\u201cIt\u2019s pretty terrifying,\u201d Eranow said.\u00a0<\/p>\n
Not all patients are experiencing such dramatic rises; costs depend on factors like age and annual income. But health care advocates worry that sticker shock will cause consumers to either find private plans with cheap price tags but lousy coverage or abandon insurance altogether.\u00a0<\/p>\n
![\"\"](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2025\/11\/ACApremiumMap.png\")
This graph from KFF Health News shows average monthly premium cost increases of Affordable Care Act health insurance plans for a 60-year-old individual earning roughly $63,000 a year. With a jump of 421%, Wyoming has the largest increase. (KFF Health News) <\/p>\n
\u201cI think that we\u2019re going to see a lot of people just not buy insurance and take the gamble that if something happens, they\u2019ll be able to figure out how to pay it off through the hospital,\u201d said Jenn Lowe, executive director of Healthy Wyoming, which advocates for affordable health care.\u00a0<\/p>\n
The consequences, Lowe thinks, will be more medical debt, more uncompensated care in hospitals, increasing insurance costs for everyone, rising health issues due to patients avoiding preventative care and higher stress \u2014 which also leads to worse health outcomes.\u00a0<\/p>\n
\u201cAll of this should be very concerning to health care consumers in the state,\u201d she said. \u201cNow that the expiring tax credits are coming and people are seeing in real time what the increase in costs are going to be, I think a little bit of reality is hitting\u00a0 that we have some of the most expensive [health] insurance in the nation.\u201d\u00a0<\/p>\n
The how and why\u00a0<\/p>\n
The Affordable Care Act marketplace, created in 2010, is available to people who don\u2019t qualify for Medicaid and don\u2019t have insurance through an employer.\u00a0<\/p>\n
In 2020, Congress created the Enhanced Premium Tax Credit during the COVID-19 pandemic to make marketplace insurance more affordable. That program provided subsidies that drastically reduced premium costs. For some low-income customers, monthly premiums went to $0.\u00a0\u00a0<\/p>\n
The program helped contribute to an all-time low in America\u2019s uninsured rate, health advocates say. But they were not cheap \u2014 and fiscal conservatives argued they were unsustainable. Congress extended the credits in 2022, but did not extend them again this year. A deadlock over the tax credits played a significant role in the recent government shutdown.\u00a0<\/p>\n
Expansion would have a $212 billion deficit impact on government spending over 10 years, according to a 2020 estimate from the Congressional Budget Office.<\/a><\/p>\n Ultimately, Congress struck a deal that did not include an extension. With the enrollment period opening Nov. 1, patients have only recently been able to log in to the system to see what their new plan options are. Open enrollment is the annual window when individuals and families can sign up for ACA health insurance, adjust plans or cancel coverage.\u00a0<\/p>\n Insurance companies increased baseline plan costs this year. With the subsidy changes factored in, some became exponentially pricier. In addition, Mountain Health Co-op stopped offering health plans in Wyoming. That means the state is down to just two providers.\u00a0<\/p>\n Lowe\u2019s organization has been holding forums around the state this fall to help educate patients about the changes. The most recent one, held last week in Casper, had the biggest attendance so far. She attributed that to people actually seeing what their increases will be.<\/p>\n \u201cI heard from people who are having to make decisions about paying for rent, paying for food and being able to pay for their insurance,\u201d Lowe said. \u201cIt\u2019s definitely kind of scary times.\u201d<\/p>\n Navigating\u00a0<\/p>\n The Lander Free Medical Clinic has also been hearing from patients it formerly helped set up with ACA plans. Audrey Zanetti, a medical assistant who supervises the clinic, brought up one who was on a $0 premium plan.<\/p>\n \u201cIt was going to auto-renew to a similar plan,\u201d Zanetti said. Except that the new premium would have climbed from $0 to $650. That equates to about 40% of the person\u2019s monthly income \u2014 and it doesn\u2019t include co-pay and deductible costs.\u00a0<\/p>\n \u201cAnd so if that individual hadn\u2019t come in, they would have been locked into that plan, it would have autorenewed,\u201d she said. \u201cThey would have seen the bill come January or February, and would have said, \u2018I can\u2019t afford that.\u2019 They would have cancelled the plan, and then not been eligible [to re-enroll] because they\u2019re outside of open enrollment.\u201d<\/p>\n Health insurance is complicated, and the auto-renewal caveat is not a detail everyone is aware of.\u00a0<\/p>\n In the past, health \u201cnavigators\u201d \u2014 trained professionals who guide customers through the open enrollment process \u2014 have been available largely thanks to federal funds. The U.S. Department of Health and Human Services slashed that funding by 90% this year.<\/p>\n As a result, Enroll Wyoming, which offered free help to those seeking insurance, cut its staff from 10 people to just one full-time and one part-time employee.<\/p>\n To make up for some of the loss, the program has established a statewide network of organizations with health counselor training.\u00a0<\/p>\n \u201cWe wanted to set up a system where people could still get help,\u201d said Enroll Wyoming Navigator Katelyn Befus. \u201cWe brought in the organizations and partners that we\u2019ve been working with for years, and leaned on them a little bit to become certified.\u201d<\/p>\n The Lander Free Medical Clinic is one of those places; VISTA Volunteer Stephanie Kohm recently completed the training. It is also holding free community sessions.\u00a0<\/p>\n As Enroll Wyoming\u2019s only full-time navigator, Befus is \u201cextremely\u201d busy, she said. \u201cI\u2019m literally completely booked for appointments all the way through the first half of enrollment. So that would be all the way through Dec. 15.\u201d<\/p>\n Befus has heard some frustrations from customers about prices going up. She\u2019s done a lot of explaining about how the tax credits were designed to sunset, she said, and people are generally understanding.<\/p>\n However, Befus said, households that earn over 400% of the federal poverty level \u2014\u00a0$62,600 for a one-person household \u2014 are getting hit hard.<\/p>\n \u201cThey\u2019re looking at extremely high premiums,\u201d she said, like in the neighborhood of $5,000 a month for a four-person household.\u00a0<\/p>\n \u201cSo we\u2019ve been having to recommend outside insurance to people over that 400% because for a lot of them, they just can\u2019t afford that much money,\u201d Befus said.\u00a0<\/p>\n Guidance and deadlines\u00a0<\/p>\n The deadline to enroll in an ACA marketplace plan starting Jan. 1 is Dec. 15. If customers enroll between Dec. 15 and the closing date of Jan. 15, coverage will start Feb. 1.\u00a0<\/p>\n Experts urge people to be deliberate.\u00a0<\/p>\n \u201cI really encourage people to go to the [Healthcare.gov] website and use the \u2018browse plans and prices\u2019 tool to see what their expected tax credit and premium is before they jump in,\u201d Befus said.\u00a0<\/p>\n Those who do not want to continue ACA policies need to be careful they don\u2019t auto-renew, she added. And for people exploring private insurance, she recommends calling insurance companies directly and fully understanding plan provisions before purchasing.\u00a0<\/p>\n Befus stressed caution in shopping online. \u201cThere are a ton of fake and scammer websites out there,\u201d Befus said.\u00a0<\/p>\n A different solution?\u00a0<\/p>\n Another thing people can do, Lowe said, is \u201cCall your federal delegates and let them know that this is impacting you personally.\u201d<\/p>\n In the tax credit stalemate this fall, Republicans were generally against extension while Democrats were in favor. Wyoming\u2019s U.S. Sen. John Barrasso, a retired physician, told NBC\u2019s Meet the Press that Obamacare is a failed measure<\/a> and Republicans want to replace it with something that works to actually lower costs.<\/p>\n \u201cI\u2019ve always wanted people to get the care they need, from a doctor that they choose, at a price they can afford \u2014 and Obamacare basically destroyed that possibility,\u201d Barrasso said. \u201cWe cannot just continue to subsidize a failing plan, which is causing more and more costs and hardship around the country.\u201d<\/p>\n It\u2019s easy to criticize Obamacare, Lowe said. What\u2019s harder is coming up with a better solution.\u00a0<\/p>\n \u201cRepublicans committed to talking about health care insurance once the government reopened,\u201d she said. \u201cWell, guess what? The government is reopened. Let\u2019s talk about health care insurance. You guys don\u2019t want the marketplace. How are you going to be able to provide health care insurance to the people of Wyoming?\u201d<\/p>\n![\"\"](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2025\/11\/HealthCostPanel.jpg\")
Healthy Wyoming Executive Director Jenn Lowe discusses health care access issues during a forum Sept. 4, 2025 in Lander. (Katie Klingsporn\/WyoFile)<\/p>\n![\"\"](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2025\/11\/InsuranceBill.jpeg\")
A customer looks over an insurance benefit statement. (Katie Klingsporn\/WyoFile) <\/p>\n![\"\"](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2025\/11\/DSC03622.jpg\")
Sen. John Barrasso (R-Wyoming) speaks to a constituent during an event for the state GOP Convention in Sheridan on May 6, 2022. (Maggie Mullen\/WyoFile)<\/p>\n