Sick of Wyoming’s high health care costs? You’re not alone.

When Wyoming residents discuss the state’s health care system, their number one problem is the high cost of treatment and insurance.    

That’s what Better Wyoming learned by conducting a statewide survey and hosting community health care summits in Casper, Cheyenne and Lander. 

The results didn’t surprise us. Wyoming ranks 49th in the nation for affordability and accessibility of medical care. That comes from a new report by the Commonwealth Fund, a national health care research organization.

While other states enact laws to increase price transparency and decrease the number of uninsured residents, Wyoming lawmakers have done little. Whether insured, uninsured or underinsured, many Wyomingites find health care far too expensive. 

Our neighbors for whom health care is least affordable are those without health insurance. This includes the roughly 20,000 people who could gain coverage if the Legislature agreed to expand Wyoming’s Medicaid program.

Others who do have insurance face high costs for premiums — as well as deductibles ranging from $1,500 to $20,000 — and the prices keep going up.

“I am terrified for my teens once they finish school and Tricare no longer covers them,” one person wrote in response to Better Wyoming’s survey. “Seems like high deductible health plans are the norm among employers here (if anything is offered at all).”

The Commonwealth Fund says Wyoming has the sixth highest rate of uninsured adults in the nation, about 16%. Meanwhile, one in 10 children in the Equality State has no health insurance, the second worst rate in the country. 

As a result of lack of insurance or high deductibles, many Wyoming residents seek care only when it’s an emergency. But untreated medical conditions don’t go away on their own. They can turn into even more serious problems that are much costlier to treat. 

Health care advocates say Wyoming should focus on access to primary and preventative care to drive down costs. 

“We should be really focusing very hard on excellent primary care,” Anne Ladd, former executive director of the Wyoming Business Coalition on Health, told the Casper Star-Tribune. “If we truly invested in making sure everybody got excellent primary care, we would go a long way to saving everybody a lot of money.”

Primary care — basic doctor’s visits, checkups, screenings, etc. — forms the foundation of any health system. But in Wyoming, only 5% of health care spending goes to primary care.

The vast majority of spending consists of expensive emergency care, surgeries, and specialty medical services, according to the Commonwealth Fund. Many could have been avoided earlier by better primary care. 

The Wyoming Legislature could dramatically increase the number of people who have access to primary care by expanding Medicaid to cover low-wage workers, which 40 other states have already done. But lawmakers here have refused on political grounds, despite the many benefits it would provide residents.

Wyoming’s sparse population is a major factor in its high health care costs. If a small-town hospital doesn’t have a steady volume of pregnant patients giving birth, for instance, it’s financially difficult to maintain a fully staffed and equipped labor and delivery unit.

But communities without basic medical services like maternal care may struggle to attract and retain businesses, and their residents must travel long distances to receive care. That adds to the costs.

Outside of providing direct public support for rural health care services, there isn’t a ton Wyoming lawmakers can do to counter the problem of geography and sparse population.

However, the Legislature could help control costs in other ways. 

Health care advocacy groups like Families USA argue that a lack of price transparency — whether for insurance plans or medical treatments — allows health care corporations to artificially inflate prices.

Most states have mechanisms to ensure price transparency for insurance and medical providers. Wyoming does not.

For instance, Wyoming is one of two states that does not conduct a premium rate review of insurance policies to assess whether price increases are “unreasonable” or “excessive.” 

Several states established their own transparency laws, plus penalties for providers and hospitals that fail to follow federal guidelines.

In 2016, Wyoming created a state database to track insurance claims and procedure-by-procedure health care costs, providing a wealth of information on the high costs. 

Three years later, a revenue shortfall led lawmakers to cut $100 million from the Department of Health’s budget.

The database has not been updated since. Aside from extending the period of time new Wyoming moms can qualify for Medicaid in 2023 — which was a welcome step — the Legislature has done essentially nothing to address what most residents consider their greatest health care concern.