The Cuts So Far (Part 2): Healthcare – Living (and dying) within our means

Over the past two years, the Wyoming State Legislature has cut hundreds of millions of dollars from state agencies and public services in response to declining mineral revenues. In a multi-part series, “The Cuts So Far,” Better Wyoming will give readers a sense of some of these cuts’ magnitude and impacts in advance of the 2018 Legislative budget session, which convenes Feb. 12.

The Wyoming State Legislature cut roughly $100 million from the State Department of Health over the past two years. These cuts have eliminated or severely decreased public health services that thousands of Wyomingites from all walks of life depended on. They affected treatment and preventative programs for physical illness, maternity care, and mental health programs that deal with substance abuse and suicide, among many others.

Even so, the Department of Health faces a roughly $32 million shortfall going into the 2018 legislative budget session. The Legislature, refusing to raise any new revenues to fund state programs, expects the department to eat those cuts.

But Department of Health Director Tom Forslund told the Joint Appropriations Committee last month: “I just can’t handle [more cuts] this time around. This’ll be the first time in my career of public management that I haven’t been able to deliver a budget in a time period under what was authorized.”

We got 99 problems and people without healthcare is a big one

As the Casper Star-Tribune reported, Wyoming’s aging population and the rising cost of caring for old folks have intensified the Department of Health’s funding problems.

The root of the department’s problems, however—along with basically all of Wyoming’s money woes—is the state’s reliance on boom-and-bust mineral revenues to fund health care and other important services. Wyoming pays for 70 percent of its state services with mineral revenues. When mineral prices are low, folks with illnesses are simply on their own.

The Wyoming Legislature could have solved many of the state’s healthcare funding problems by expanding Medicaid under the Affordable Care Act. Doing so would have brought Wyoming nearly $300 million from the federal government and provided coverage to nearly 20,000 Wyomingites. But the Legislature has repeatedly refused to expand the program, apparently preferring to cut services for sick people instead.

What suicide problem?

Wyoming has a famously high suicide rate. Ours hovers just around double the national average—roughly 24 suicides per 100,000 people, while across the country the figure is around 13.

So, how does the Legislature combat this epidemic? Up until 2015, the state was funding its suicide prevention program to the tune of $1.9 million. During that year’s budget session, however, legislators cut it down to a paltry $100,000, and the following year eliminated it altogether.

For the time being, suicide prevention will be the job of churches and charities. The Episcopal Diocese of Cheyenne hopes to raise $100,000 for suicide prevention. But that’s a one-time act of desperation—not a sustainable solution.

Bishop John Smylie told the Casper Star-Tribune: “I don’t understand the thinking of the legislators and how they can choose not to care about this profound crisis. This is their responsibility.”

Going cold turkey

Of course, suicide is just one of Wyoming’s many glaring health problems that will now go largely unaddressed.

Contributing to our suicide problem in Wyoming, for instance, is rampant substance abuse. But over the past two years, the Legislature cut what in 2015 had been a $3 million budget for alcohol and drug treatment programs down to roughly $300,000.

Separately, the Wyoming Behavior Health Division’s addiction treatment program was cut $2.9 million and the state’s Court Supervised Treatment program lost $1.2 million. At the Wyoming State Hospital in Evanston, in- and outpatient substance abuse saw a combined $5.7 million cut, on top of a $1.8 million cut to the hospital’s operating budget.

Good thing there’s not an opioid crisis or anything like that going on!

Old and young, rural and urban—everyone gets screwed

Wyoming’s rural population makes delivering health care difficult. It’s even more difficult now, after lawmakers slashed the state’s Rural and Frontier Health budget nearly in half with a $1.6 million cut. The rural oral care program was entirely eliminated.

But rural and urban, as well as the young and old in Wyoming will feel the effects of the past two years’ health cuts.

A program to help expectant single mothers take care of their newborns was completely scrapped as part of the Legislature’s cuts to the state’s Maternal and Child Services division. Meanwhile, $14 million was axed from the general Wyoming Children’s Health program, and preschool health services lost $5 million.

Meanwhile, the DOH’s Aging Division saw budget cuts of $1.4 million and the Wyoming Senior Services Board saw $1 million in reductions. Retirement centers across the state lost $4.2 million. The Wyoming Life Resource Center in Lander, a residential elderly community, was cut $2.7 million.

Good luck now, old folks!

Sick, dying, addicted, and killing themselves

Wyoming Governor Matt Mead recently told the Legislature to reverse several cuts to the Department of Health’s budget from the past couple years. Mead said it has become abundantly clear that the cuts are hurting the agency’s ability to provide crucial health services.

But we’re supposed to “live (and die) within our means,” right?

During the upcoming 2018 budget session, we’ll get to see whether legislators listen to Mead and do what it takes to restore funding to critical healthcare programs.

Or, we’ll see whether lawmakers would rather stand idly by as more and more Wyoming residents are sick, dying, addicted, and killing themselves.

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