SHERIDAN — While every other state in the union has seen a decrease in the number of uninsured residents since 2013, Wyoming’s uninsured rate has increased 1.6 percent.
That statistic comes from a recent Gallup survey, which measured the number people who had health insurance throughout 2013 compared to the number of people who had insurance through the first half of 2015.
This data is based on Americans’ answers to the question, “Do you have health insurance coverage?”
According to the survey, in states where Medicaid expansion and a state exchange were implemented the uninsured rate went down 44 percent.
States with only one or neither of those changes implemented saw an average uninsured rate decrease of 28 percent.
Wyoming is one of 19 states in the union that haven’t adopted Medicaid expansion; the Gallup numbers point to this being the reason Wyoming’s uninsured rate hasn’t decreased like states that have expanded Medicaid.
Wendy Ongaro, executive director of the Sheridan Health Center, said there’s a problem in Wyoming of having a need for health care.
“We’re really not seeing the benefits a lot of other states are,” Ongaro said.
Ongaro said this is the case for two reasons. The first is that the Affordable Care Act isn’t seen as affordable to the state Legislature. The second is a result of the first; because of the Legislature’s inaction, nothing is getting better.
State Sen. Dave Kinskey, R-Sheridan, said he and his colleagues didn’t vote in favor of Medicaid expansion because the system was wrong for Wyoming.
This is because the cost of medical coverage is determined by population size and the age of the average user. If there’s a large population and the average age is young then premiums aren’t very expensive. But, the legislators said Wyoming’s older population and small user base would create a system that costs too much, so they are waiting for something to change.
But waiting isn’t a game seriously ill people can play.
“They’re still having car accidents, and having heart attacks, and ending up in the hospital,” Ongaro said.
Ongaro said she sees cases where people are so sick that they can’t work, and she sees them frequently enough that they create an issue.
“These are people who have been hanging out for 15 or 20 years without health insurance,” Ongaro said.
In her mind, if those people could get health coverage they would go back to work and pay their way, instead of relying on government funding.
But legislators don’t see the benefit.
“Of course it’s significant, but at what cost?” Kinskey said. “There’s just no end of the need to take care of the programs we have now.”
Susan Novak, director of financial services at Sheridan Memorial Hospital, said the shift hasn’t left any obvious impression on the hospital.
“I am currently not seeing any shift in the dollars or number of uninsured people we are caring for from the financial side,” Novak said.
But the number of Wyoming who are uninsured went from 16.6 percent to 18.2 percent.
However, this survey data does have a standard of error in Wyoming of plus or minus 4 percent. That means the number of uninsured people in Wyoming is between 14.2 and 22.2 percent of the population.
Wyoming is either holding steady or slipping toward more uninsured residents.
To go along with that, Novak said, an increase in the number of uninsured people in the state could end up costing the hospital — but it isn’t the only possible result.
“It depends, depends on if the uninsured people access our health care systems,” Novak said. “If they do, then we have more self-pay. Not all self-pay are without resources and apply for Medical (and/or) Community Assistance. Some choose not to be uninsured or have a high deductible and they pay their bills.”
Still, the number of uninsured people isn’t decreasing.
Other states are within that margin of error as well but the survey said Wyoming has the second largest rate, after Texas, of people who are uninsured.
And Texas saw it’s uninsured rate drop from 27 percent to 20.8 percent. This happened even though Texas didn’t accept the national Medicaid expansion plan.
Similar to Texas, Kinskey said Wyoming isn’t planning to accept the Affordable Care Act plan. Instead, the state will wait for something that’s “right for Wyoming.”
“In the states that have voted in (Medicaid) expansion, the costs have come in higher than expected,” Kinskey said.
State Rep. Elaine Harvey, R-Lovell, is the chairman of the Labor, Health and Social Services committee, which oversaw bills for Medicaid expansion during the 2015 session. Earlier this year, she said it’s unlikely another health care expansion plan will even be considered in the Legislature’s 2016 session.
“Even if oil were not in the dumper, even if gas weren’t down, even if coal wasn’t under fire, I would still be worried about any Medicaid expansion,” Kinskey said.