It\u2019s a typical reaction by politicians who want to hold budgets hostage while taking divisive, ideological swipes at a department that has managed to craft sound health and fiscal policies despite being handicapped by poor legislative decisions.<\/p>\n
For many years, the Wyoming Legislature has viewed the Health Department as the first place to cut when tax revenues decrease. With a budget of $2.2 billion in the current two-year fiscal cycle, it\u2019s a big target.<\/p>\n
This effort to mimic the federal government\u2019s \u201cDepartment of Government Efficiency\u201d at the state level will hopefully fail and not result in the carnage that the Elon Musk-led DOGE was responsible for at the beginning of President Donald Trump\u2019s second term. Still, the fact that the Freedom Caucus decided it needed to DOGE the Health Department at all is ample reason to worry.<\/p>\n
How did we get here? As the Grateful Dead would say, what a long, strange trip it\u2019s been.<\/p>\n
In June, at a Joint Appropriations Committee meeting in Gillette, the panel heard a pitch for more funding for the Medicaid developmental disabilities waiver program. Through it, more than 570 providers care for about 2,500 people with intellectual and developmental disabilities or acquired brain injuries in home and community-based alternatives to an institution.<\/p>\n
One of the disability waiver program\u2019s biggest boosters for additional funding was Rep. Ken Pendergraft, R-Sheridan. I wrote a column in July about how remarkable it was to see a member of the Freedom Caucus say a social safety net program is \u201cone of the reasons why we have government.\u201d<\/a><\/p>\n I stand by that statement as well as my own support for this worthwhile program. But I didn\u2019t know exactly where Pendergraft\u2019s mission to obtain more funds would take us.<\/p>\n The Sheridan lawmaker said, \u201cBefore I sit down and authorize a $20-or-$30-or-$40 million check, knowing that taxpayers are already sacrificing, I want to look across the breadth of the Department of Health. If it considers this to be a high priority, what\u2019s it willing to sacrifice to pay for it?\u201d<\/p>\n Stefan Johansson, the department\u2019s director, gave a diplomatic answer. He noted that three times in the past dozen years, the Department of Health saw its budget cut by more than $100 million. While the Legislature added some money back into critical programs like suicide prevention and substance abuse treatment when it could afford to, the department never fully recovered that money.<\/p>\n At the JAC\u2019s August meeting, Pendergraft again pressed his point about sacrifices. Johansson explained that the disability waiver program\u2019s biennium budget is over $300 million.<\/a> \u201cIt\u2019s a large-scale, very expensive program, because these services and the acuity of some of these clients is very high,\u201d the director said.<\/p>\n It\u2019s not a difficult concept to understand: The Legislature can\u2019t add, say, $80 million to one expensive program and cut other health programs dollar-for-dollar and not do a considerable amount of damage to the latter.\u00a0<\/p>\n Here\u2019s another fact: Programs that are either required to be offered under federal law or part of lawsuit settlements account for more than 90% of the department\u2019s budget.<\/p>\n Still, at the end of the meeting, Pendergraft moved that the JAC appoint a three-member subcommittee to investigate and analyze the Department of Health\u2019s budget because \u201caggressive legislative oversight and attention is warranted.\u201d<\/p>\n The JAC agreed, and the Legislative Management Council approved enough money for the subcommittee to meet up to five times before next February\u2019s budget session. Lo and behold, Pendergraft is chairman.<\/p>\n The first two meetings in Casper and Cheyenne have not been particularly well attended but were generally cordial affairs where Pendergraft has held court over his subcommittee\u2019s \u201cfact-finding mission.\u201d Johansson and his staff dutifully covered every section of the budget, proving what long-time observers of the department already knew: It\u2019s a well-oiled machine that spends 95% of its budget on providing medical services and a modest 5% on administrative costs.<\/p>\n What concerns me about this fishing expedition to find waste and abuse \u00e0 la DOGE is that the Legislature is looking for massive savings but is likely to find minuscule amounts. In its self-righteous anger, does anyone seriously think the Freedom Caucus isn\u2019t going to take an ax to whatever in the budget would inflict the most pain, just because it can?<\/p>\n Simultaneously, lawmakers are ignoring that up to 25,000 Wyomingites are about to be hit with a more than 300% increase in their health insurance costs<\/a> when the enhanced premium tax credits on the Affordable Care Act marketplace expire at the end of the year under Trump\u2019s \u201cBig Bill.\u201d<\/p>\n It\u2019s a solid bet many will forego health insurance. They won\u2019t receive preventative health care, and will instead leave rural hospitals that are already at risk of closing to pick up the tab for emergency room care.<\/p>\n What types of wasteful health care spending does the Freedom Caucus expect to find and shut down? When Wyoming Public Radio posed that question to Freedom Caucus Chairman Emeritus Rep. John Bear \u2014 who also co-chairs the JAC \u2014 this is what he came up with: a federally funded advertising program to ensure children get vaccinated.<\/a> No, I\u2019m not kidding.<\/p>\n It goes against my nature, but I\u2019ll close on a potentially hopeful note, only because Johansson told the JAC subcommittee that the $50 billion Rural Health Transformation Fund that was included in the \u201cBig Beautiful Bill\u201d to appease some Republican critics may actually improve health care access in rural Wyoming.<\/p>\n![\"\"](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/10\/drakes-take-480x480.jpg\")
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