By Seth Klamann

Casper Star-Tribune

Via Wyoming News Exchange

CASPER — Nearly 25,000 Wyomingites have signed up for health care on the federal exchanges as of Dec. 15, a slight increase from last year, even as the Affordable Care Act faces a new wave of uncertainty. 

Open enrollment closed last week, with 24,937 Wyomingites signed up via the exchange. That was a slight jump from last December’s 24,889. Dennis Delpizzo, a spokesman for the Centers for Medicare and Medicaid Services, said a final enrollment snapshot will be released next week but that those numbers should “closely reflect” the Dec. 15 figures. 

Nationwide, enrollment figures dropped about 300,000 over the past year, from 8.8 million to 8.5 million, according to a CMS press release. The agency attributed part of the decline to low levels of unemployment and that “90 percent of U.S. workers are employed by a firm that offers health benefits to at least some of its workers.” 

Premium rates had spiked dramatically in 2017 for exchange plans offered by Blue Cross Blue Shield, Wyoming’s sole provider on the federal marketplace. They remained fairly stable this year. Blue Cross Blue Shield vice president and spokeswoman Wendy Curran told the Star-Tribune last month that the insurance giant had hiked rates last year because of uncertainty and executive action taken in Washington, D.C. — moves that were absent this year. 

Enrollment wrapped up in 2018 in an even more perilous position than it had the year before, after Congress and President Donald Trump spent several months in spring and summer 2017 working to unravel the Affordable Care Act, through which the exchanges are run. While that work was largely missing from a contentious election year, a federal judge issued a sweeping decision last week that ruled the entirety of the ACA, often referred to as Obamacare, was unconstitutional. 

The judge, Texan Reed O’Connor, found that because the individual mandate had essentially been gutted by the tax reform bill passed in late 2017, the entire bill — which he said was inextricably tied to the mandate — was unconstitutional. 

However, O’Connor did not issue an injunction against the ACA, so it remains in place and all of its provisions — including the exchanges — continue to function. 

The ruling is widely predicted to end in a Supreme Court showdown, as several attorneys general from states like California have already appealed the decision. 

In the Equality State, the exchanges had a strong year in 2017 despite budget cuts to the state’s navigator program, which provided help to Wyomingites trying to enroll. This year’s numbers seem to have surpassed, albeit by just a hundred or so enrollees, last year’s gains. 

Monica Jennings Woodard, who is a navigator at Cheyenne Regional Medical Center, told the Star-Tribune last month that budget cuts affected how much time navigators can spend in rural areas of the state.