By Noah Zahn
Wyoming Tribune Eagle
Via- Wyoming News Exchange

CHEYENNE — Over two days of testimony, lawmakers heard about how Wyoming is losing its ability to provide care close to home.

On Thursday and Friday, the Joint Labor, Health and Social Services Committee convened to address what some stakeholders described as an existential crisis for Wyoming’s healthcare infrastructure, as many call for long-term solutions over recent short-term ones.

Maternity care deserts

The committee’s first priority was the alarming rise of maternity care deserts across the state. Franz Fuchs, deputy director of the Wyoming Department of Health, presented a map illustrating a state increasingly void of labor and delivery services.

Since 2022, four hospitals — in Evanston, Rawlins, Kemmerer and Wheatland — have closed their labor and delivery wards, leaving only 16 birthing hospitals to serve a 97,000-square-mile state.

Fuchs said these closures are rarely intentional, but are instead “a symptom of financial distress” and “load shedding” of unprofitable service lines. He noted that the average Medicaid reimbursement for a birth in Wyoming is approximately $7,500, while the actual cost often nears $20,000.

While the Legislature recently appropriated $17.1 million to increase Medicaid rates for hospitals offering these services, the struggle to recruit and retain providers remains a major hurdle.

Dr. Susan Sheridan, an OB-GYN in Casper, provided a look at the front-line reality.

“A year-and-a-half ago there were six of us (OB-GYNs in Casper)” she said. “There are now two of us.” 

Sheridan pointed to the lack of tort reform — limits on the amount of money plaintiffs can receive from personal injury lawsuits — as a primary reason physicians avoid coming to Wyoming.

“My personal assets are at risk,” she said, noting that without caps on damages, recruiting specialists is nearly impossible.

The discussion also touched on the role of midwifery. 

Marie Adams, an independently practicing midwife, said that 202 home births occurred in Wyoming in 2024. She distinguished between Certified Nurse Midwives, who have full practice authority, and Certified Professional Midwives, who currently face more regulatory restrictions.

Lawmakers discussed expanding the CPM scope of practice to include limited prescriptive authority, though some physicians, like Sheridan, expressed concerns about “care gaps with providers that have less training.”



Behavioral health shortage

Lawmakers also discussed behavioral health, a field which every single Wyoming county has designated as a professional shortage area.

Marianne Gibson of Inseparable, a national mental health advocacy organization, said the shortage is not just a pipeline issue, it’s also a payment and coverage issue. She praised the state’s investment in the 988 suicide lifeline, noting that the in-state answer rate has increased from 0% to 90%, with suicides declining in areas with more coverage.

However, the pipeline remains a bottleneck. 

Todd Helvig of the Western Interstate Commission for Higher Education proposed a multi-site internship consortium to grow and retain psychologists in the state. He noted that Wyoming lacks sufficient clinical training slots for students, who often leave the state to complete their education and never return.

“If you capture somebody for a year to do their internship … many times they stay in the same area in which they train,” Helvig testified.

Public comment revealed deep frustrations with the current system. 

Clark Fairbanks of the Wyoming Youth Services Association testified that licensure often takes “multiple months” because the state uses a “paper and pen” manual system. Ryan Anderson, who serves high-risk youth, noted that vacancies in his Gillette facility have remained unfilled for two years.

The most controversial testimony came from Sheila Matthews of AbleChild, who challenged the perspective of a “shortage.” She cited FOIA-requested data showing that Wyoming spends nearly $11 million annually on psychiatric drugs for children on Medicaid. AbleChild is a nonprofit whose mission is to “protect children from psychiatric labels and drugs,” according to its website.

“There is no shortage,” Matthews argued. “What there is a shortage of is informed consent.”

She urged the committee to focus on “de-prescribing,” rather than simply adding more providers to a system she labeled as “saturated.”

Provider shortages and accessibility

Toni Decklever of the Wyoming Nurses Association highlighted a critical barrier in the nursing pipeline: federal and state regulations that prevent many experienced nurses from teaching Certified Nursing Assistant classes. Decklever noted that to teach CNAs, a nurse must have at least one year of long-term care experience, a rule that disqualifies even highly trained ICU nurses.

“We have many, many, many nurses that would like to be instructors … but they do not qualify,” Decklever said.

The accessibility debate also centered on scope of practice. 

Melinda Carroll of the Wyoming Pharmacy Association advocated for allowing pharmacists to practice to the “full extent of their education,” including limited prescribing and lab-ordering authority. She argued that with a projected shortage of over 100 primary care providers by 2030, pharmacists are an untapped resource.

“The solution already exists in the community pharmacies professional Wyomingites rely on every day,” Carroll said.

This proposal was met with what Sheila Bush of the Wyoming Medical Society called “the gloom,” the predictable tension between provider groups over scope expansion. Bush argued that fragmented care drives up costs and reduces health outcomes.

“The less you know, the less you don’t know what you don’t know. And that’s where things get really dangerous,” she said. 

Instead of broad scope changes, Bush advocated for “synchronous telehealth,” where a primary care doctor and an out-of-state specialist see a patient together in real time.

On recent abortion policy, critics argue the legislative moves to ban abortions make it more difficult to recruit OB-GYNs while spending more taxpayer funds on litigation fees.

Britt Boril, executive director for reproductive advocacy group WyoUnited, said “abortion bans have actually really made it difficult for us to recruit providers.”

“Why would qualified providers want to practice in Wyoming when they’re threatened with criminal charges, jail time and revocation of their licenses just for providing the full standard of care to their patients?” she asked. “And we have seen in states like Idaho, for instance, after they passed one of the most severe abortion bans in the country, they’ve lost over a third of their practice in OB-GYNs there.”

Opposing this notion, Sen. Lynn Hutchings, R-Cheyenne, noted that no doctors or physicians have testified that this policy stance has been a factor of deterring providers from coming to the state. Instead, she cited Wyoming being a “rough place to live” as a primary driver of shortages.

Looking ahead

As the meetings concluded, committee members acknowledged that short-term solutions will no longer suffice. While no decisions were made to sponsor individual bill drafts just yet, lawmakers indicated interest in several options going forward:

• WDH representatives urged lawmakers to repeal the 2027 sunset date for extended postpartum coverage, which currently provides 12 months of care for new mothers.
• The committee may reconsider a bill to allow internationally trained physicians to practice under supervision, an effort to add at least 10 providers to the state.
• Lawmakers are discussing moving the 988 trust fund toward its full $40 million target to ensure long-term stability for the crisis hotline.
• At the same time, the state is awaiting federal approval for the Rural Health Transformation Program, a program that could provide between $800 million and $1 billion over five years to stabilize rural hospitals and incentivize labor and delivery services in Wyoming.

The committee will continue to work these items throughout the interim, meeting next in October.

The above story may be used ONLY by members of the Wyoming News Exchange or with the express consent of the newspaper of its origin.