Will the Wyo. “Freedom Caucus” kill health coverage for new moms?

A House bill to continue offering Medicaid postpartum coverage to low-income Wyoming mothers for a full year after they give birth has widespread support. 

The alternative is rolling back coverage, so that uninsured mothers can only count on two months of Wyoming Medicaid after they give birth before they are cut off.

Gov. Mark Gordon, doctors, nurses, counselors, hospitals, psychologists, women’s organizations, clergy, and medical groups have all urged the Legislature to pass “House Bill 4 – Medicaid twelve month postpartum coverage.”

The governor and several other supporters described it as “a pro-life bill.”

“The best way to support the baby is to support the mom,” said Dr. Rene Hinkle, co-founding partner at Cheyenne Women’s Clinic. She testified at the House Labor, Health and Social Services Committee, which passed the measure 5 – 4 and sent it to the full House.

But the far-right Freedom Caucus may stop it there. House Majority Floor Leader Chip Neiman (R-Hulett)  opposes HB-4, and he controls which bills are brought for debate and a vote.

Neiman knows that stripping young mothers of healthcare is not a popular thing to do. So, if he allows HB-4 to go to the House floor for a vote, he puts his Freedom Caucus members in a tough spot.

Thanks to a rule change this year that gave unprecedented powers to the second-term lawmaker and Freedom Caucus co-leader, Neiman has the ability to simply not allow the bill to go to the floor. 

But the calculus Neiman must navigate involves more than his and his caucus’ opposition to what they view as “socialist” healthcare for young mothers.

The Freedom Caucus—whose name is interesting, given the group’s demand for obedience among its members—votes almost uniformly in a bloc. So, if a lawmaker wants to be part of their club, they must vote with its leaders. They follow the same “Ride for the Brand” mentality that currently guides the Wyoming State Republican Party (which happens to also strongly oppose HB-4).

Neiman knows that stripping young mothers of healthcare is not a popular thing to do. So, if he allows HB-4 to go to the House floor for a vote, he puts his Freedom Caucus members in a tough spot: They can either vote “no” to appease their leaders while potentially upsetting their constituents, or they can vote “yes” on behalf of the people they represent but fly afoul of their hardline caucus.

This tough spot might be the reason why HB-4 was passed out of the House Labor Health Committee nearly two weeks ago and is still sitting in Neiman’s desk, while other bills that advanced from committee more recently have already been heard.

At the same time the Freedom Caucus jockeys to kill HB-4, many moderate members of the House strongly support the bill. Even though they cannot directly force Neiman to put it to the floor for debate and a vote, they may have other means of pressuring him to do so.

Rolling back healthcare for moms

Historically, uninsured mothers in Wyoming have been eligible for coverage under the state’s Medicaid program for a measly 60 days. As many have pointed out, this is hardly the amount of time it takes to recover from pregnancy and birth, particularly when factoring in mental health issues like postpartum depression.

Thanks to the federal American Rescue Plan Act (ARPA) passed during the COVID-19 pandemic, Wyoming received funding to extend its postpartum Medicaid coverage for new mothers—from two months to an entire year.

But that funding is about to expire, since ARPA was a temporary emergency program. Now, Wyoming must decide whether to keep covering uninsured mothers for an entire year—which is what HB-4 would do—or return to the insufficient pre-COVID status quo.

Notably, no other state surrounding Wyoming has to deal with this issue, since they have all expanded their Medicaid programs. Under Medicaid expansion, uninsured low-income mothers would be eligible for healthcare coverage in the first place.

A separate bill before the Wyoming Legislature, “House Bill 80 – Medical Treatment Opportunity Act,” would fully expand Wyoming Medicaid and take care of the problem altogether. HB-80 has also passed committee and is waiting for Neiman to bring it to the floor.

Broad support for HB-4

Support for HB-4 is robust. At the House Labor Health Committee meeting two weeks ago, hospital officials lined up beside faith leaders and women’s advocates to ask the committee for an affirmative vote.

Erin McKinney, clinical director of women and children’s service at Cheyenne Regional Medical Center, said two-thirds of postpartum symptoms are preventable with extended coverage. This includes potential suicides resulting from postpartum depression. 

The Wyoming Women’s Foundation Director Rebekah Hazelton said one in five women lose insurance after giving birth. Family support for mothers often wanes after three weeks, so they need professional help.

Rene Hinkle, an OB/GYN for nearly 20 years, said future unintended pregnancies and abortions could be avoided by extending postpartum coverage.

Catholic Diocese of Cheyenne Deacon Michael Leman, one of the state’s leading pro-life advocates, spoke in favor of the bill, asking lawmakers to “realize not every government program is an inevitable slide into the fiery pit of socialism.” 

“Man up,” mommies

The close 5 – 4 vote in the House Labor Health Committee reflects the near-even split between moderates and the far-right Freedom Caucus in the Wyoming Legislature.

At that meeting, Freedom Caucus leader Rep. John Bear (R-Gillette) was in the front row, monitoring his first-year members on the committee to ensure they stayed in line.

In his own testimony to the committee, Bear described Wyoming Medicaid coverage for new mothers as “the growth of government disguised as free health care from D.C.”

Of course, many new Wyoming mothers would be better off in the first year after they give birth having access to actual healthcare, rather than relying on their own inner men. 

Freshman Freedom Caucus member Rep. Jeanette Ward (R-Casper), derided HB-4 as another “entitlement” the state can’t afford. This is confusing, given the program’s $1.9 million price tag and the state’s $3 billion surplus going into the 2023 session (not to mention other Freedom Caucus-backed proposals like giving Arizona $2 million to build its border wall).

Another freshman Freedom Caucus member on the committee, Rep. Sarah Penn (R-Lander) said she would vote “no” on HB-4 because uninsured new mothers simply need to man up.

“If we create situations where there’s always a safety net, when women don’t have to stand up and be strong—to show their strength—then the natural man in all of us falls back into that comfort and safety net,” Penn said.

Of course, many new Wyoming mothers would be better off in the first year after they give birth having access to actual healthcare, rather than relying on their own inner men. 

Whether the House even has the chance to weigh in on the situation will depend on whether Rep. Neiman decides it is in his Freedom Caucus’ best interest.