New task force targets rising health insurance costs

WYOMING

A new state task force is working to bring down the cost of healthcare insurance for Wyoming residents.

The Health Insurance Affordability Task Force met for the first time Wednesday and Thursday, bringing together legislators, state officials and healthcare stakeholders to explore ways to reduce insurance costs for Wyoming residents.

The legislature created the task force for the 2026 interim session at the urging of state Rep. Lloyd Larsen, R-Lander. Sen. Tara Nethercott, R-Cheyenne, the task force's co-chair, said Larsen proposed the panel to the Legislative Management Council. Larsen serves as the task force's other co-chair.

"Those of us who are serving in the legislature know that right now… in the top one or two of all the conversations [of our constituents] is healthcare affordability and access," Larsen said.

He warned the group to be wary of trying any option until something "sticks."

"It's going to be very easy to just start throwing things against the wall and seeing what will stick. Experience has taught me that there's probably a better approach," Larsen added. "I think, particularly, guided by our agency directors that are in this room. They've been very thoughtful in teaching us that if you get the data together and thoughtfully look at it, you can generally come up with a better policy than just throwing something against the wall."

State of insurance

Health insurance operates under a different set of economic pressures than most other types of coverage, said Wyoming Department of Health Deputy Director Franz Fuchs.

"Unlike a lot of other insurance products, fundamentally, the identity and character of the policy holders really drive those underlying costs," Fuchs said.

The pool of individuals who choose to enroll in an insurance plan and their health risks determines how an insurance will charge its clients.

Adverse selection is when insurance costs go up because more "sick" people are joining the insurance pool and the "healthy" people leave because of increasing premiums. A "death spiral" occurs when adverse selection is out of control, and the concentration of "sick" people is too great and drives prices to a point where no-one can afford the premiums.

Fuchs and Health Department Director Stefan Johansson, who serves on the task force, also reviewed how the Affordable Care Act reshaped health insurance coverage, pricing and consumer protections.

The Affordable Care Act, commonly known as Obamacare, created standardized insurance tiers, often referred to as "metal levels," based on a plan's actuarial value, or the share of medical costs an insurer is expected to cover for a typical population, Fuchs said.

The law also established a uniform set of benefits that most health plans must cover. Those 10 essential health benefits include preventive care, emergency services, prescription drugs and maternity care.

"It also standardized the pricing and the purchasing," Fuchs said. "Every product is going to be a standardized product, so [to] ensure people can go on the exchange and shop for the lowest premium or the plan that covers their doctors and network. But the people shopping will know that all the benefits are going to be roughly the same and that, based on the 'metal' level, they can extract a certain cost-sharing, a certain deductible, a certain obligation to pay for those expenses."

The ACA also allowed young adults to remain on their parents' insurance plans until age 26, prohibited insurers from denying coverage based on preexisting conditions and eliminated annual and lifetime coverage limits.

Advance premium tax credits were also created to lower the cost of insurance on the healthcare exchange for lower income individuals based on the state's second lowest "Silver" premium and household income.

The credit is only available to people over 100% and under 400% of the federal poverty level. In 2021, Congress passed an act to allow households above 400% of the federal poverty level to be eligible. The additional subsidies expired in 2026, according to a report from the Congressional Research Service explaining the tax credits.

A chart presented to the task force showed which Wyoming households qualify for health insurance subsidies and at what level. Darker shades of green indicated larger subsidies, while white denoted no subsidy eligibility.

"A relatively new problem we find ourselves in is interesting because the very bottom of this chart is another white box where you see, again, very white color," Johansson said. "There's not a lot of options for reduced cost health coverage [to people above 400%]. And so it's interestingly very similar from a extremely low income population that is in a coverage gap between not having marketplace subsidies and not having access to Medicaid."

Nearly 30,000 people in Wyoming have a household income of 400% or more of the federal poverty level.

Johansson said families in that category can face monthly insurance premiums of several thousand dollars, putting coverage out of reach for many.

Fuchs said many of those affected are small-business employees, self-employed workers and entrepreneurs who do not have access to employer-sponsored health insurance.

The challenge extends beyond these households. Wyoming's lowest-income residents have also fallen through the cracks.

Larsen said around 16,000 to 19,000 people in Wyoming fall within the "Medicaid coverage gap."

Johansson said Wyoming residents ages 21 to 64 who earn less than 100% of the federal poverty level fall into a coverage gap because they are ineligible for marketplace subsidies and do not qualify for Medicaid.

Medicaid expansion would have extended coverage to those individuals, but Wyoming is one of 10 states that has not adopted the policy, leaving thousands of residents without access to Medicaid or reduced-cost coverage options.

One difference between those groups is the children within a household. Children in a household making less than 200% of the federal poverty level qualify for Medicaid of the Children's Health Insurance Plan. Households above the 200% federal poverty level do not qualify to have their children enrolled.

Currently in Wyoming, a single-person household making $14,000 a year would have access to the same plans at the same cost as one making $140,000 in the healthcare exchange. And those plans are hundreds of dollars every month for just one person, based on research done by the Star-Tribune.

"And I think that's really what we're going to be, you know, wrestling with as a task force is what's the role of the government, what's the role of the legislature, what's the role of the state in addressing either one of these two boxes that you hear constituent complaints or or community complaints on," Johansson said.

Where the task force goes next

The task force has only three more working days scheduled to address the problem they set out to solve. They will meet again on Aug. 14.

In the meantime, Nethercott and Larsen will review decade-old legislation related to privately billing detained individuals.

"My hesitation is it's going to open up the door to a conversation that this committee is not designed to do, which is a lot to do with the underserved population, county costs, emergency mental health services," Nethercott said. "Not the committee's purpose, but it does go to some of the testimony we heard."

While the task force cannot sponsor legislation, it will forward its final recommendations to a standing committee for sponsorship.

The task force voted in favor of seeing a bill draft to repeal the grandfather provision in a non-compete bill passed in 2025.

Nethercott also requested a list of items hospitals and other health care facilities purchase, so the task force can explore creating a statewide group purchasing organization to negotiate lower prices through bulk buying.

She also directed the Legislative Service Office to review reinsurance programs in Idaho, Colorado and Montana and report on how they operate.

"This topic is an elephant and we are taking very small bites at it, and that's all we're probably going to be able to do," Nethercott said.

Allison Allsop is the education and health reporter for the Casper StarTribune. She can be reached at 307266-0544 or [email protected].