The so-called “Freedom Caucus” has vowed to cut as much as 30 percent of the state’s budget now that they have control of the Wyoming Legislature.
As the state’s largest agency, the Wyoming Department of Health might seem like an obvious target.
But the agency sends more than 90 percent of its funds into local communities for critical healthcare programs. Cuts won’t impact bureaucratic bloat in Cheyenne, but instead would decrease resources for clinics and programs that people throughout the state depend on—including folks in Freedom Caucus members’ districts.
With encouragement from grassroots healthcare advocates, including Better Wyoming, the Legislature in 2024 not only prevented $121 million in potential cuts to the Health Department’s budget, but added $10 million more to the state’s “988” suicide lifeline.
Cuts won’t impact bureaucratic bloat in Cheyenne, but instead would decrease resources for clinics and programs that people throughout the state depend on
Now, for the 2025 session, the Health Department is requesting funds to support maternity care, behavioral health, pre-K special education, and at-home care for people with severe medical issues.
The total ask for the Department of Health contained in Gov. Mark Gordon’s budget this year is modest in the context of the state’s overall spend: roughly $14 million, mostly in the form of higher reimbursement rates for doctors treating patients on Medicaid.
But out-of-state groups that helped install the Freedom Caucus in Power—notably, Honor Wyoming, which has ties to an Idaho militia and is backed by a California billionaire—are pushing for cuts to Wyoming healthcare spending, no matter where it goes.
Freedom Caucus lawmakers will need to decide between the people in their districts who need healthcare and the powerful donors who got them elected.
Funding care for pregnant women
Gordon’s call to increase Medicaid reimbursement rates for OB-GYN physicians is largely a response to the closure of four hospital maternity wards in recent years, most recently in Evanston.
These closures speak to a larger problem in Wyoming: so-called “maternity deserts” that cover large swaths of our state, where there are no facilities offering prenatal care for pregnant women.
Five entire Wyoming counties fit this description, with seven more offering not much better. Pregnant women in these places have to travel great distances, often in bad weather, to receive care that helps ensure a healthy pregnancy and birth.
Increasing Medicaid reimbursement rates for maternity care would help this situation because one-third of Wyoming births are covered by Medicaid.
A higher reimbursement rate would help incentivize OB providers to continue to practice in Wyoming, even though it would still not be enough to cover the actual cost of care.
Health Department Director Stefan Johansson told the Joint Appropriations Committee this month that it’s unlikely labor and delivery services would come back where they have been lost solely as a result of a reimbursement rates increase.
Instead, he called the funding proposal “a modest measure the state could take to stave off additional elimination of maternity wards.”
Outside influence
Gov. Gordon said that funding for maternity care is his number one priority for the Department of Health’s budget in 2025.
Even though the Freedom Caucus has not made healthcare funding cuts a priority so far, Gordon’s focus may have put maternity care in the crosshairs.
The Freedom Caucus’ new chairwoman, Rep. Rachel Rodriguez-Williams (R-Cody), said that her group’s main priority this year will be fighting against the governor.
Egging them on is Honor Wyoming, a shadowy group that has spent hundreds of thousands of dollars in recent years promoting extremist causes and candidates in the state, mostly via social media ads.
Honor Wyoming’s “boss,” John Guido, lives in South Dakota, and its funding comes largely from Chris Rufer, a billionaire California tomato tycoon.
This fall, as part of the group’s digital output, Facebook and Instagram accounts in Wyoming started seeing Honor Wyoming ads accusing the state of overspending on healthcare.
The ads ran in November and December and reached more than 30,000 social media feeds—a significant number in our small state.
As the session starts in January, we will see whether Honor Wyoming’s allies in the Freedom Caucus adopt this line of thinking and vote to block funding that would improve healthcare access.
A prelude to the 2026 budget session
Whatever happens in the upcoming 2025 general session will serve as a prelude to 2026, the Legislature’s next formal “budget session.”
The Freedom Caucus has said that dramatically cutting property taxes is its number one priority in 2025.
Since cutting taxes leads to a decrease in revenue, the state will likely have far less to spend in 2026, when the Legislature crafts its next full two-year state budget.
Even if the Freedom Caucus punts this year on healthcare cuts, the story will almost certainly be different—for the Department of Health and all state agencies—when property tax cuts have decreased the amount of money left to work with, and Freedom Caucus lawmakers look in earnest for programs in the budget to slash.