A wonderful opportunity for Wyoming to reform rural health care

If there’s one thing Americans of all political affiliations should be able to agree on, it’s that health care costs are outrageously high and getting worse all the time.

The Affordable Care Act (ACA) hasn’t delivered on its name’s promise to reduce insurance costs, and neither major party has produced a suitable plan to replace it. Meanwhile, as costs continue to rise and COVID-era subsidies expire, more and more people are unable to afford the monthly premiums, forcing them to go without coverage and the resulting preventative care it helps to cover.

The one good thing Congress and President Trump were able to accomplish last year on this front was creation of the Rural Health Transformation (RHT) Program. Part of the One Big Beautiful Bill Act, this $50 billion, five-year program is designed to improve access to quality health care for people living in rural parts of the country.

According to the Centers for Medicare and Medicaid Services, RHT will make $10 billion available each year, with half distributed equally among “all approved states,” and the other half “allocated by CMS based on a variety of factors, including rural population, the proportion of rural health facilities in the state, the situation of certain hospitals in the state and other factors to be specified by CMS ...”

When the OBBBA was signed into law last summer, states had until Nov. 5 to submit their application for this money. To their credit, Wyoming Department of Health officials wasted no time, meeting with health care providers statewide, and taking input from residents at 11 public meetings around the state and through an online survey that generated more than 1,300 responses.

This inclusive process resulted in an application that generated $205 million for the Equality State in this first year of funding. That’s certainly worthy of both celebration and appreciation in itself. Yet as Wyoming Medical Society Executive Director Sheila Bush told WyoFile last week, “We have a lot of work in front of us, but it’s exciting work.”

Ms. Bush was spot-on when she also said, “There’s real potential for this money to meaningfully improve health care in Wyoming, I think, as long as the other pieces come together, and our state works as a team to implement the varying aspects.”

That’s the crux of the issue. For this injection of federal money to make any lasting impact, public officials and private providers must work together to identify the key problems and develop long-term solutions.

Among the challenges rural Wyomingites face are:

• Maternity deserts, created by medical facilities shuttering their labor and delivery services due to low demand and financial pressures
• Large sections of the state without emergency medical services (EMS), such as ambulances, impacting the ability to get medical care to someone in urgent need in a timely manner
• Rural health facilities unable to recruit and retain quality medical professionals; and
• Lack of insurance alternatives to the ACA Marketplace.

Lawmakers on the Joint Appropriations Committee dug into Wyoming’s plan for this new rural health care funding this week and directed legislative staff to draft a bill for further discussion next week. Seemingly the highest priority was creating a perpetuity fund to turn a large portion of the first-year funding into a long-term investment that helps the state avoid a fiscal cliff at the end of the five-year program.

That’s wise, and we agree with lawmakers who said it makes sense to roll out new initiatives carefully. At the same time, though, there are likely immediate changes that could be made to benefit rural residents, and they shouldn’t have to wait when the federal government expects this money to have an immediate positive impact.

Regardless of the timeline, however, there are a few things state officials shouldn’t do.

The most important is not creating a dependence on this federal money. Whatever new programs are created need to come with a plan for keeping them operational over the long term, if that’s deemed necessary.

Secondly, government programs shouldn’t supersede or negatively impact private industry. At the same time, state leaders must be willing to provide residents with options like the proposed BearCare catastrophic care insurance if they aren’t being offered by private businesses.

Next, government and health care industry officials need to look for ways their efforts can overlap and support one another. Public-private partnerships could be the best solution to many of Wyoming’s current struggles.

Finally, everyone involved needs to be open to a wide variety of suggestions and success stories from other places. We say it often, but Wyoming officials have to be willing to listen to the experts who have addressed similar challenges where they live, with proven results.

Whether it’s extending appropriate telehealth access to utilize Wyoming-licensed out-of-state providers or expanding the number of mobile health clinics offering preventative services in rural communities, Wyoming officials need to consider all possibilities for helping the state’s residents to be as healthy as possible.

These RHT funds offer a golden opportunity to fix many of the things that ail us — if they’re pursued cooperatively and designed to be sustainable for the long term.