access help,” explained Caitlin Befas, a registered navigator in Wyoming. “We leaned on trusted partners to assist with certification.”

As the only full-time navigator at Enroll Wyoming, Befas is currently overwhelmed with requests. “We are fully booked for the initial period, right up until December 15,” she mentioned.

Customers have voiced concerns about rising prices, and Befas has had to explain the unwinding of tax credits. She’s noticed those making over 400% of the federal poverty level are particularly affected by these increases.

“They’re facing some really steep premiums—around $5,000 a month for family plans,” she said. “For many of them, private insurance may be the only option now.”

Enrollment Deadlines and Recommendations

The deadline for signing up for a Marketplace plan effective January 1 is December 15. If one enrolls from December 16 to January 15, coverage begins on February 1.

Experts are advising caution.

“I want people to check out [Healthcare.gov] and use the ‘View Plans and Prices’ tool to understand expected tax credits and premiums before making any decisions,” Befas recommended.

Those wishing to opt-out from their ACA plans should avoid auto-renewing and should also talk directly with insurers about any private options.

Be aware of online shopping risks, as many fraudulent sites exist, Befas cautioned.

Advocacy for Change

Another suggestion is to “reach out to your federal representatives and express how these changes impact you personally,” Lowe said.

The discussions around the tax credit extension see a typical division—Republicans opposed it while Democrats favored it. Wyoming Senator John Barrasso has publicly criticized the Affordable Care Act, calling it a failed policy that needs replacement.

“I’ve always believed that people should access care from their chosen doctor at an affordable price, but Obamacare undermines that opportunity,” Barrasso stated. “We can’t keep funding failing programs that raise costs and create hardships.”

Lowe acknowledges the criticisms but argues that providing a workable solution is more challenging.

“Republicans have indicated they will address health care once the government reopens,” she noted. “Now that it’s back in operation, it’s time to have those conversations about how to provide quality health care in Wyoming.”

Ultimately, health insurance is crucial for leading longer, healthier lives. “This is a policy issue we need to address,” Lowe concluded.

It’s essential to hold leaders accountable: “Let’s ask, ‘What could we do differently?’”