It is again the time when Wyomingites can apply for health care through the federal marketplace established by the Obama-era Affordable Care Act. The state has put new resources toward helping residents apply, and those looking for coverage will have a new option this year.
Gov. Mark Gordon in October allocated $600,000 of federal coronavirus relief money toward promoting the open enrollment period.
“Wyoming is facing increased numbers of uninsured residents as a result of the pandemic,” Gordon said in a release announcing the funding. “This assistance is an important resource for those seeking health insurance during these challenging times.”
The open enrollment period this year is already underway. It began Nov. 1 and runs through Dec. 15, and experts say it could be a critical year for health insurance access nationwide as millions have lost their jobs amid the coronavirus pandemic.
Heather Webb is a health care “navigator” for Enroll Wyoming, the state’s federally funded program meant to aid residents in signing up for health insurance. Her team this year is larger than ever as the state anticipates a greater need for non-employer-provided health insurance. The $600,000 from the state has funded new staff to assist with outreach and walk residents through the steps of applying for insurance.
What had been a team of one full-time and two part-time employees is now more than a dozen strong.
And those navigators will have another option to tell prospective buyers about this year. Since the launch of Wyoming’s marketplace, Blue Cross Blue Shield has been the only insurer to offer a plan on the site, leaving residents with few choices when looking for coverage. But this year, a new provider is hoping to give Wyomingites a little more freedom.
Mountain Health CO-OP has expanded into Wyoming this year after starting in Helena, Montana, five years ago. The company is a nonprofit and a cooperative, meaning it’s owned predominantly by the same people it covers.
The ACA created the pathway for health insurance co-ops, but few have found success. Only three co-ops are still operating on the marketplace nationwide. In 2015, there were more than 20 such organizations serving more than 1 million people, Fortune Magazine reported.
Still, Mountain Health CO-OP has made gains the last two years, and Rich Wessenberg, the Wyoming representative for the company, called the nonprofit cooperative model the future of the industry.
Wessenberg said Wyomingites should be excited about the new venture for several reasons. First, competition in the marketplace improves quality, and it could eventually lead to better prices, he said.
Studies have found competing evidence of this fact.
Wessenberg also said the co-op prioritizes prevention in a way larger insurers don’t.
Webb and her team will help residents navigate the new options. Typically this would involve a lot of face-to-face assistance, but like most professions, they have had to adjust to the realities of a pandemic. They’re holding virtual office hours and doing a lot of work over the phone.
Residents in need of assistance can reach a navigator by going to wy211.communityos.org.
Their focus is on ACA enrollment, but they will help anyone navigate finding insurance, on or off the marketplace. And, Webb said, the benefit of using their services is that many people don’t realize they qualify for tax credits that could dramatically lower their health care costs.
Without those tax credits, the average premium for Wyoming’s roughly 25,000 residents covered by a marketplace plan would be nearly $1,000. But with the tax credits, for which nearly 90% of residents qualify, the average premium falls to $128 per month, according to federal data.
So her team does a lot of education on that front, too.
“If we don’t understand our health insurance plans, a lot of times that means we’re not using it,” Webb said.
Still, those who make less than 100% of the poverty level ($12,760 for an individual) most likely won’t be able to afford a marketplace plan, Webb said. Kaiser Family Foundation estimates roughly 10% of Wyomingites fall below that mark.
“We see a lot of individuals where that is their current reality,” Webb said.
She said they will help find people who can’t afford marketplace insurance some level of coverage, even if all they can do is connect that person to a sliding scale fee clinic. She said Enroll Wyoming’s services are also available outside of the open enrollment period.
Follow health and education reporter Morgan Hughes on Twitter @m0rgan_hughes