SHERIDAN — Health insurance can be confusing. What’s a premium? What’s the difference between deductibles? Sheridan Memorial Hospital’s health talk about open insurance enrollment sought to answer these questions for Sheridan residents, patient accounts manager Cheryl Relaford said.

The open enrollment talk offered an opportunity for people to receive assistance navigating the complex process of finding affordable health insurance and determine if they qualify for subsidies, Relaford said. Open enrollment lasts until Dec. 15.

Certified application counselors were there to help each applicant understand HealthCare.gov and ask questions to make the best informed decision possible, she said.

U.S. Census Bureau data from 2018 showed an increase in the rate of uninsured Americans for the first time since the Affordable Care Act was enacted in 2010 — especially among children.

From 2017 to 2018, Wyoming was one of a few states that saw a slight decrease in the rate of uninsured people, while still holding the sixth highest rate of uninsured people in the nation, according to health insurance and health reform authority Louise Norris, who writes for healthinsurance.org.

Across the U.S., the number of people without health insurance increased by about two million from 2017 to 2018, while the official poverty rate decreased 0.5 percentage points and the median household income remained the same.

Relaford said the cost of uninsured people can spread throughout communities. As the cost of health care increases and the economy struggles in many industries in Wyoming, employers are passing the cost of high premiums onto their employees, she said.

“There’s a lot of businesses here locally that don’t even offer health insurance to employees, so they have great jobs but they just don’t have that health insurance that they would like to have to give them — their family — that financial protection.”

Health care is a concern that weighs on individuals and families, Relaford said. Many fail to access preventative care over concern for the cost, but early detection for many health issues is likely to lower the overall cost of care, she said. Having health insurance supports accessing primary care and early detection.

A low population and rural nature contribute to high health insurance premiums in Wyoming, making coverage unaffordable for some who don’t qualify for subsidies, according to Norris.  Before applying income-based subsidies per the Affordable Care Act, Wyoming’s premiums are the highest in the nation. Many people living at or below the poverty line aren’t eligible for subsidies, leaving a wide gap in coverage.

“If you don’t have any income you may not qualify,” Relaford said. “So [in that case] we try and enroll you in Wyoming Medicaid or seek other assistance for you.”

Sheridan Memorial Hospital is losing money on self-pay patients without health insurance, Relaford said. Patients who don’t receive regular care for their conditions through primary care doctors can heavily impact their own health and the hospital down the road.

“It’s a really burden for the whole community because we provide services, we don’t get paid, it also puts a struggle on that patient because you have a large health [bill]…and it’s financially straining you.”

It’s far more expensive to provide care through an emergency room for the patient and the hospital, she said.

The benefit of obtaining health insurance is the reassurance that if something goes wrong, a family is covered and protected, Relaford said. Individuals can access preventative care without worrying about health issues that may become more challenging — and expensive — in the future.

Premiums through Wyoming’s only insurer offering plans in the state health insurance exchange, Blue Cross Blue Shield, dropped slightly this year, compared to the previous year when they nearly doubled, according to Norris.

U.S. lawmakers have generally opposed the Affordable Care Act and Medicaid expansion. Rep. Liz Cheney, R-Wyoming, Sen. Mike Enzi, R-Wyoming and Sen. John Barrasso, R-Wyoming all voted in favor of legislation to repeal the ACA in 2017.

Many argued in 2018 that the decision to deny more than $500 million in federal funding to expand Medicaid led to a substantial slow-down in reducing the number of uninsured people in the state.

Still, enrollment through the exchange reached a statewide high in 2019, despite the Trump Administration’s elimination of the ACA mandate penalty last year and funding cuts to HealthCare.gov enrollment assistance, according to Norris.

Support systems to navigate enrollment help to provide an avenue for families to achieve peace of mind with affordable health insurance, Relaford said.