Without affordable health insurance, all Wyomingites suffer

Recently, the Mountain Health Co-Op, one of two insurers offering individual insurance, announced that it was withdrawing from the Wyoming health insurance marketplace. The co-op’s 11,000 Wyoming members will have to find a new health insurance carrier before next year — if they can afford it. Rates in Wyoming are forecast to increase by approximately 25% in 2026. Due to high claims costs and significant losses here, the co-op will focus its operations on its other two markets: Idaho and Montana. 

While this is a blow for the co-op’s Wyoming members, the withdrawal of a health insurer is significant for everyone for several reasons. We should all take note. First, a little background.

Mountain Health Co-Op was established to offer a low-cost health insurance option in the individual market. Initially, it offered health insurance only in Montana. Eventually, both Idaho and Wyoming reached out to Mountain Health to offer plans because neither state had a co-op option. Blue Cross Blue Shield of Wyoming was the only option for Wyoming workers whose employers did not offer coverage. In the co-op’s first year of operation in Wyoming, health insurance premiums dropped 12% confirming that customers benefit from competition. Recently, the operating environment for all health insurers nationwide has been deteriorating. Publicly listed insurers such as UnitedHealthcare and Cigna have reported disappointing earnings because of the continued rise in health care costs. The drop in Medicaid funding in the Big Beautiful Bill and the expiration of the enhanced advanced premium tax credits at the end of this year have darkened the outlook for all health insurers. 

The co-op is not the only health insurer re-evaluating markets and refocusing operations. Unfortunately, health insurance rates will be rising by double digits across the United States as health insurance companies scramble to keep up with rising costs. The co-op’s departure is a symptom of some deep-rooted challenges facing Wyoming.

First, providing health care in Wyoming is very expensive. We have a small population, which makes it difficult to spread risk. Being a thinly populated, rural state makes the cost of providing health care more expensive. To do business here, a new insurer must negotiate provider contracts with nearly every provider, even if that provider only sees a few insureds. This means the health care entity holds all the power in the negotiation. By law, the insurer needs to contract with every hospital and most doctors to be eligible to sell insurance here. There is simply no control over what health care providers can charge for care. Moreover, Wyoming has one of the oldest populations of the 50 states. An older population consumes more health care. Without younger, healthier members to offset the risk pool, insurance costs rise.

Wyoming likes to believe that it is a business-friendly state. In general, we offer a lower cost of doing business, such as lower taxes and fewer regulations. But Wyoming ranks toward the top in health care costs and health insurance costs. This is a hidden tax, and a very expensive tax, for any business or sole proprietor. The Wyoming Legislature, as well as our federal delegation, has tools available to help lower health care costs. 

When we look for care, we often don’t factor in the cost when we have insurance. The cost for the same procedure could vary by thousands of dollars between providers, but we pay the same out of pocket with our benefits. As health care consumers, we have a stake in the game, too. We should try to keep our costs down and challenge health care providers who charge much more than others for the same services. 

The rising cost of health care is not a new discussion. As the number of people without health insurance increases, the amount of care going unpaid increases. Those uncompensated costs are passed along to those who have insurance. Then, health insurance rates go up. What most of us see is the cost of health insurance, but we don’t examine what drives those costs. The U.S. was starting to get a handle on these drivers. Expanded Medicaid eligibility, expanded premium tax credits, coverage of essential and preventive care, and requiring insurance companies to spend more of your premium on care help keep the cost of care down. 

Mountain Health is the type of company we want operating in Wyoming. They are a true nonprofit that is governed by its members. They invest in their members with zero-dollar co-pay prescriptions, travel reimbursements for more specialized care, a focus on preventive medicine and they invested in our communities. The next company that comes in to sell insurance in Wyoming may not have that commitment. The departure of the co-op should be a wake-up call to all of us that our state faces some serious problems. The can has been kicked down the road long enough.