Sticker shock? Wyomingites could see skyrocketing bills on ACA health insurance marketplace

When the Affordable Care Act marketplace, where roughly 42,000 Wyoming residents get their health insurance, opened enrollment Saturday, customers likely faced a double whammy: higher prices and fewer resources.

The landscape looks different this year between federal changes to the marketplace's administration and the ongoing government shutdown — caused in part by a deadlock over ACA tax credits designed to make insurance cheaper for consumers.

As things stand, consumers are generally experiencing less help in navigating the system, seeing higher premium costs for plans and facing new reporting requirements. In some cases, people could find their health insurance costs spiking by thousands or even tens of thousands of dollars annually.

Wyomingites have two months to shop for a plan before open enrollment closes Jan. 15. WyoFile reached out to experts and gathered information and tips for residents to keep in mind through the process:

Costs may rise drastically

The Affordable Care Act marketplace is available to people who don't qualify for Medicaid and don't have insurance through an employer.

Open enrollment is the annual window when individuals and families can sign up for health insurance through the ACA, adjust their plans or cancel coverage.

Price jumps aren't uncommon as insurers do raise premiums over time, but this year those increases will be larger due to the expiration of some enhanced premium tax credits.

"Health insurance has always been and continues to be very, very expensive," said Sabrina Corlette, a research professor with Georgetown's Center on Health Insurance Reforms. "But going into 2026, it's only going to get more expensive."

The tax credits were created in 2021 to essentially lower monthly out-of-pocket costs for ACA consumers, in some cases, all the way to $0. Congress did not extend them in the One Big Beautiful Bill in July, and an attempt to extend them now is one of the factors driving the government shutdown.

The average ACA marketplace consumer will likely pay about 100% more for coverage in 2026, according to a fact sheet from the Robert Wood Johnson Foundation.

In Wyoming, the impacts will vary depending on income, demographics and other factors. According to Healthy Wyoming, a 60-year-old couple with an annual income of $82,000 will face an increase of $37,422 in annual health care costs due to the tax credit loss. The premium increase for a 45-year-old who earns $62,000 annually could be upwards of $6,000.

Less help, more paperwork

In the past, health "navigators" — professionals who guide customers through what can be a confusing open enrollment process — have been available largely thanks to federal funds. The U.S. Department of Health and Human Services, however, slashed that funding by 90% this year.

As a result, Enroll Wyoming, which offered free navigator help to those looking for insurance, experienced a significant budget cut. Despite paring down its staff from 10 individuals to just one full-time and one part-time employee, Enroll Wyoming will still offer services.

"Enroll Wyoming stresses that it will be still around to educate and empower consumers," reads an August press release. Consumers can learn more about accessing those services here.

The nonprofit will have more emphasis on online and phone communication in its new iteration, the release says. "At the same time, Enroll Wyoming is building a statewide network of partners to provide more referral support."

Consumers will also have fewer options. Mountain Health Co-op announced in August that it will no longer offer health plans in Wyoming at the end of the year. That means Wyoming will be down to just two providers.

Finally, people should brace for more paperwork, Corlette said. That can include filing extra forms or submitting paperwork to reflect any changes in income.

Stay informed, don't rush

Enrollment opened Saturday. To get coverage starting Jan. 1, consumers must enroll in a plan by Dec. 15. If they enroll between Dec. 15 and the closing date of Jan. 15, coverage will start Feb. 1. If people are already enrolled and do nothing, they will be automatically re-enrolled in their plans.

The ACA marketplace only opened up what's called "window shopping" two days before enrollment began, Corlette said, which means that it's been hard for customers to suss out their new options.

"Also, the federal government told insurance companies that for this year only, they don't have to include premium information in the notices that they send to consumers, which usually go out in October," she added. That could further veil price changes.

"I can imagine some people will be taken by surprise," she said. "This will be a uniquely challenging year."

So what can people do?

First, Corlette said, they can contact their members of Congress to urge them to find more affordable solutions and let them know "the delay is not helping anyone."

Next, she said, they should stay informed. "If you see your premium is unaffordable, don't lose hope. There is still a chance that Congress will strike a deal here and provide premium relief."

Folks can hold off until Dec. 15, Corlette noted; they don't have to rush into anything.

If they do decide to leave the marketplace and look elsewhere, Corlette said, they should have caution.

"There's a lot of junk out there and a lot of aggressive marketing, so just be careful," she said, adding that using a local insurance broker who can meet in person is generally a good way to help sort the quality plans from those that don't offer much financial protection.

What Corlette fears at this point is that "a lot of people will check their accounts, see their premium, get sticker shock, and say, 'I can't afford this,' and walk away.

"And once they walk away, it's really, really hard to get them to come back," she said. "I think there's still time for Congress to act, but probably too late to be sure that everybody stays insured."

If people opt out of marketplace insurance, it would likely trigger even more cost increases. According to BlueCrossBlueShield Wyoming, when healthier people leave the marketplace, those who remain often require more care. That drives up costs for everyone.