In 1993, Wyoming leaders created a commission to make recommendations for reforming the state’s health care system. One out of every four Wyomingites at the time spent more than 20% of their income on medical expenses.
“Wyoming’s greatest natural resource is our people,” Thomas Stroock, a U.S. ambassador and Republican state politician who chaired the committee said that year. “Caring for their health is essential to the future of our state.”
A decade later, the state empanelled another commission to grapple with many of the same questions over health care affordability. And yet cost and accessibility remain vexing issues here, experts in the field say.
That reality is spurring state officials to take another crack at the problem with a new commission. But this one, unlike the previous iterations, would be permanent: the Wyoming Healthcare Authority.
“If you don’t have health care in an area, it’s really hard to have economic development and stability.”
Jen Davis, Governor’s Health and Human Services Policy Director
As proposed, that authority would be made of experts from the public and private sectors who aggregate data and real-world experiences to make recommendations on how to improve the state’s health care system. And unlike the previous panels, this group would stick around to see them through.
“They put the recommendations forward, but then they ended,” Jen Davis, Gov. Mark Gordon’s health and human services policy director, said of the previous attempts. “So then there was no continued conversation after that to make sure that those recommendations continued to move forward, that those recommendations were still appropriate. They just kind of fell flat.”
The authority would focus on things like cost, quality, innovation and access to health care, according to the proposal, and would only require one full-time paid position: an executive director.
“The mission of this group is to engage in collaborative decision making for improved health outcomes and economic diversification,” Davis told the Legislature’s Joint Labor, Health and Social Services Committee while introducing the concept Monday. “If you don’t have health care in an area, it’s really hard to have economic development and stability.”
There were plenty of concerns voiced during Monday’s meeting, though, largely from members of the Wyoming Freedom Caucus and other far-right politicians. Questions ranged from who’d be part of this new authority to whether this new body was necessary when committees like theirs already exist.
“Some of us are concerned about what we see happening in departments and different portions of the medical community,” said Sen. Lynn Hutchings (R-Cheyenne). She also expressed concern that the proposed commission would add an extra “layer” of government. “This kind of bothers me in that you’re trying to alleviate a process that seems to be working really well.”
Davis countered that she didn’t believe today’s system is working that well.
“I respectfully disagree,” she said. “I think sometimes constituents maybe come forward to all of you and you hear one side of the issue and not necessarily all the sides of the issue, and sometimes that results in policy that doesn’t work for everybody.”
The committee voted 8-6 to draft bill language to form a healthcare authority. Legislators intend to review and vote on that legislation at their next meeting in June.
History and conflicts of interest
Like now, the state’s previous commissions on health care reform sought to address the rising cost of medical care in Wyoming.
“[I]n 1993, 126,000 residents were paying more than 20% of their household income on health related expenses, while data from 2021 shows that 13.5% of our adult population are not seeking care due to the high cost of healthcare in Wyoming,” the task force proposal says. “Regardless of the previous commission’s efforts, Wyoming has fallen flat in improving cost and accessibility to healthcare services.”
So now, the governor’s health task force is recommending a permanent group that continues the work task force members have been doing individually for the last few years. Since the task force is Gov. Gordon’s initiative, it could end with him.
But skeptical lawmakers at Monday’s meeting questioned who’d be part of this commission and what views they hold.
“Are you aware they elect us to protect them from the experts?” asked Sen. Anthony Bouchard (R-Cheyenne). “I’d like your view on regulatory capture and how these kind of committees actually pull that industry in where the experts get to have the say and maybe control it for better profit or profitability on their end. And that becomes a driving force.”
Good policy comes from a comprehensive approach with both sides providing expertise via first-hand experience, Davis said. But, she noted, many legislators aren’t working in health care every day, and this authority will have the flexibility to hear hours of testimony from both sides of every issue.
“So I do think experts are necessary,” she said. “How we define experts is different, depending on what side of the issue you’re on, and that’s OK. We have to have those discussions.”
Bouchard was unconvinced, referencing how those who questioned COVID-19 policies were denounced by experts. Bouchard was one of the loudest critics in Wyoming of the government’s response to the pandemic, at one point suggesting then White House Chief Medical Advisor Dr. Anthony Fauci should be executed.
“I’m quite frankly appalled thinking that we’re going to get experts in a room and come tell us how it’s going to be because they have better views,” he said. “How is having a certain group of experts, hand-picked experts, hand-picked, going to help us decide when everybody has an agenda.”
The commission as proposed would include only nonpartisan members appointed by the governor, including a licensed nurse, physician, hospital administrator, EMS provider, business owner, a dean or administrator in higher education, and a Wind River Indian Reservation tribal member, among others.
It would also include “ex-officio” members, including in part: Davis, the health department director, the Department of Family Services director and the co-chairs of the Joint Labor, Health and Social Services Committee.
Freedom Caucus members also questioned whether this was being done to support passage of Medicaid expansion — Wyoming is one of 10 states that haven’t expanded Medicaid — and whether the idea for a health care authority was driven by out-of-state interests.
Davis replied that previous commissions explored similar questions going back decades and this was a Wyoming-based solution. She also stated that while Medicaid expansion has been discussed by the governor’s health task force, the Legislature has voted against it, and “I don’t think there’s one solution that solves everything.”
Medicaid Expansion would be a start.
The medical services disparities between WY and other states is great.
Community based “go fund me” efforts to help with medical expenses is not a sound economic approach to health care.
Those who cant afford care or insurance, or the ability to travel to get care, eventually leave WY one way or another.
The state is an advertisement for poor health care delivery, no public health policy, and deliberately
inadequate insurance coverage. Its a wonder the suicide rates arent higher! Maybe a new evaluation might look at the correlation between absence of affordable and available health care and the highest suicide rates in the country to move the needle in favor of safe adequate and affordable health care.
I was born and raised in lander Wyoming. 2/27/62. For the majority of my life, I worked heavy construction. On state and federal jobs. In Nov. 2019 I crushed the T8 vertebrae. Local Dr at sagewest hospital, said no big deal, it’ll heal.
Went back to work, light duty. Worked until March 20 2020, pandemic shit everything down.
Feb. 6 2021, blew out the L1 & L2 vertebrae, working for a friend at his grocery store. Got a new local Dr, he had me get a bone density scan & MR, at Washakie Medical Center, Worland Wyoming. Checked my Testosterone level, & checked for cancer. Results were
-4.4 on the T scale, -1.10 on the Z scale. Testosterone level was 282.
No cancer. Dr knew an awesome neurosurgeon in Jackson Wyoming. I have EXTREMELY SEVERE OSTEOPOROSIS. I am the one half of one percent. Nothing can be done, to fix my spine. Just trying to increase bone density, to where the recurring damage stops.
A bone fragment at the L1 is cutting my spinal cord. Utah, Colorado, even Mayo Clinic agreed,
There’s nothing that can be done,
Other than what we’re doing to increase bone density. I was granted disability 4 months after applying. Granted Medicaid March 2022, Wyoming Dept of health took away the Medicaid May 2023. Fed. Turned on Medicare August 2023.
Every state around Wyoming that expanded Medicaid, costs went down, patient care went up, healthier people. FACT. Wyoming will spend money on frivolous things, like a State Shooting Complex. But the excuse for not expanding Medicaid is “we don’t want the federal government telling us what to do”. Remember when Wyoming refused to raise the drinking age to 21. The Fed. refused to release highway funds.
Come on people. Wake up. The health of people is important.
Thank You for your time. Darrell C. Franch
The only thing that changes your mind about the need for good, affordable healthcare, is getting sick with a disease that requires hours of travel for treatment. Because we are pretty remote compared to cities, our fresh food supplies are not the greatest. We get the last of everything when it comes to vegetables and fruit. A healthy lifestyle is great if you can afford it. But cancer, Parkinson’s, MS, etc. still happen. Denying people Medicaid is wrong. Not being aggressive about attracting medical people is wrong. The Governor is trying to do something helpful and our “legislature” are acting, as usual, like the idiots they are. Vote for an educated legislature, not grandstanding do nothings. I pay taxes for a reason and don’t mind doing so. We need to send some STRONG messages to these people who don’t care about the people they supposedly serve.
The comments of the “Freedom Caucus” are so illogical and delusional as to make me concerned for these members’ mental health and grasp of reality: we must make everyone aware that these people are simply unqualified to represent us:
“Are you aware they elect us to protect them from the experts?”
“I’m quite frankly appalled thinking that we’re going to get experts in a room and come tell us how it’s going to be because they have better views”
“you’re trying to alleviate a process that seems to be working really well.”
As to the question of “whether the idea for a health care authority was driven by out-of-state interests,” all of us must wake up to the reality that the entire premise and name of the “Freedom Caucus” is imported from a national agenda-pushing organization comprised mainly of election-denying extremists – and vote these members out of office to replace them with people who actually care about Wyoming and its citizens.
Having served on the second health care commission, the biggest weakness was that its existence did not continue after the recommendations were made to the Legislature and largely ignored by it. Dealing with the problems in the health care field are difficult and finding solutions don’t come easily or quickly. The proposed health care authority’s existence past one term of the Legislature is critical to its success. But without such a provision, the proposed authority will fare no better than the two commissions.
Quality medical care is not available to all whether it is no insurance or high deductibles. Barb Spencer expressed it very well. I had the same experience with my best friend as she did with her aunt. He did not seek health care because of money and died young because of it. The freedom caucus opposes every solution to our lack of healthcare but offers no solution of their own. This in a Country with lowest life expectancy , highest maternal death rate and highest death rate among children of any of the 28 richest countries except China and Russia.
These right wing hacks demonstrated long ago that they cares not a damn for the health of Wyoming residents, especially the less fortunate and the disadvantaged, when they repeatedly refused the expansion of Medicaid. As long as we keep electing idiots, nothing will change.
Instead of railing against experts, shouldn’t these Freedom Caucus people ask themselves why all of the smart people disagree with them on every issue.
Dr. Fauci was the Director of the NIAID for close to 40 years, worked under 7 presidents. Bush 43 awarded him the Presidential Medal of Freedom, one of 8 awards as Director, before ending his second term. Fauci attended Holy Cross then went on to Cornell where he studied medicine. He was one of the top researchers in HIV in the country ,where he helped accessbility for experimental medicines not yet FDA approved. He had his battles with many in the LGBTQ community because of politics. This was the early 80’s and we know where the president at that time stood. Here we have a State Representative who knows almost nothing about medicine calling for his execution. This appears cult like, I wonder why.
The neverending struggle, healthcare is expensive, everyone has access, one way or another. Maybe a healthier lifestyle would help.
How in the world can you possibly think everyone has access? Often, it devolves into an emergency situation and if the person doesn’t outright die, they go to the ER, too late, too little, and end up with a bill they can’t pay which gets transferred off to you and I in the form of higher healthcare costs, higher insurance, write offs by the hospital, even bankruptcy on the part of both the patient and health care facility. My aunt deferred care because she could not afford it, did not have Medicaid expansion and she died of a curable disease had she been able to get care sooner, care that was affordable or covered.
So many times we keep hearing from the Freedumb Caucus that they are apposed to experts, apposed to Medicaid expansion yet have offered no alternative solutions. They’re nothing but ‘against’ but have no ideas on how to make access to medical care easier for Wyoming people. By the way, polls show the majority in Wyoming support Medicaid expansion….now if they would make it a priority at the ballot box…
It is reasonable to conclude that a new healthcare advisory panel would not be able to effect any changes in the healthcare system in Wyoming. The previous healthcare panel made up of intelligent citizens who were willing to spend extraordinary amounts of time and effort to analyze the healthcare system in Wyoming and came to understand the changes necessary to provide more affordable and higher quality medical care to all citizens were stymied at every turn by our amateur legislature.
The laziness of all legislatures since the final recommendations were delivered to them continued to disregard the fundamental changes necessary to reduce cost and increase quality.
The conclusions of that panel are still valid and much of the work has already been accomplished. Because of the knee jerk reactions from legislators already in print any thoughtful action would be to no avail. It is easier to get rid of the legislators who continue to oppose the changes that a vast majority of Wyoming citizens support.
Mr. Strook? I forgot about him and some of the other quality politicians that Wyoming used to have. We really have fallen to the current misfits and controlling oddballs.
Ya, but the freedom caucus gave people more road-kill opportunities.
“How is having a certain group of experts, hand-picked experts, hand-picked, going to help us decide when everybody has an agenda.”
Bouchard claims he is a 2nd amendment “expert”
Once again, he owes the people of Wyoming septic dumping fees for speaking.