Highlight on Wyoming: Rankings Down but Enrollment are up; are Hopes High in the Cowboy State?

 

While Wyoming typically maintains a place in the middle of the pack in terms of health statistics when compared to other states, in 2014 the state saw a significant drop in rankings. According to the 2014 America’s Health Rankings, Wyoming slid from 17th best in 2013 to 25th in 2014. Yet, early reports regarding enrollment of Wyoming residents on the federal Health Insurance Exchange indicate that significant numbers of residents in that state are enrolling in coverage during the second annual open enrollment period. Moreover, although Wyoming has thus far rejected expanding Medicaid coverage to residents under the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148), some sources are predicting that may change in 2015.

Health Rankings

America’s Health Rankings publishes an annual report that, according to the organization, analyzes “the health of the nation holistically, with in-depth data and analysis.” Specifically, the reports provide health information state-by-state using an approach that measures the prevalence of certain factors in each jurisdiction, such as: (1) cardiovascular deaths; (2) infant mortality; (3) diabetes diagnoses; (4) preventable hospitalizations; (5) premature death; (6) air pollution; (7) primary care physicians; (8) adolescent immunizations; (9) obesity; and (10) physical activity. The report then organizes this data in order to determine which factors have a positive or negative impact on overall health and assigns the state a ranking. In 2014, Mississippi was rated last among all the states, while Hawaii was deemed the healthiest state.

In terms of the health of Wyoming in 2014, the report indicated the state’s strengths in terms of health were: (1) a low violent crime rate; (2) a low percentage of poverty among children; and (3) low levels of air pollution. On the other hand, the report noted a negative health impact stemming from such factors as high occupational fatality rates, high prevalence of low birth weights, and limited availability of primary care physicians. While the study acknowledged that smoking in Wyoming decreased by 10 percent in the past two years in the state, it also highlighted the fact that obesity among adult Wyoming residents increased by 13 percent in the last year alone.

Enrollment numbers

While the annual rankings evidenced the reduction in health status of many residents of and conditions in the state, it appears the amount of Wyomingites gaining health care coverage is increasing thanks to the ACA. In particular, a recent report released by HHS found that 9,020 individuals in Wyoming signed up for coverage on HealthCare.gov during the second open enrollment period thus far. Further, the report indicated that 49 percent of these individuals are new enrollees while the remaining amounts are returning customers to the federal Health Insurance Marketplace.

Medicaid expansion

Besides enrollment in health care coverage, the ACA may have implications for the health or at least health care coverage options for a portion of the Wyoming population if the state elects to expand Medicaid under the law. While Wyoming has failed to opt for the expansion in the past, recent actions indicate that Medicaid expansion may come to fruition in the state in the near future. Late in 2014, Governor Matt Mead announced a plan that would provide coverage to approximately 18,000 Wyoming residents through the Medicaid program. As a part of that plan, however, certain covered individuals would have to chip in for their coverage as those earning between 100 and 138 percent of the federal poverty level would be required to pay monthly premiums that would range from $20 to $50 per month. This plan, also known as the SHARE plan, was rejected in legislative committee in favor of an alternative expansion plan proposed by State Senator Charlie Scott (R-Casper). While the SHARE plan failed at the committee level sources indicate it could return later in the session. The alternative expansion plan would require workforce requirements for enrollees and would rely on the existence and funding of personal health savings accounts.

While it is unclear as to how Wyoming will expand Medicaid, it appears to be on the horizon for the Cowboy State. As to how that, or other options for expanded coverage for Wyoming residents through the Marketplace and its subsidies, will affect the overall health of the state remains to be seen.