Wyoming has the third highest healthcare costs in the nation because of how far medical supplies have to travel, the high turnover rate of providers and the aging population, among other things.

But Wyomingites are keeping costs down by getting advanced premium tax credits from the Affordable Care Act. The Robert Wood Johnson Foundationrecently found that enrolling in the marketplace got Wyomingites’ premiums down from $937 a month to $118.

“People in Wyoming should understand that nobody pays retail for health insurance, except millionaires. I mean, nobody can. So there should not be any stigma at all,” said Katherine Hempstead, the foundation’s policy advisor.

Hempstead says the irony is that even though it’s most reliant on the ACA’s marketplace, Wyoming is one of 10 states that still hasn’t expanded Medicaid.

“Of those 10 states, Wyoming and Kansas are the only two of those 10 states that haven’t an expanded Medicaid,” Hempstead said. “There are people in the marketplace between 100 to 135 percent of the poverty level who could be on Medicaid. So if Wyoming expanded Medicaid, you'd see, for sure, your uninsurance rate will go down, you would see more people in Medicaid, for sure, and you may actually see a little bit of a transfer from the marketplace to Medicaid.”

Hempstead said this new data shows there’s a willingness in Wyoming to take advantage of subsidized healthcare, even if there hasn’t been a political will to expand Medicaid in the past.