02-04-2025
CRMC expects cuts; Enroll Wyoming, mental health, law enforcement to be impacted
CHEYENNE – Amid major cuts in federal grants to health departments nationwide, Cheyenne Regional Medical Center was notified last week that three of its 10 federal grants will be impacted.
Funding for these grants was either paused or cut for the next fiscal year. As a result, there will be funding reductions to the mental health co-response program, mobile integrated health program and Enroll Wyoming, said CRMC spokesperson JJ Barley-Dunning.
'We know that there's going to be significantly less funding – grant funding – available next year,' Barley-Dunning told the Wyoming Tribune Eagle.
Federal sources account for approximately 44% of the total net revenue for the Cheyenne hospital, 'most of which is provided through direct patient care we provide,' she said. In addition, CRMC has also experienced delays in payments from federal insurance providers Medicare and Medicaid.
Last week, the federal Department of Health and Human Services (HHS) announced plans to lay off 10,000 full-time employees. Hospitals across the nation, including CRMC, are concerned about the 'future of (these) timely payments,' Barley-Dunning said in an email to the WTE.
'Despite these challenges, CRMC remains dedicated to providing high-quality care and support to our patients and community,' she wrote. 'We are actively monitoring the situation and will take necessary steps to ensure continuity of care for our patients, their families and our communities.'
Cuts to Enroll Wyoming
One of the three impacted grants is funding for Enroll Wyoming, a statewide nonprofit and affiliate of CRMC that helps Wyomingites navigate health insurance options at little to no cost.
On Feb. 14, the Centers for Medicare and Medicaid Services (CMS) announced a 90% reduction in federal funding to the Affordable Care Act Navigator Program, from $97.6 million to $10 million.
Enroll Wyoming was awarded $1.5 million in its last grant from the program last year, and the funding is expected to last through late August. The next grant should arrive by the last week of August, said Enroll Wyoming marketing director Caleb Smith.
'We do not know specifically what we're going to receive,' Smith said. 'Nationally, the amount of money for that grant has been reduced by about 90%, so we're expecting to see our funding be reduced by a proportional amount.'
While specific funding allocations haven't been announced, Enroll Wyoming anticipates a proportional reduction from its current $1.5 million budget to $100,000 for the 2025-26 fiscal year. The nonprofit Wyoming program is 'exclusively' funded through federal money, according to Smith, and it anticipates major budget cuts following these funding reductions, including potential layoffs.
Enroll Wyoming is currently seeking alternative sources of funding outside the federal government, Smith said.
'This is something that has occurred in the past,' he said. 'We have a history of (working) with the resources that are made available to us.'
However, with potential staff cuts looming, some staff members of Enroll Wyoming, including Smith, are on the lookout for other job opportunities.
'I think anybody in this type of industry is keeping their eyes open,' Smith said. 'We just don't know what's going to happen next.'
Major cuts to health care
The Wyoming Department of Health (WDH) was notified last week it will lose nearly $40 million in federal grant funding, part of an $11.4 billion pullback of COVID-19-related funds by HHS.
WDH spokesperson Kim Deti said the department expects to lose more than $39 million in grant funding for the Public Health Division and less than $1 million for the Behavioral Health Division. Affected funding includes COVID-19-related grants for immunizations, epidemiology and laboratory operations, health disparities and substance abuse prevention, Deti said in an email to the WTE.
Wyoming counties, hospitals and health care programs will be impacted by these cuts, Deti said, including some in Laramie County.
'We have started notifying direct recipients of these grant funds about the situation,' Deti said in an email, 'and we recognize there will be some tough effects.'
It's unclear at this point what the impacts of these cuts will be. WDH officials are currently working to clarify and work through the timing issues of the loss in grants.
'At the same time, it was always known these grants were temporary,' Deti said. 'We have been planning, where possible, for funding transitions to ensure many key activities could continue. This week's notices mean those transition plans will begin a little sooner than expected.'
The Department of Government Efficiency (DOGE) posted a list on March 23 of every state and university health department that will lose federal grant money, claiming $33 billion in total savings.
A review of the list by the WTE calculated an estimated loss of $45 million in federal grants to the WDH. However, Deti said she could not confirm whether those numbers are reflected in actual cuts to the state health department.
Furthermore, Deti could not confirm if the $39 million in terminated grant funding was related to the DOGE cuts. Last week's notification came through the federal grant system, she said, and the action was covered by an executive order.
'We're not sure how the federal government is labeling or attributing reductions,' Deti said.
Justifying cuts
CMS announced cuts for the ACA Navigator Program on Feb. 14, returning funds to pre-pandemic amounts, expecting pre-pandemic results.
CMS said 'savings from this reduction will allow the Federally-facilitated Exchanges (FFEs) to focus on more effective strategies that improve Exchange outcomes and to reduce the user fee in future years, which would translate into a reduction in premium,' according to the release.
CMS also expects to see enrollment costs decrease from $1,061 per enrollment – in 12 cases, $3,000 per enrollment – down to $211 per enrollment.
'These numbers indicate that Navigators are not enrolling nearly enough people to justify the substantial amount of federal dollars previously spent on the program,' the release reads. 'This reduction will ensure funding is focused on meeting the statutory goals of the program more efficiently and effectively.'
The Navigator program is funded by user fees, and the decrease in funding to $10 million per year will save a total of $360 million over a five-performance period that runs through Aug. 26, 2029, according to CMS.
Because the user fee is directly passed through to the premium that health insurers charge, the savings supports lower premiums for consumers in the individual health insurance market.
'People who do not qualify for federal premium subsidies will directly benefit from lower premiums,' the release reads. 'Lower premiums will also translate to less federal spending on premium subsidies.'
When asked why CMS experts expected pre-COVID funding to produce pre-COVID results, given that the economy has drastically changed, CMS redirected the Wyoming Tribune Eagle to the press release, which did not answer the question.
CMS also did not provide clarity on whether these cuts are related to external pressures for government efficiency or how they determined enrollment costs.
In coordination with its announcement, CMS posted 2017-2024 Navigator Funding and Enrollment Data.
While CMS anticipates savings and a reduction in premiums, Enroll Wyoming expects to work with limited resources in the upcoming grant year.
'Our staff, our partners and the consumers we serve know how valuable our work is, and we are incredibly proud of what we do,' Enroll Wyoming project manager Jason Mincer said. 'Our services will continue as scheduled through August. If you or someone you know needs help securing health insurance, now is the time to reach out. Call, email or find an Enroll Wyoming Navigator – we're here to help.'
As of Jan. 15, Wyoming reported 46,643 enrollments in health care coverage during the Marketplace Open Enrollment Period for 2025. CMS releases Marketplace Open Enrollment Period Public Use Files (PUFs) on an annual basis. PUFs for 2025 have not yet been released.
Enroll Wyoming will continue assisting as many people as possible, running awareness campaigns and promoting advanced tax credits that make marketplace health insurance more affordable. Even outside of open enrollment, many individuals qualify for marketplace plans through special enrollment periods.
'We are actively exploring partnerships and alternative funding sources,' Mincer added. 'Strengthening collaborations with health care providers, nonprofit organizations and government agencies will be crucial in ensuring that Wyomingites do not fall through the cracks.'
