Wyoming Health Insurance 2026

Wyoming has the smallest ACA marketplace in the country — only 5–12 plans available statewide — and consistently posts the highest average Silver premiums in the nation, with a 40-year-old facing costs of $640–$685/month before subsidies. BCBS Wyoming is effectively the only major carrier across most of the state, with Mountain Health CO-OP providing limited competition in some areas. Wyoming's tiny population, vast geography, and aging demographic create a challenging risk pool with limited insurer incentives to participate. Many counties have effectively one carrier choice. Wyoming uses Healthcare.gov for marketplace enrollment.

Wyoming has not expanded Medicaid and is unique in that it lacks a viable ballot initiative pathway to bypass the legislature, making it more difficult for advocates to pursue expansion without legislative action. The Republican supermajority legislature has consistently blocked expansion. Wyoming's Medicaid program covers primarily children, pregnant women, and severely disabled individuals. An estimated 25,000–30,000 Wyoming adults fall in the coverage gap. Wyoming has the smallest absolute coverage gap of any non-expansion state simply because its population is so small, but proportionally it has one of the highest uninsured rates in the Mountain West.