State Spotlight: Insurance companies denying treatments for patients in Wyoming
We’re launching our state spotlight series. This week, we’ll be exploring the challenges facing patients across the country.
Our policy director and co-founder Jonathan Wilcox kicks off the conversation with a focus on the Cowboy State. He writes in the Casper Star-Tribune that Wyoming’s health care “system has effectively turned patients into expenditures on a spreadsheet” where “many patients forgo the fight for the medications prescribed by their doctor and submit to insurer decision in favor of a less-expensive, often less-effective medication.”
“Wyomingites are paying their premiums, but when a medical necessity arises, their insurers are saying no,” Wilcox explains. “Despite doctors prescribing medications they believe will attain the best outcome for their patients, health insurers have exercised their authority over these assessments and are rejecting much-needed medications.”
What Patients in Wyoming Think about Health Care
A recent nationwide study by the Partnership to Fight Chronic Disease found the challenges facing patients in Wyoming:
- 88 percent of Wyomingites say it’s somewhat or very important for health plans to disclose how often and why they decide to deny coverage of doctor-prescribed treatments.
- 33 percent of Wyomingites say their health insurance coverage is getting worse.
- 47 percent of Wyomingites have seen their health care costs increase.
- 20 percent of Wyomingites said the treatment their doctor recommended was not covered by insurance.
Wyoming Patients Face Marketplace Health Care Monopoly
Wyoming patients face fewer health care choices and high premiums.
“Wyoming’s insurance prices are typically among the highest in the country,” says Wyoming Public Media. That’s the result of decreased competition. Blue Cross Blue Shield is the only health insurance company that provides coverage to patients through the federal marketplace.
The Urban Institute’s 2014 analysis of health insurance premiums found that more competitive markets tended to have lower premiums.
“It’s important to have competition in the exchange markets, both to have consumer choice and to keep premiums competitive,” Caroline Pearson, a senior vice president at Avalere Health, told the New York Times earlier this year.
2017 Insurance Rate Hikes: 8 Percent
The Wyoming Tribune Eagle reports that “the cost of health insurance premiums for Wyoming residents who are insured through the Affordable Care Act will increase by an average of 7 to 8 percent next year.”
An estimated 24,000 people are enrolled in health insurance through Wyoming’s insurance marketplace. In 2017, state health officials are seeking to enroll another 20,000 to 23,000 Wyoming residents.
