Wyoming Targets up to $800M in Rural Health Cash to Shore up Care, Workforce and Access

WyoFile and CBS News contributed to this report.

Wyoming is going after a big pot of federal money to fix rural health care. The state filed its application Wednesday for up to $800 million from the new Rural Health Transformation Program, with winners set to be announced Dec. 31 by the Centers for Medicare & Medicaid Services.

Created under President Donald Trump’s One Big Beautiful Bill Act, the $50 billion, five-year program is meant to stabilize small hospitals and expand services in rural America.

“Wyoming is taking full advantage of the Rural Health Transformation Program,” Gov. Mark Gordon said, calling the proposal a way to “keep critical services local.”

After 11 public meetings and 1,300 survey responses, the Health Department boiled community feedback into four big moves:

• Keep the basics close to home. Right-size and, where needed, consolidate rural hospitals and EMS around sustainable payers — while protecting essential services like maternity care.
• Build the workforce. Grow training slots and career paths for nurses, paramedics and other frontline staff; recruit and retain more primary-care doctors.
• Prevent what we can. Push nutrition, exercise and other healthy-living efforts to lower Wyoming’s high rates of diabetes and heart disease.
• Use tech smarter. Expand tools that help manage chronic disease and improve access in far-flung communities.

Wyoming’s health gaps are widening — long drives for care, nursing shortages, and rising hospital costs. On top of that, enhanced ACA premium tax credits expire at the end of 2025, which could spike premiums and put 11,000–20,000 residents at risk of losing coverage, according to Healthy Wyoming. Meanwhile, the federal law that created this fund also cuts Medicaid spending by an estimated $793 billion over 10 years, a change experts warn will strain rural systems even more.

Maternity care is already feeling the squeeze: Banner Health paused labor and delivery in Wheatland this fall, the fifth Wyoming hospital in recent years to shutter a birth unit.

Lawmakers plan two bills for the 2026 session to shore up maternal care:

• Allow Medicaid coverage for freestanding birth centers staffed by midwives.
• Set rules for pregnancy centers, a contentious move that sparked lengthy debate.

Wyoming’s application also nods to “BearCare,” a proposed state-sponsored plan that would kick in after medical emergencies — one more attempt to plug coverage holes without expanding traditional programs.

Critics nationally worry the rural fund could become a political slush pile or bypass small hospitals for bigger systems. Wyoming officials say they’re treating the money as one-time and will prioritize projects that outlast the grant window.

“Our application reflects a clear vision for Wyoming’s healthcare future,” Gordon said. “This money isn’t forever. The investments must stand the test of time.”