Locals face tough choices as insurance premiums soar
BUFFALO — Buffalo’s Lara Schuman is losing sleep as the Dec. 31 deadline looms for Congress to extend enhanced tax credits that made health insurance more affordable.
Schuman owns and operates Heartland Tree Care with her husband Paul. The small business owners have purchased health insurance through the federal marketplace for years, but without the enhanced tax credits that made the insurance affordable for the couple, Lara said the family is facing the very real likelihood of going without health insurance next year.
“When the marketplace opened Nov. 1, I was on there first thing in the morning, and I was just horrified,” Schuman said. “I figured for sure we’d have to switch plans, and we’d be paying a lot of money for a crappy, high-deductible plan, but that we’d have something. But then I quickly realized, we no longer will qualify for any of those tax credits or subsidies. So that means the cheapest plan available to us is $2,900 a month. That’s way more than our mortgage. There’s
just no way.”
The Schumans are among the roughly 42,000 Wyomingites who buy health insurance plans on the Affordable Care Act marketplace.
Many of those 42,000 are seeing higher premiums during this season’s open enrollment as carriers in the state have raised their rates and enhanced tax credits that made health insurance more affordable are set to expire on Dec. 31.
Self-employed, small business owners take a hit
Buffalo’s Dr. Aubrey Dozier Tabb and his wife Nancy Tabb purchased health insurance from Blue Cross Blue Shield on the federal marketplace this year. Dozier is an independent contractor and Nancy works part time at the library, so neither can get insurance through an employer. The couple, who are in their early 60s, expected their premiums to increase for 2026 but were shocked when they learned their premiums were increasing six-fold.
“They (Blue Cross Blue Shield) did tell us in November that we would have to re-evaluate, and to expect it would be different than what we have,” Nancy Tabb said. “What we had gotten originally was very affordable and very good coverage. This hurts.”
Dozier Tabb said that the couple will pay almost $120 a day for a Blue Cross Blue Shield plan in 2026.
“It’s a sensitive subject, because it does interfere with your future,” Dozier Tabb said. “But it’s also a necessity, just like drinking water. So we have to have something, and right now, since it’s a limited time, we chose to go with good coverage.”
The Affordable Care Act marketplaces opened for enrollment on Nov. 1, with the average premium for a mid-level insurance plan in Wyoming increasing by 75%, according to KFF, formerly the nonprofit Kaiser Family Foundation, a nonpartisan health policy organization.
But for some consumers, particularly people in their 60s who are not yet Medicare-eligible and those earning over 400% of the federal poverty limit, the price hike was even steeper.
The fight over extending the enhanced tax credits was at the heart of the federal government shutdown in October, and Senate Democrats say they will force a vote on extending the tax credits this week.
“This year, with the expiration of the enhanced tax credits that were put in place during COVID, we are seeing really, really big increases in out-of-pocket premiums, depending on where people are on that income scale,” said Katie Befus, Enroll WYO navigator.
Befus said that many people who still qualify for some subsidies – those who make less than 400% of the federal poverty level or around $62,600 for a single person and $128,600 for a family of four – are considering policies with a higher deductible in order to minimize their premiums.
“Unfortunately, households with income over that 400%, they’re no longer eligible for any tax credits at all, so they are having to look for outside insurance, private purchase policies, stuff like that, just because the marketplace is unaffordable for those households,” she said.
Befus said that single individuals who are over the 400% mark are seeing policies in the $1,7000 per month range, while couples’ costs are around $3,000 per month. Families with four or more are seeing out-of-pocket premiums of $4,000 to $5,000, depending on age and family composition.
Befus said that with its many self-employed individuals, ranchers and small-business owners, Wyoming has a disproportionately large number of households that aren’t eligible to get insurance through an employer and whose household income is over 400% of the federal poverty level.
“The over 400% of the federal poverty level households are absolutely getting hit the hardest by the changes to the marketplace,” she said. “I wouldn’t call them high-income earners, but according to the federal government, they are. They are getting just massively slammed, including our retirement-age population, people who are not quite eligible for Medicare, yet; they are also getting slammed.”
Limited options, tough choices
Faced with a steep increase, the Tabbs investigated private insurance options – coverage that is purchased directly from an insurance company, not through the Affordable Care Act marketplace – but Nancy wasn’t satisfied that the coverage was sufficient for the couple.
The couple also looked into “cost-sharing ministries” – a faith-based alternative to health insurance in which members pool money to help pay each other’s medical bills. Members pay monthly shares, cover an “unshareable” amount (like a deductible) and then the ministry facilitates payment for eligible medical needs.
Though the fees are typically lower than health insurance, there is no guarantee of coverage for all conditions and there is no out-of-pocket cap. The Tabbs were particularly concerned that the cost-sharing plan would not provide adequate coverage in the event of a catastrophic health event.
Ultimately, the couple decided that since they are only a few years away from qualifying for Medicare, they would make the sacrifice.
“We’re very healthy and we try to stay healthy,” Nancy Tabb said. “After the sticker shock, I didn’t want to pay for it, but I just got to the point where I didn’t want to risk it. It’s been an interesting ride.”
Earlier this week, Lara Schuman went online and canceled the couple’s plan so that it will not automatically re-enroll them on Jan. 1. She also looked at private insurance options. So far, those options do not seem like they would offer the couple much coverage.
“I’’m desperately looking to see if there is anything else,” Schuman said. “I have to do some more research about it, because I’m not sure that it’s going to be worth it. Honestly, I’m coming to terms with the fact that we’re not going to have health insurance. It’s so scary.”
Schuman said that while she and her husband are relatively healthy, she’s terrified that an accident, something as routine as a slip on the ice, could cause financial ruin.
“When I was younger, we went without health insurance for a long time,” she said. “I was younger and healthier and I didn’t really understand the consequences, but that was so stupid. Now the prospect of us not having health insurance is terrifying. I’m losing sleep.”
With their insurance canceled for next year and no good other prospects, Schuman said she and her husband Paul have had really difficult conversations about whether it even makes sense to operate their small business or whether they can continue to live in Wyoming.
“I don’t want to have to move away again. My mom is here. Our lives are here. We love it here,” she said. “But I don’t know what we’re going to do. We haven’t quite figured that out. We’ll certainly just keep going as is this year, but we may make an exit plan for self employment if this continues and nothing’s fixed, because it’s just not sustainable.”
Time is running out
Nancy Tabb has written a letter to Wyoming U.S. Sen. John Barrasso, asking him to consider options to help Americans afford health insurance.
“We’re hoping all of our congressmen can work together and bring it back down to that affordable health care that Americans need,” Nancy Tabb said. “But until we’re 65, I’m just very nervous without good coverage.”
Schuman has also written letters to Wyoming’s congressional delegation.
“I have written to them multiple times about this,” she said. “This last time, I sent them our exact numbers of what this means for us, and I’ve not even gotten a response from them. I hope that the powers that be will read and think about this and how it’s affecting real people.”
Dozier Tabb agreed that eventually America is going to have to confront the soaring costs of health insurance.
“We couldn’t pay $120 a day for insurance forever,” Dozier Tabb said. “I feel strongly that this is such a major issue that it actually will be dealt with. It’s just they’re not dealing with it now, but it’s coming.”
This story was published on Dec. 11, 2025.