When applying for more than $500 million in the $50 billion of federal money Congress allocated for rural health initiatives this summer, the Wyoming Department of Health thought “Bear Care” would be a catchy name for one of its pitches, a state-run insurance program geared toward emergencies only.
Because many swaths of Wyoming are bear territory and clashes with bears can happen.
If approved, the proposed program would give individuals and small business groups a government-backed option to provide insurance for catastrophes and emergencies.
It weathered scrutiny Monday in the legislature’s Joint Appropriations Committee, which met at the state Capitol to broach the second week of its four-week budget-planning marathon.
House Appropriations Chair John Bear, R-Gillette, offered to rename the program “Gordon Care,” after Wyoming Gov. Mark Gordon, an oft-moderate Republican who emphasized health care funding in his own vision for the state budget.
Sen. Mike Gierau, D-Jackson, parried that, saying he wanted to rename it “Wyoming Care.”
Either way, said Senate Appropriations Chair Tim Salazar, R-Riverton, lawmakers will want more explanation of it from the Wyoming Health Department (WDH).
The department included Bear Care in its Nov. 5 application to the federal Centers for Medicare and Medicaid Services, for the Cowboy State’s slice of a $50 billion Rural Health Transformation Fund that’s being funded as part of the Trump-backed One Big Beautiful Bill Act.
The bill passed in July.
The WDH should know by the end of this year whether the administration approves its application for about $100 million a year for the next five years, to implement changes geared toward benefitting health care in rural Wyoming areas, WDH director Stefan Johansson told the committee on Monday.
John Bear doesn’t favor Bear Care, he said. That’s because it would be a government-backed insurance program.
“We’re getting into a business that, frankly, the government created the problem in the first place,” said Bear. “So I’m not inclined to want to compete in the private sector; I don’t think that’s the proper role of government to do so.”
Bear cast the insurance program as government competing against private insurance companies, heaping more hardships upon them.
Johansson cast it instead as an alternative to compete with the Affordable Care Act-backed programs, or “Obamacare.”
He said it would be designed to extend “catastrophic” incident or emergency medical event coverage to individuals and small business groups, so that they wouldn’t have to buy a “Cadillac” program from those in the marketplace now to extend those offerings.
He also said the federal money for which WDH is applying would be “seed” money to get it started, but after that it would be a self-sustaining program borne by those paying into it for services “at cost.”
Johansson emphasized that Bear Care and other programs for which WDH has applied under the Rural Health Transformation Fund are meant to change the health sector in the long-term, in ways that will keep benefits flowing after the five-year funding window closes.
Bear asked why Wyoming doesn’t seek instead to wipe out the unpaid bills hospitals have amassed.
Johansson said the Trump administration’s guidance disallows that option. He also said that comes with “moral hazard.”
Wyoming offering a program just for catastrophic incidents is at least a “novel” idea, Bear continued. But the government won’t be able to power and negotiate its way through the ever-increasing costs of health care as well as the private sector could if left alone, he asserted.
Across 1,300 or 1,400 responses to a WDH survey about rural health care needs, and after 11 or 12 public town hall meetings, the cost of health insurance emerged as the no. 2 top concern Wyomingites voiced, Johansson said.
That’s driven by potential changes in the marketplace now, but also by the general state of it, the director added.
The Affordable Care act requires individual and small-group insurance policies to include 10 “essential health benefits” which include mental health services, hospital services, prescription drugs and pregnancy care.
The state’s not under that mandate, so it can offer the cherry-picked coverage product of catastrophic care to Wyomingites, said Johansson.
WDH’s hope is that offering that option will help individuals and small-businesses buy cheaper plans alongside their Bear Care, and in turn help Wyoming businesses pay their employees more.
Bear wasn’t the only skeptic.
Rep. Abby Angelos, R-Gillette, indicated that history should discourage this effort.
“Anytime the government has gotten involved in health care, education, home loans, those industries have gone up in price significantly,” she said.
Rep. Ken Pendergraft, R-Sheridan, said he doesn’t see how it’s the proper role of government, “to go into competition with the free market.”
Franz Fuchs, deputy director of the Wyoming Department of Health, emphasized that enrollment in Bear Care, or Gordon Care, or Wyoming Care, would be optional. So Wyomingites would inform their government by their participation or non-participation whether it was a good idea.
“And because it would be self-insured, there’d be no additional costs for people who are enrolled,” said Fuchs. “The costs would be borne by the pool.”
Johansson said he believes this program would extend a “trust factor.” Often, he said, people find they’re not able to be reimbursed just when they badly need the money – after decades of paying toward a program.
The Appropriations Committee’s meetings are ongoing through the second week of December and for two weeks in January. The Wyoming legislature will contemplate the full state budget – including the Wyoming Department of Health’s proposals, in its session opening Feb. 9.
