Wyoming’s health insurance marketplace has the unfortunate distinction of opening with some of the highest average prices in the nation. Premiums for a benchmark plan will average $516 a month for an individual, compared with $328 for the nation as a whole.
But there are problems with making simple price comparisons with premiums already sold through the private sector. For one, many Americans will qualify for marketplace subsidies that could cut a sizeable chunk from the amount they would actually pay. A 27-year-old with a $25,000 income would save about $200 each month on a plan that covers 70 percent of his medical expenses, according to a federal report released last week.
At the same time, people won’t be getting the same products as they have in the past, Wyoming Insurance Commissioner Tom Hirsig said.
The Affordable Care Act sets minimum standards for health plans sold on the exchange, and for new plans sold outside the marketplace to small businesses and individuals. All plans must include benefits in 10 basic areas including pediatric care, emergency room visits and lab tests. Those essential benefits won’t have lifetime limits.
Wyoming didn’t have many mandated areas of coverage before. Broader benefits could translate to higher prices, but consumers will also be getting richer coverage, Hirsig said.
“The plans are going to cover way more than they ever have before,” he said.
Every insurance plan, for example, will cover maternity and newborn care. Very few plans in Wyoming now offer that benefit, Hirsig said.
“The good thing is the plans cover a lot more,” he said. “The bad thing is: It’s not a menu. If you are a 40-year-old male, and you don’t want maternity and newborn care, you’re out of luck.”
The new requirements begin Jan. 1.