Lawmakers comb through WDH’s $205M rural health funds proposals
CHEYENNE — State officials and the Wyoming Legislature’s Joint Appropriations Committee met this week to discuss recently awarded federal funds intended to overhaul the state’s struggling rural health care infrastructure.
Following the passage of the federal One Big Beautiful Bill Act, Wyoming has been awarded an initial $205 million for the first year of the Rural Health Transformation Program. The state has the potential to receive more than $1.025 billion over the next five years, in part to replenish the health care cuts that occurred because of the same legislation passed by Congress earlier this year.
Providing the basics
Wyoming Department of Health Director Stefan Johansson presented a plan Tuesday that was developed from 11 town hall meetings and a survey of more than 1,300 residents. Johansson told lawmakers that the public’s feedback made him feel “surprised and humbled,” as it focused on essential services like emergency departments and ambulance stability.
“What we received from the public... was not a wish list,” Johansson said. “... The public’s feedback was pretty resoundingly clear in ‘we need the basics.’”
The WDH application, which received federal approval in late December, prioritizes hospital viability, EMS sustainability and bolstering the health care workforce, he said.
Perpetuity fund
The cornerstone of the WDH proposal is the creation of a perpetuity fund to avoid a fiscal cliff when federal funding ends in five years.
While the WDH initially suggested depositing 69.5% of the funds into a long-term investment vehicle, the JAC moved on Wednesday to increase the first-year deposit to 80% and remain at 69.5% every subsequent year.
The fund was designed to generate a consistent 4% annual return, which would provide roughly $28.5 million every following year to fund rural health initiatives.
Rep. John Bear, R-Gillette, argued for this approach of investing in perpetuity funds.
“It’s going to take a little bit of time for the rural health providers to understand how the program is going to work, and I think the demand for grants and funds is going to go up over the five-year period,” he said. “So it may be a graduated approach and putting more money into the account now, while we are waiting on things to be clarified, would be a wise approach.”
Rep. Jeremy Haroldson, R-Wheatland, warned that “massive amounts of money” often lead to “massive amounts of waste,” arguing that a metered approach through a perpetuity fund would better meet the state’s genuine needs.
Debate over BearCare
One of the most contentious topics was BearCare, a proposed state-operated public health benefit plan designed as a low-cost alternative to the Affordable Care Act marketplace. The plan would cover only catastrophic emergent episodes, such as major accidents or sudden medical emergencies.
Bear was skeptical of the government’s role in the insurance market. He referred to the plan as “Gordon-Care” to signal the governor’s support and previously stated, “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,” continuing to make clear the program is not named after himself.
Johansson countered that BearCare would select risk-averse, healthy people who are currently being priced out of comprehensive insurance. He said it would both encourage healthier lifestyles and potentially incentivize investment in senior centers.
Despite the WDH’s defense, the JAC ultimately decided to strike BearCare from the immediate list of time-limited programs to be authorized in the initial draft bill, opting to leave it for future legislative debate.
No sex changes or abortions
On Wednesday, the committee moved rapidly through a matrix of decision points to shape the draft ahead of the upcoming budget session, which begins Feb. 9. Lawmakers voted to include language ensuring the funds are used strictly for federal and state-approved purposes to prevent influence from the federal government.
Co-Chairman Sen. Tim Salazar, R-Riverton, led a vote to prohibit the use of any RHT funds for abortions or sex-change treatments, which passed with nearly unanimous support from the committee.
Additionally, the committee sought to balance executive flexibility with legislative oversight. Lawmakers proposed a threshold where projects exceeding $500,000 would require review by the Management Council or another legislative body, while smaller grants would be handled by the WDH and a new Rural Health Transformation advisory committee.
Next steps
The committee also signaled an interest in “telehealth freedom.” Rep. Scott Smith, R-Lingle, proposed an amendment to allow out-of-state medical professionals to see Wyoming patients via telehealth without redundant state licensing.
Lawmakers voted to broaden the title of the upcoming bill to include general “health care,” potentially opening the door for broader health care reforms during the session.
Legislative Service Office staff will now spend the coming days drafting the formal bill, which is scheduled for committee review next Thursday.
With $205 million expected to arrive in state accounts within the next 30 to 60 days, the Legislature must work quickly to establish the perpetuity fund’s legal framework, as the item will be up for full approval or denial in this year’s four-week-long budget session and cannot be amended.
This story was published on Jan. 8, 2026.