A year after lawmakers spent the summer discussing possible solutions to Wyoming’s crippling shortage of maternity care services and came up dry, the interim Joint Labor and Health Committee is moving two proposals forward that they say will help.
The 14 lawmakers on the committee discussed maternal health deserts for almost five hours at a recent meeting. Maternal health deserts are defined as areas without a hospital or birth center offering obstetric care and without any obstetric physicians. The committee declared the topic its number one priority this year, requesting the Legislative Service Office (LSO) to draft five bills.
On Oct. 16, it voted to introduce two of them to the Legislature’s budget session set to kick off in February.
The discussion comes a month after Wheatland’s labor and delivery department announced its closure. The Banner Platte County Hospital CEO told Wyoming Public Radio it was just a pause in services. Their main challenges to keeping the department open were recruiting OB-GYN providers and a decline in births in the past several years.
There are currently nine counties in the state without labor and delivery capacity.
Pregnancy centers and freedom of speech
Pregnancy centers often provide free pregnancy tests, ultrasounds and other resources for soon-to-be mothers. Some, referred to as crisis pregnancy centers or CPCs, don’t offer abortions and dissuade women from ending their pregnancies.
The bill draft states it will prohibit "the state and specified governmental entities from adopting any law, rule or policy that targets pregnancy centers from oversight or regulation based on the centers’ stand against abortion.”
The proposed legislation, also known as the Care Act, has been pushed by the national Christian law group Alliance Defending Freedom. Montana passed a version of the law earlier this year. In South Carolina, it got stuck in the House. All three bills have almost identical language in intent and protect the activities of pregnancy centers.
Denise Burke, senior counsel for Alliance Defending Freedom, testified during Wyoming’s recent committee hearing in favor of the bill.
“ This bill prevents them from being singled out for this censorship or discriminatory treatment simply because of their pro-life ethic and practices. It does not, as some opponents falsely claim, make centers and their volunteers or employees completely immune from oversight,” Burke said.
During the discussion of the bill, Sen. Charles Scott (R-Casper) asked whether the bill was a copy of a national bill.
A LSO staff member responded, “I’m pretty sure it is a national bill that’s been introduced in several different states.”
However, later in the discussion, Rep. Rachel Rodriguez-Williams (R-Cody) replied directly to the claim.
“ I did carry this bill in the previous session. I am [a] Wyoming legislator, worked with [a] Wyoming attorney and LSO staff to draft it. So it is modeled specifically for Wyoming,” she said.
Rodriguez-Williams sponsored the same bill in 2025. It sailed through the House but then failed to be introduced to the committee of the whole in the Senate.
The majority of public comments and discussion focused on First Amendment concerns, not the crux of addressing maternal health care deserts.
“ When we talk about protecting freedom of expression, [we] should ask ourselves: Whose expression really counts?” said Sophia Gomelsky while testifying against the bill draft. “The trained doctors, nurses and midwives who are providing evidence-based care, or unregulated centers that are impersonating them? As a young woman from the state, I’ve seen why young people are leaving.”
Rep. Cheri Steinmetz (R-Torrington) asked Gomelsky, “ It's always interesting to me how worried we are about the next generation, and yet we're killing the next generation. So what do you have to say about that?”
“ There's no such thing as an unborn child, certainly not in science,” Gomelsky replied. “And so that isn't the next generation. I'm the next generation. I'm sitting right in front of you. And what I'm asking you guys to do is to protect us while we're here, the people that are here, and the people that you really do serve.”
Those testifying in favor included Valerie Berry, the executive director of LifeChoice Pregnancy Care Center in Cheyenne. She said she’s not aware of any problems with government oversight in the state at the moment, but the bill is needed as a proactive step just in case.
Those in favor also argued that these centers are in areas where there is no other maternal healthcare. A couple of Republican self-described pro-life lawmakers said they had concerns about unforeseen consequences as a result, like Sen. Gary Crum (R-Laramie).
“I think there are some things in this bill that are concerning,” Crum said. “I think there's things in this bill that as we get into a budget session, are gonna be really, really hard to deal with.”
Those issues included going against the Governmental Claims Act, First Amendment questions and setting a precedent that's pro-life but potentially "overreaching" for the nonprofit pregnancy centers.
Crum and others with similar sentiments still voted in favor. The bill passed 10 to 2. It will need a two-thirds majority to be introduced in February during the budget session.
Birthing centers, Medicaid reimbursements and insurance parity
Birthing centers struggle with insurance and getting reimbursed for their facility costs. The centers work with low-risk clients who want to give birth outside of a hospital setting. They also offer prenatal and postpartum care, birth services and lactation classes.
But Medicaid doesn’t reimburse birth centers for facilities and administration.
Wyoming currently has two birthing centers. Earthside Birth and Wellness Center in Cheyenne was Wyoming’s first freestanding birth center. Earthside is now nationally accredited. Mountain Heart Midwifery in Evanston opened after the local hospital shut down its labor and delivery services.
Earthside co-founder Sarah Morey previously told WPR that they eat $4,000 to $5,000 per Medicaid client, so they lobbied to fix this with state lawmakers creating a draft bill that will cover Medicaid fees for their facilities.
Earthside’s other co-founder, Allison Hayek, testified about the need to the committee.
“ There were around 6,000 births in the state of Wyoming [in 2023]. Around 30% of those are covered by Medicaid at the time of birth. The Medicaid dollars that will be used in the future to pay for birth center facilities are not new dollars. These are dollars that are currently and would otherwise be paying a hospital facility, either a hospital facility in the state or an out-of-state facility, if clients were seeking either a birth center or a midwifery-led birth out of state,” she said.
She noted it costs much less to reimburse for a birth at a birthing center versus a hospital. She said the total cost for an Earthside client giving birth is $7,500. Half of that is for the provider, which Medicaid reimburses, and the other half is the facility cost.
“ The average hospital facility rate alone – no midwife services, no physician services, no OB services – hospital facility rate is $10,000 for the vaginal birth. Not for room and board,” she said.
Hayek concluded that if the bill were passed, it could help open doors for more birthing centers in the state.
”It will also create a known pathway for other midwives around the state to have the incentive to open birth center facilities when they know what they'll be reimbursed for as Medicaid facilities,” she said.
Lawmakers and Hayek agreed licensed birthing centers could open in more areas that don’t have labor and delivery, potentially addressing a piece of the problem. However, there was some worry about competition for services, since the state’s birth rate is low.
However, a second bill related to birthing centers that would give them insurance parity died due to no motion. Lawmakers said they worried it would get too much discussion and not enough votes to pass during the budget session. And some wanted to see what happened with the Medicaid reimbursement bill first, before taking on insurance parity. It was discussed that it should be introduced at the next general session.
Increase in reimbursement rates for obstetric services
One bill draft that public commenters were in favor of was increasing Medicaid reimbursement rates for obstetric services. The bill proposed to increase reimbursements by 5%.
Those testifying said it would help with retaining and recruiting OB-GYNs in the state. Plus, they said it could help stabilize the teetering maternal healthcare situation in the state.
Jacques Beveridge is a Wyomingite and Cheyenne OB-GYN. He’s also on the governor’s maternal health task force. He said this idea came from that committee.
“ I think retention and recruiting of OB-GYNs, really all physicians specific to obstetrics in the state, is really challenging, and I think this takes a step in the right direction of helping. I am not sure that the 5% is enough,” said Beveridge.
Lawmakers barely discussed the bill, ultimately voting 6 to 8 against moving it forward.
Medicaid birth cost recovery from fathers
Rep. Mike Yin (D-Jackson) brought forward this draft bill that would repeal a state law that requires the Wyoming Department of Family Services to recover the costs of a Medicaid-covered birth from the child's father by establishing paternity and ordering payment. This concerns any father making 400% over the federal poverty level when the parents aren’t married.
“The problem it was trying to address was that we were getting ripped off in the Medicaid program on quite a scale,” said Sen. Charles Scott (R-Casper) to explain why the law was passed in 2018. “What would happen is you have a couple where the male member was very high earning, and some of the cases were coming out of, frankly, our big coal mining areas. The female was not as high an earner. What they would do is not get married when they decided to have kids, and therefore, it just depended on her earnings. And this, frankly, very wealthy couple was getting on our welfare program with Medicaid.”
However, Christie Gordy, senior administrator of the Department of Family Services, told the committee, “ Based on our experience in implementing the current law, it is not achieving the outcomes envisioned when it was enacted back in 2018. If the committee wishes to continue pursuing the underlying policy goal, repealing the current statute would provide an opportunity to consider alternative mechanisms that may be more effective in achieving the desired outcome.”
Gordy said the department has recovered $742,000 in judgments since 2018. Fifty percent has to go back to the U.S. Centers for Medicare & Medicaid Services and the other 50% goes back to the Wyoming Department of Health. This means the state has collected $371,000 through the law. In the meantime, the Department of Family Services, through the child support program, has spent nearly $524,000 to do this work for a net loss of $152,000.
However, after some discussion, lawmakers decided not to move the repeal bill forward, saying the budget session won’t allow enough discussion and thought.
“ I'm not opposed to listening to this topic more at this time. It’s probably not the right place in time for the budget session,” said Rep. Jacob Wasserburger (R-Cheyenne). “One of the things that just has me a little bit concerned is the part in here removing the part about not having a requirement for the father to pay for birthing costs. I could just see that being kind of another easy way for some folks if they're not having any type of responsibility on birthing costs.”
The Wyoming Legislature will convene on Feb. 9 for the budget session. Wyoming Public Radio’s and WyoFile’s podcast, Cheyenne Roundup, will return to keep you updated.
