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CODY — A panel of health insurance experts shared the state’s plan to offer alternatives to the American Care Act on Tuesday night, saying that Wyoming needs to create a bottom-up strategy that meets the state’s unique challenges.

The message, however, didn’t gel with a few members of the audience, who accused the state of taking federal funding to resolve the state’s health care problems while also suing the government to stop the American Care Act from being implemented.

The topic, “A Wyoming Solution to Health Care Reform,” touched on the possibilities and challenges of creating a state-based health insurance exchange to help cover the state’s 83,000 uninsured residents.

As envisioned, the exchange would serve as a Web-based marketplace where individuals and small business owners could compare the price and quality of health insurance and review the products in everyday language.

“The fundamental function of an exchange is to allow people to shop and compare,” said Rep. Elaine Harvey, R-Lovell, and a member of the state’s health care committee. “It’s where everybody comes together in one place.”

Harvey said that such an exchange could help improve the overall cost and quality of health care in Wyoming. It could make medical billing easier for both the provider and the patient, and make purchasing the right insurance plan easier for consumers and small businesses.

While the Supreme Court is expected to rule on the American Care Act in June, Harvey said, the state must be prepared to resolve its health care problems whether the ACA survives or not.

“We don’t want the federal government doing this for us,” Harvey said. “But there’s still 83,000 people out there without insurance. Do we say that because you have no money, you don’t deserve health care?”

Elizabeth Hoy, the health care policy advisor under Gov. Matt Mead, said the state is attempting to create a bottom-up strategy that could be implemented in place of the American Care Act.

But Hoy said a Wyoming-run health insurance exchange could also be a challenge for the state and its small population base. Because it would be supported by a per-member monthly premium, costs could rise with fewer participants.

“We may also have larger administration fees, because you’ll have people manning phones, running computers and the [Internet] side,” said Hoy. “But because of our state’s small size, there’s also opportunity for efficiency.”

Hoy also touched on the geographical challenges. The state is home to only 500,000 people who live in small population pockets over a large geographical region.

Many, she said, already drive 70 miles one way to access care. Given the large cities surrounding the state, including Denver; Salt Lake City; Rapid City, S.D., and Billings, Mont., many already leave Wyoming for less expensive care.

“There’s infrastructure that can’t be built in Wyoming because people go out of state,” she said. “It may be important that whatever product we sell, we sell across state lines. If you watch a Billings station, are you going to get Wyoming news? It’s going to be difficult to get the word out.”

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The possibility of creating a state-run health benefits exchange proved a tough sell to some in the audience who were resistant to the panel from the start. Several argued self responsibility when lambasting the state’s plan to cover the uninsured and to fend off the American Care Act.

Others went after the state’s poor and infirm in making their point. One man said health care wasn’t required under the Bill of Rights. Some blamed apathy for the reason that many state residents didn’t have health insurance.

“When I go to Walmart and around town here, half the people I see either look like they’re sick or should be, because they’re in such poor physical condition,” said one man. “When I was young, getting sick was not allowed. There’s a lot of people in this county who don’t take good care of themselves.”

Another man told the panel that he wasn’t insured, but “he’s not crying about it.” In a rhetorical manner, he asked Hoy and Harvey if the state or federal government should be in the business of health care.

“There’s a cost to society when people don’t have health insurance,” Hoy replied. “There is some element of health care which is essentially a public good. Without a healthy population, we can’t have healthy workers, we can’t have educated children, and we can’t have a strong democracy.”

Hoy will be looking for input from Wyoming residents as she continues her seven-city tour that also includes Gillette, Casper, Rock Springs, Jackson, Riverton and Cheyenne.

The results will be reviewed by the Wyoming Health Benefits Exchange Steering Committee. The committee is expected to meet in Casper in March.

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