{"id":505275,"date":"2026-01-10T03:54:14","date_gmt":"2026-01-10T03:54:14","guid":{"rendered":"https:\/\/www.europesays.com\/us\/505275\/"},"modified":"2026-01-10T03:54:14","modified_gmt":"2026-01-10T03:54:14","slug":"whats-at-stake-if-wyoming-lawmakers-dont-act-on-205m-proposal-to-improve-rural-health","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/us\/505275\/","title":{"rendered":"What\u2019s at stake if Wyoming lawmakers don\u2019t act on $205M proposal to improve rural health?"},"content":{"rendered":"

Though Wyoming only learned last week it will receive $205 million in federal rural health funds this year<\/a>, the state doesn\u2019t have a lot of time to idle over the money, Department of Health Director Stefan Johansson explained to lawmakers Tuesday.<\/p>\n

That\u2019s because Wyoming risks blowing an opportunity for $800 million in additional program funds if it does not fully spend the initial allotment, fails to implement the proposed policy actions in its application or goes rogue with other measures, according to the health department.\u00a0<\/p>\n

\u201cThe Trump administration has been very clear with us that anything outside of these approved purposes that are within our application risks clawback from the federal government,\u201d Johansson told the Joint Appropriations Committee during a Tuesday budget hearing.<\/p>\n

The health department needs legislative action to advance some of its rural health plans with steps like approving funding expenditures and drafting a bill that would create a permanent, investment-generated revenue fund.\u00a0<\/p>\n

So in a roundabout way, the federal funds are applying pressure on lawmakers to advance multiple initiatives aimed at supporting health care access in the state. And those include some measures that Wyoming\u2019s small-government conservatives are wary of \u2014\u00a0like a state-run health insurance plan.<\/p>\n

Committee Chairman Rep. John Bear of Gillette, who is a member of the Wyoming Freedom Caucus, criticized that insurance proposal in earlier talks. On Tuesday, he paid the department a barbed compliment.\u00a0<\/p>\n

\u201cYou all have done an excellent job of, I\u2019m going to call it, twisting the arm of the federal government, to get this thing through,\u201d he said. \u201cStuff that I think our staff and us were kind of surprised that you were able to get accomplished. So, well done in that regard.\u201d\u00a0<\/p>\n

Regardless, lawmakers will move forward on related actions, Bear said.\u00a0<\/p>\n

\u201cWe certainly are taking this up as a matter of legislative action, so we\u2019ll be working on this, and we\u2019ll keep in touch with you to make sure we get it right,\u201d he said.\u00a0<\/p>\n

Wyoming\u2019s award<\/strong><\/p>\n

The Rural Health Transformation Program is a new federal initiative created by President Donald Trump\u2019s One Big Beautiful Bill Act. The program will funnel $50 billion to states over five years to stabilize and strengthen rural hospitals and providers.\u00a0<\/p>\n

The application process for states unfolded rapidly. In Wyoming, Department of Health staff held stakeholder conferences and 11 public meetings starting in September to gather input. The state received 1,300 responses to an online survey it circulated. Staff prepared an 84-page application<\/a> and submitted it by the Nov. 5 deadline.<\/p>\n

\"\"AMR ambulances in the ambulance bay in Lander. (Katie Klingsporn\/WyoFile)<\/p>\n

The application proposed an array of initiatives to bolster health care. They include incentives for small rural hospitals to provide basic services and cut extraneous ones that can be performed at regional facilities; grants for clinical workforce training programs and five-year commitments from grads; a state-run insurance plan for catastrophic events; and permanent, investment-generated revenue to boost the industry.<\/p>\n

Wyoming applied for an initial budget of $200 million. The Centers for Medicare and Medicaid Services announced Dec. 29 that all 50 states will receive awards in 2026 under the program. Wyoming got $5 million more than it requested and received the second-largest award per capita, behind Alaska.\u00a0<\/p>\n

Now, the work begins. In Wyoming, it will require drafting contracts, hiring staff, crafting bills and gaining legislative approval. On Tuesday, health department staff came before the appropriations committee with an outline of where they think money could be best spent and a draft bill to establish the perpetuity fund.\u00a0<\/a><\/p>\n

A path to sustainability\u00a0<\/strong><\/p>\n

Even among health care advocates who view the federal program as a major opportunity for Wyoming, there has been concern about the temporary nature of the funds not being able to fix long-term problems here.<\/a>\u00a0<\/p>\n

To address that issue, Wyoming proposed the establishment of the \u201cWyoming Health Transformation Perpetuity\u201d \u2014 an actively managed investment account designed to generate long-term revenue.\u00a0<\/p>\n

\u201cThe state stands to receive over a billion dollars through this program,\u201d Johansson said Tuesday. \u201cThat\u2019s a lot of money, and that\u2019s something we take seriously. And so what we hope you see designed into our application is a priority around how to sustain that.\u201d<\/p>\n

\"\"Wyoming Department of Health Director Stefan Johansson, Wyoming Department of Family Services Director Korin Schmidt and Gov. Mark Gordon led a Dec. 15, 2023 town hall-style meeting in Pinedale focused on Wyoming\u2019s mental health challenges and resources. (Mike Koshmrl\/WyoFile)<\/p>\n

The perpetuity vehicle would allow the state to stretch the federal benefits into the future to meaningfully address some of Wyoming\u2019s historically intractable health care challenges, Johansson said, such as hospital and EMS viability and workforce retention.\u00a0<\/p>\n

The bill draft would establish both the fund and rules for how the money is managed and used.\u00a0<\/p>\n

Johansson emphasized that this specific part of the proposal can unlock a great deal of potential.\u00a0\u00a0<\/p>\n

\u201cI know I sound like a used-car salesman here,\u201d he told lawmakers, but \u201cI think this could be truly transformative to some of the problems we have in our rural communities with health care. The idea is that we invest a smaller amount each year, so that over time, instead of five years of benefits, we\u2019re going to accrue decades of benefits.\u201d<\/p>\n

There will also be some time-limited funds, Johansson said, which would be allocated to one-time grant programs related to technology adoption, integrated primary care and exercise and diet promotion.\u00a0<\/p>\n

The appropriations committee is scheduled to revisit the perpetuity bill during its Jan. 15 meeting.\u00a0<\/p>\n

BearCare<\/strong><\/p>\n

The proposal in Wyoming\u2019s application that has drawn the most attention is the state-run public catastrophic insurance plan.\u00a0<\/a><\/p>\n

As proposed, the plan, dubbed \u201cBearCare,\u201d would cover health care emergencies, such as a car crash or a bear attack, for dues-paying members. The department has pitched it as low-premium, high-deductible coverage that could be useful for major health emergencies, but doesn\u2019t cover typical care.<\/p>\n

Gov. Mark Gordon lauded the proposal in his budget letter, calling it \u201can innovative, but basic, health benefit plan that offers individuals and small businesses a practical alternative to costly ObamaCare insurance.\u201d<\/p>\n

Appropriations lawmakers were skeptical the first time BearCare came up in a meeting in early December, and retained wariness Tuesday.\u00a0<\/p>\n

\u201cWe have the state stepping in and competing with private business on an unfair level,\u201d said Rep. Ken Pendergraft, R-Sheridan. \u201cAnd I\u2019ve always been of the impression that it was the responsibility of the state to provide a level playing field so that anybody who wanted to build a business could build a business. So philosophically, I have a real problem right there.\u201d\u00a0<\/p>\n

\"\"Rep. Ken Pendergraft, R-Sheridan, listens during the Wyoming Legislature\u2019s 2025 general session. (Mike Vanata\/WyoFile)<\/p>\n

However, the plan also emerges as thousands of Wyomingites are facing huge spikes in health insurance costs with the expiration of Affordable Care Act tax subsidies.<\/a>\u00a0<\/p>\n

The proposal is not designed to replace an Affordable Care Act Plan, Johansson said.<\/p>\n

Instead, he said, \u201cit\u2019s an alternative, in a way, that is a very different type of product that says, \u2018if you are choosing to go uninsured as an individual, here is something at a lower cost that would protect you against those larger financial issues.\u2019\u201d<\/p>\n

The concept, he continued, \u201cwas intriguing enough to the federal government, to the Trump administration, to say, \u2018hey, while all this is going on with these expiring ACA subsidies \u2026\u00a0 here\u2019s one state that\u2019s at least considering an alternative to cover this.\u2019\u201d<\/p>\n

He added that the BearCare proposal is a very small component of the state\u2019s application and proposed budget \u2014 it would require about 1.4% of the overall allocation.\u00a0<\/p>\n

However, he said, lawmakers will have the final say.\u00a0<\/p>\n

\u201cI\u2019ll state unequivocally, we will not stand up that program without legislative authorization,\u201d Johansson said.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"Though Wyoming only learned last week it will receive $205 million in federal rural health funds this year,…\n","protected":false},"author":3,"featured_media":505276,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[210,1141,1142,151821,67,132,68,90296],"class_list":{"0":"post-505275","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-health","9":"tag-health-care","10":"tag-healthcare","11":"tag-rural-health-transformation-program","12":"tag-united-states","13":"tag-unitedstates","14":"tag-us","15":"tag-wyoming-department-of-health"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/115868786193226021","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/505275","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=505275"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/505275\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/505276"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=505275"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=505275"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=505275"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}