• More people lost the government health coverage than maintained it as the state re-analyzes who still qualifies following steady pandemic-era enrollment.

By Madelyn Beck, WyoFile.com

New estimates show that more than 10,000 people have lost Medicaid or Kid Care CHIP coverage since the start of a Wyoming eligibility review and removal process in April. 

That’s compared to about 9,000 who’s coverage was renewed for the government programs.

While about 600 of those removed no longer qualify, the Wyoming Department of Health writes, more than 10,000 lost coverage for “procedural reasons.” Those reasons could include not returning or not completing forms.

Three quarters of those procedural terminations involved children, according to the health department, noting that caretakers and providers play an important role in updating addresses and looking out for Medicaid and Kid Care notices.

The lost coverage could put more pressure on hospitals — many of which have been struggling financially since the pandemic — as well as other providers who work directly with the uninsured.  

The state initially estimated between 10,000 and 15,000 people would lose coverage during this process. Being only four months into a full year of review, the disenrollments could easily surpass that, if not balloon multiple times higher.

“Average monthly enrollment in Wyoming Medicaid before the pandemic was around 55,000,” said Medicaid agent and health department administrator Lee Grossman in a press release. “Because eligibility could not be reviewed until recently, this year it’s reached a historic high of about 87,000. It is not unreasonable to expect enrollment to return much closer to the range we saw before the pandemic.”

This review is something that used to happen annually as the state checked back with Medicaid and Kid Care recipients to ensure they were still eligible. That process came to a halt in 2020 as the federal government requested states maintain enrollment during the pandemic in exchange for more funding. The annual renewal process is required by federal regulations, per the Wyoming Health Department. 

Clinics and hospitals

Patients losing coverage will have a “big impact” on the state’s hospital system and those who rely on it, said Wyoming Hospital Association President Eric Boley. 

His first concern was about the uninsured not getting appropriate, regular and preventative care, he said. Beyond that, he said pandemic strains left hospitals with shaky finances. Recovery has been hard for smaller facilities with fewer patients. 

“Most of our hospitals are struggling to a certain degree,” he said. “Our critical access hospitals, many of them are still really, really struggling.”

Treating more people who can’t pay will only add to that challenge, he added, and could contribute to hospitals already considering cutting services like OB-GYN, surgeries, home health care and nursing homes.  

“I mean, the system [as a] whole right now is really in turmoil,” he said. “And in our state, it seems to be exacerbated just because of volume and distances. You know, it’s really hard to create economies of scale and to create the volume that’s necessary to support a lot of these services.”

Already, very few facilities offer dialysis in Wyoming for that very reason, he says. 

Facilities working specifically with the uninsured like the Downtown Clinic in Laramie will likely be affected, too, according to the clinic’s executive director Pete Gosar. 

“We’re going to see increases from this,” he said. “Rental assistance ended [too], and so people are just in tougher positions, just by and large overall.”

Gosar noted that costs of having more uninsured people in Wyoming are passed on to everyone else. 

“To pay for that, we raise the cost of services [for] people who can pay, which raises the insurance rates for everybody in Wyoming,” he said. “And so, this does have an impact to everybody in Wyoming.”

Gosar advocates for Medicaid expansion in Wyoming, which the state estimates could cover an additional 19,000 residents.

Boley with the hospital association hopes that some of those who’ve lost coverage are still able to regain it, he said.

“It’s unfortunate that folks are losing out on that opportunity to continue their coverage, and I’m sure there’s a million different reasons why,” he said. “But I hope [health department employees] continue to work with those that haven’t gotten their paperwork back in and find other ways to maybe help them with that so that numbers aren’t as bad as they appear.”

How to regain/retain coverage

Eligibility for Medicaid in Wyoming can be complicated: It doesn’t just rely on someone’s income, but is also based on categories like age or health status. 

There are also special waivers within Wyoming Medicaid that conform to different rules. Those serve people who are older than 65, those with a qualifying disability or people with a brain injury. Even people with these waivers must return forms to continue getting coverage. 

For those who have lost coverage due to “procedural” reasons, the good news is if they can get their paperwork in and re-enroll within 90 days, they can get retroactive coverage for that time, according to the health department. 

Not everyone has received their notices to review their Medicaid or Kid Care CHIP coverage yet, but for those who have, they can update contact information or go through the renewal process online at www.wesystem.wyo.gov or by calling 1-855-294-2127.

There is also the option of looking at other insurance options at enrollwyo.org or work with an insurance navigator, some of which are embedded in larger Wyoming hospitals.

WyoFile is an independent nonprofit news organization focused on Wyoming people, places and policy.