By Noah Zahn
Wyoming Tribune-Eagle
CHEYENNE, Wyo. — The Centers for Medicare & Medicaid Services announced Monday that Wyoming will receive more than $205 million in federal funding for the first year of the Rural Health Transformation Program (RHTP).
This investment, established under the One Big Beautiful Bill Act, is part of a five-year, $50 billion national initiative designed to strengthen health care in rural communities following the health care cuts that occurred because of the same legislation passed by Congress earlier this year.
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For Wyoming, the most sparsely populated state in the nation, the award represents a unique opportunity to address health care gaps.
“I am excited for what this award means for health care in Wyoming, particularly for our rural communities across the state,” Gov. Mark Gordon said in a statement following the announcement. “Thanks to President Trump, Wyoming now has a unique opportunity to help address some of our state’s most challenging rural health care issues, like hospital viability, EMS sustainability, OB care, and bolstering workforce.”
Wyoming’s plan
The funding follows a rigorous merit review of the state’s application, which was developed through 11 local town hall meetings and a survey of more than 1,300 Wyomingites. The resulting plan focuses on four key initiatives: improving access to basic medical care, building a durable health workforce, improving population health and leveraging technology to bring care closer to home.
U.S. Sen. John Barrasso, R-Wyo. , applauded the award, noting that the state’s approach is tailored to its unique geography.
“The State of Wyoming has a smart and targeted plan to address our unique healthcare challenges,” Barrasso said in a statement. “With this over $205 million award, Wyoming can get to work expanding access to care, recruiting and training new health providers and strengthening rural healthcare across our state.”
Rural hospitals and EMS
A primary focus of the program is the financial viability of small, rural hospitals. Wyoming intends to establish the “Critical Access Hospital — Basic” incentive program, which encourages smaller facilities to focus on essential community services like 24/7 emergency departments, and labor and delivery services.
The state also aims to reverse the growth of “maternity deserts,” where hospitals have been forced to close delivery facilities due to financial stress.
“Families, seniors, and communities are stronger when they are healthy and have reasonable access to healthcare,” Gordon wrote in his biennial budget request. “We must maintain access to safety net services for all Wyoming communities, including quality care for children, seniors, people with developmental disabilities, and others who lack physical or financial means.”
Emergency medical services (EMS) will also see significant changes. The plan incentivizes small ambulance services to consolidate into regionalized systems supported by stable funding bases. This is intended to improve response times in “frontier” areas, which are the most rural areas in the state where some residents currently face wait times of more than 30 minutes for an ambulance.
Workforce and insurance
To combat a severe shortage of medical professionals, Wyoming will also use the funds to expand educational opportunities for nurses, paramedics and physicians. New graduates who receive RHTP awards will be required to commit to five years of service with Wyoming health care providers.
In a move to address high insurance costs, the state has proposed “BearCare,” a state-operated public health benefit plan. BearCare is designed as an alternative for individuals and small businesses, providing coverage for catastrophic emergent episodes, such as a major accident or a sudden medical emergency.
This proposal faced pushback during recent Joint Appropriations Committee meetings when Rep. John Bear, R- Gillette, stated the plan is designed as a low-cost alternative to the Affordable Care Act marketplace, intended for individuals and small businesses, covering only catastrophic or major medical needs.
“I’m not inclined to want to compete in the private sector. I don’t think it’s the proper role of government to do so,” he said at a JAC meeting in December, adding that he chose to refer to the plan as “Gordon Care,” indicating that the governor has supported this application from the state.
The state will also invest in technology like remote patient monitoring and tele-specialty hubs to help providers manage chronic diseases such as diabetes and cardiovascular disease while keeping patients in their own communities.
Long-term sustainability
The plan aims to support Wyoming long-term through the creation of the Wyoming Health Transformation Perpetuity, which invests a significant portion of federal funds with the hope to generate a permanent revenue stream that will support health care initiatives following the conclusion of the five-year grant period.
“Recognizing while the funding is prodigious, it is ephemeral,” Gordon wrote in his proposed budget, “we must ensure this federal money is well-spent and put to use for the greatest good, not just over the next five years. Changes we make must be valuable and enduring.”
Though the state requested up to $800 million in its submittal to the federal government, it has been awarded $205,004,743 just for the first year. If it remains the same each year for five years, it would be equivalent to $1.025 billion. Some of this surplus of anticipated funds could likely be invested in the perpetuity fund.
“Just as we have done with other transitory federal programs, we recognize this money is not forever and it is taxpayer money,” Gordon said in a statement in November. “So the investments we make must stand the test of time and not further burden our grandchildren.”
Wyoming Department of Health Director Stefan Johansson expressed confidence in the state’s readiness to begin work in his department’s official submittal to the federal government. “This application reflects Wyoming’s dedication to building a sustainable and innovative rural health system that addresses our communities’ needs,” he wrote.
The next phase of implementation involves collaboration between the state’s executive branch and the Wyoming Legislature to appropriate the funds and establish the necessary statutory frameworks for the new programs.
When the upcoming budget session commences on Feb. 9, the Legislature will have little room to amend the grant package, meaning elected officials must ultimately decide to approve or deny the appropriation of the potentially more than $1 billion for WDH, while items like BearCare could be subject to standalone approval.
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