Federal administrators with the Centers for Medicare and Medicaid Services have given final approval to Wyoming’s $205 million plan to fortify its precarious rural healthcare network.  The money is for the state’s Year 1 application to the Trump administration’s Rural Health Transformatio n Fund. Wyoming stands to receive hundreds of millions more through 2030 from the $50 billion initiative.  “This $205 million investment gives hospitals and clinics across Wyoming new opportunities to improve the healthcare services our communities rely on,” Wyoming’s U.S. Sen. John Barrasso said in a press release from Gov. Mark Gordon’s office. The Wyoming doctor and Republican majority whip championed the Rural Transformation Fund as a sensible solution while railing against the expansion of Affordable Care Act subsidies that expired in December. “I look forward to seeing the innovative ways Wyoming uses these resources to recruit and train health providers and strengthen healthcare across our state.” Wyoming’s final application outlines an array of proposals to prop up hospitals, build workforce and bolster preventative health. They include regionalizing emergency medical services, establishing clinical workforce training grants and creating financial incentives to persuade small designated “Critical Access Hospitals” to focus on essential community services of an emergency department, an ambulance service and a delivery facility for babies. Craig Jones stands for a portrait in front of Basin Pharmacy in Basin on Feb. 21, 2024. It’s the key healthcare access point for the town of about 1,300 people and the surrounding area. (AP Photo/Mike Clark) However, the final application that the Centers for Medicare and Medicaid Services approved omitted two significant proposals from the original application: a state-operated public insurance plan for healthcare emergencies and a system of investments that could generate revenue for the measures in perpetuity. The state ditched the health insurance plan, dubbed “BearCare,” after legislators frowned on the idea. The so-called “perpetuity” was dropped, meanwhile, after it did not pass muster with federal administrators and certain “esoteric federal regulations,” Wyoming Department of Health Director Stefan Johansson told the Legislature’s Labor, Health and Social Services Committee last week.  Even without these two components, Wyoming’s plan focuses on providing and sustaining basic care in its rural and frontier communities, Johansson said in a press release, which was the No. 1 priority that emerged from providers, public and stakeholder groups. “We are excited to begin implementing this program, which is a unique opportunity to transform the economics of basic care and incentivize the services we know our rural constituents need.” How we got here The Rural Health Transformation Program was created by President Donald Trump’s 2025 One Big Beautiful Bill Act.  Wyoming Department of Health staff gathered input and drafted an 84-page application, outlining the state’s priorities: building the state’s healthcare workforce; improving residents’ metabolic, cardiovascular and behavioral health; and using technology to improve chronic disease management and bring care closer to home. Some of the initiatives proposed to address those include: Build cooperative agreements for EMS agencies to work together on a regional basis. Stand up a grant process for technology to improve care delivery. Fund annual awards to cover educational costs for individuals interested in joining one of four clinical pipelines: nursing, EMS, behavioral health and physician.  Add more slots to Wyoming’s existing accredited programs for postgraduate medical education, likely in new sites.  Implement the Presidential Fitness Test in Wyoming’s primary and secondary schools.  Limit the state’s SNAP benefits to healthy food purchases, not including things like sodas and candy.  The Centers for Medicare and Medicaid Services announced in December that all 50 states will receive awards in 2026 under the program. Wyoming was awarded $205 million. That kicked off a deeper scrutiny of the application by federal administrators, who took issue with the perpetuity fund as an allowable cost, Johansson said. President Donald Trump attends an event to promote investment in rural healthcare in the White House on Jan. 16, 2026, in Washington. He is joined by Secretary of Health and Human Services Robert F. Kennedy, Jr., and Mehmet Oz, administrator for the Centers for Medicare and Medicaid Services. (AP Photo/Evan Vucci) The state’s application identified the perpetuity as core to Wyoming’s sustainability plan. Similar to Wyoming’s Permanent Mineral Trust Fund, this “perpetuity” would use investments to continually generate revenue for healthcare programs, the application said. When Johansson told the legislative committee last week that the feds would not allow the perpetuity, he urged lawmakers to keep the concept on the table for a future federal opportunity or even a state-driven initiative.  “It’s just a very unique and Wyoming-specific financing vehicle that I think could be very productive and fruitful for the state,” when it comes to sustaining basic healthcare services in Wyoming, Johansson said. What’s next Though Wyoming leaders are celebrating the approval, it will also require a lot of work in a short timeframe. Wyoming must obligate Year 1 program funds by the end of October. That means drafting contracts, hiring staff, requesting proposals, making approvals and obligating funds. State workers, contractors and healthcare providers will have to hustle to lay the groundwork for programs they hope will shore up healthcare for the long term. Future funding under the program will be based on the state’s implementation process and performance, according to the Centers for Medicare and Medicaid Services. The post Feds greenlight Wyoming’s plan to spend $205M on healthcare initiatives appeared first on WyoFile . ...read more read less