Latest news with #CRMC
Yahoo
03-05-2025
- Health
- Yahoo
Potential $880B cut to Medicaid could have big impacts on Wyoming hospitals, nursing homes
CHEYENNE — Should Congress follow through with a proposed $880 billion cut to Medicaid, Wyoming hospitals and nursing homes stand to lose significant funding on top of an already fragile health care system, stakeholders told the Wyoming Tribune Eagle this week. Congress is having ongoing discussions about how to cut $880 billion in program spending. There is a current deadline of May 9 for congressional committees to make their budget recommendations, but this deadline is not set in stone, according to reporting by Politico. 'To get to that number, Medicaid would have to take a pretty big hit,' said Wyoming Hospital Association Vice President Josh Hannes. States with expanded Medicaid programs under the Affordable Care Act are going to feel the brunt of these cuts. Although Wyoming is one of a handful of states that didn't opt in to Medicaid expansion, the Cowboy State is far from being in the clear, according to sources. 'Wyoming didn't expand Medicaid, so that wouldn't touch us. But that also doesn't get them to $880 billion,' Hannes said. 'So, what else are they gonna do?' One potential area that has health care officials concerned is the looming expiration date of premium tax credits. These are a federal subsidy that makes insurance policies more affordable on the health insurance marketplace. Around 42,000 Wyomingites depend on these tax credits, Hannes said. 'If those go away … rates on the marketplace are going to jump dramatically,' he said. This is a 'significant concern' for Cheyenne Regional Medical Center, said Cheyenne Regional Health System Chief Financial Officer Yvonne Wigington. First and foremost, hospital associates are worried about the impact the loss of these credits will have on patients, she said. People will either have to forgo their health insurance or choose a plan that doesn't fully meet their health care needs. More people will be at risk of losing their health coverage and delaying treatment, Wigington said. 'We really don't ever want patients to feel like they have to delay their care,' she said. On the financial side, CRMC would lose between $9 million and $18 million in annual revenue if the tax credits were to expire. 'We care for any patient, regardless of their ability to pay for their services,' Wigington said. 'If those individuals did not have health care insurance and did not have a way to pay for their health care, that would be $9-18 million that we don't get paid for.' Hospital officials are currently evaluating 'many different scenarios for potential cuts' at CRMC, Wigington said. However, it's difficult to pinpoint what the actual impact would be, with so many cuts being proposed at the federal level. 'We're not sure exactly which cuts may actually be implemented,' Wigington said. In addition, the hospital is facing stress from another major federal action — increased tariffs. Wigington said President Donald Trump's tariffs affect the hospital's vendor contracts, medical supplies, pharmaceuticals and the information technology area. However, with the percentage of these tariffs constantly changing, preparing for financial impacts has been a moving target. 'We're in the preliminary stages, but we definitely have seen price escalations,' Wigington said. 'Some of our vendors have notified us that they're not able to honor quotes that they've given us previously until they are better able to evaluate the impact of tariffs.' Wigington said tariffs have not impacted services or employment at CRMC so far. 'The (tariffs') percentages have changed a few different times,' Wigington said. 'We, like probably every other hospital, are really just trying to plan with what we know now and anticipate those things that are being proposed.' Uninsured rates in Wyoming The Kaiser Family Foundation (KFF) reported that 59,400 Wyomingites, or 10.5% of the state's population, were uninsured in 2023. By comparison, 8% of the entire U.S. population was uninsured that same year. 'We already have struggling hospitals and nursing homes, and Medicaid is a lifeline for a lot of those facilities,' Hannes said. 'Medicare and Medicaid together represent way over half of total revenue for our hospitals in the state.' A 2022 contribution analysis conducted by the Center for Business and Economic Analysis at the University of Wyoming found that Wyoming's hospitals and nursing homes directly contribute a combined $47.5 billion to the gross state product. The hospital and nursing home industry made up 3.5% of Wyoming's total economic contribution, as well as provided 19,370 jobs, according to the analysis. 'If you're not investing in our health care infrastructure, you're doing harm, and if you're going to pull away investment, that's even worse,' Hannes said. 'So it's certainly concerning, the discussions that are going on at the federal level.' Adding to the number of uninsured patients increases cost of care, Hannes said. When a patient is unable to pay for services, 'hospitals eat that.' 'Our industry is different from so many others, because we don't get to decide what we get paid, and we have to serve everyone who comes in through the door,' he said. About 7% of CRMC's total patient population is on Medicaid, Wigington said. The potential $880 billion cut in funding to Medicaid, equivalent to about an 11% spending reduction for the program, would expand the local hospital's funding gap by $1.8 million. 'The payments already that we receive for caring for our Medicaid patients don't cover our cost to care for those patients,' Wigington said. In the 2024 fiscal year, there was a $10 million shortfall in Medicaid payments, which the hospital tries to alleviate through other funding sources, she said. 'That is a lot of money,' Wiggington said. In January, U.S. Sen. John Barrasso, R-Wyo., brought up Wyoming's challenges with rural health care to Robert F. Kennedy Jr., who is now U.S. secretary of Health and Human Services. Barrasso said six Wyoming hospitals are at risk of closing, two are in immediate risk of closing in the next two years, and 10 have had to cut available services, according to a news release from his office. 'We have 33 hospitals in Wyoming. Twenty-six are located in various locations often hard to get to, or weather impacts them,' Barrasso said. 'This is a concern of rural hospitals in both Republican and Democrat states. It's bipartisan. It is critical that the financial, workforce challenges that we are facing are addressed.' Nursing homes at risk Most states finance at least a portion of their Medicaid spending through taxes collected from health care providers, which generates additional federal matching payments to the states, according to a Congressional Budget Office (CBO) analysis. States return the collected taxes to those providers in the form of higher Medicaid payments. Wyoming's had a hospital provider tax since 2017 and a nursing home provider tax since 2011, according to the Center on Budget and Policy Priorities, a progressive think tank based in Washington, D.C. These mechanisms help draw down federal dollars to the state, Hannes said, and nursing homes are a huge benefactor of these programs. There is currently a 6% provider tax cap. The CBO estimated a 5% cap on the provider tax 'would reduce the deficit by $41 billion from 2024 to 2032.' A 2.5% cap 'would reduce the deficit by $209 billion over that period.' Critics of restricting provider taxes argue this 'will create financing gaps for states that could result in higher state taxes, reductions in Medicaid eligibility, lower provider payment rates, and fewer covered benefits,' according to KFF. 'If they dial back these provider loopholes, that's a direct reimbursement reduction to the nursing homes,' said Wyoming HealthWorks CEO Tracy Brosius. 'They're almost entirely dependent on that.' Around 70-80% of patients in nursing homes are reliant on Medicaid, Brosius said. People are there because they have a high clinical need and no one to take care of them. She questioned where these people are supposed to go once nursing homes start shutting down. 'What happens if they cut the provider taxes and now the nursing homes start to fold?' Brosius said. 'What happens to the 80 people that are there?'
Yahoo
16-04-2025
- Business
- Yahoo
NOAA calls for R.I. officials to fill open seats on CRMC
Crystal Serenity, a cruise ship owned by Crystal Cruises visiting Newport, is anchored in the Anchorage D area west of Goat Island on Oct. 3, 2024. (Photo by Janine L. Weisman/Rhode Island Current) The National Oceanic and Atmospheric Association (NOAA) gives top marks to the expert staff of Rhode Island's coastal regulatory agency in a new evaluation. But federal regulators remain concerned over three open seats on the politically appointed Rhode Island Coastal Resources Management Council (CRMC), calling on Gov. Dan McKee and the legislature to fill the vacancies 'as soon as possible.' 'It is essential that a quorum is maintained and the Rhode Island Coastal Resources Management Program conducts a regular and full schedule of Council and subcommittee meetings in order to implement Rhode Island's approved coastal management program,' NOAA's Office of Coastal Management wrote in its April 10 report. The 148-page document examined federal data collection, in-person meetings with staff and council members, and verbal and written public comments on the agency's performance spanning the five-year period from September 2019 to October 2024. Federal monitoring of the state coastal program is required as part of a 1972 federal law setting up coastal regulations and funding for state-level programs. More than one-third of CRMC's $6.2 million budget in fiscal 2025 came from federal funds, including roughly $1.7 million from NOAA. NOAA's latest evaluation concludes that the state is 'successfully implementing and enforcing' its federal coastal management program based on examination of its program administration, offshore wind projects, public access and protections against shoreline erosion. However, NOAA highlighted several weaknesses in Rhode Island's adherence to federal regulations, including the vacancies on the 10-member council. Seven spots are filled, with the newest gubernatorial appointee, Dr. Michael Reuter of Barrington, confirmed by the Rhode Island Senate last month. The three open seats risk canceled meetings and delayed decisions if the council can't get at least six of its sitting members to show up — a problem that has plagued the appointed body for years. Olivia DaRocha, a spokesperson for McKee's office, said in an email Wednesday that the governor was seeking qualified candidates for the open seats. She confirmed candidates are now under consideration, but did not respond to follow-up questions such as how many contenders are being vetted. Council vacancies are one of many problems cited by critics, whose frustrations with the panel's controversial, and at times, unlawful, decisions have reached a boiling point. Coastal advocates have teamed up with Rhode Island Attorney General Peter Neronha and state lawmakers to overhaul the agency, proposing to eliminate the council and reshape the CRMC as an administrative body akin to the Rhode Island Department of Environmental Management. Several versions of this proposal have been introduced in the Rhode Island General Assembly this year, but not advanced beyond committee prior to the legislature's April break. NOAA took no position on the pending state legislation but noted states have flexibility to determine the structure of their coastal management programs. Of the 29 states with federal coastal management programs, only three — Rhode Island, California and North Carolina — give significant decision-making power to an appointed panel, according to a February report from the Rhode Island Department of Administration. Jed Thorp, advocacy director for Save the Bay, saw NOAA's indifference to how Rhode Island executes its coastal management program in a positive light. Save the Bay is a leading advocate for the proposed overhaul of the CRMC. 'Sometimes, opponents [of the reform bill] will point to NOAA as this sort of bogeyman,' Thorp said in an interview Wednesday. 'NOAA is basically saying, 'we don't care how you set it up. You have a menu of options available to you.'' Save the Bay ultimately wants to get rid of the council, but Thorp still wants the open seats filled in the interim. 'We need the council to be fully seated so they can function and conduct their business,' Thorp said. The CRMC issued a statement on April 10 celebrating its 'good grade' from NOAA. Jeffrey Willis, CRMC executive director, acknowledged requests for an interview but did not respond to subsequent calls and emails. The report offered high praise for the agency's 32-person staff who 'excel at defining their role as regulator and policymaker, forging strong partnerships with others who have complementary skill sets and missions.' However, the increasing scope of their work and responsibilities, from the slew of proposed offshore wind projects to disputes over public access to the shoreline and complex permitting applications, are more than the current employee roster can handle. Employees worked 60 to 80-hour weeks during reviews of proposed offshore wind projects, according to the report. 'Moving forward, a continued insufficient staffing level and strain felt by staff places the state of Rhode Island at a disadvantage in being asked to manage and analyze a significant amount of information and material required to complete additional federal consistency reviews,' the report stated. Lack of staffing has also contributed to a backlog of permitting applications, insufficient enforcement against violators such as Quidnessett Country Club, and delayed and incomplete reporting required for federal grants, the report stated. McKee has rejected calls to fund new hires for the strapped coastal agency. His proposed fiscal 2026 budget rejects the CRMC's request for money for five more employees. In lieu of more full-time workers, NOAA suggested partnerships with university law programs and use of third-party contractors. And it reiterated a requirement first made in a 2020 report to transition to an online permitting database. The original 2024 deadline has now been extended to Sept. 30, 2026. The CRMC did not respond to questions Wednesday regarding the delays in creating the online database. The evaluation comes as the Trump administration has imposed major layoffs and budget cuts at NOAA. How attempts to gut the federal regulatory agency will trickle down to Rhode Island's state coastal program remains murky, though Willis told council members during an April 8 meeting that the CRMC could lose up to 10% of its $1.7 million in NOAA funding. When incorporating additional administrative costs for the state to seek and carry out federal funding, the cuts could rise to 17%, Willis said. 'At this time of year, we usually have our federal allocation in hand,' Willis said. 'Right now, we don't know how we're going to put it in our budget and we don't know what kind of funding we're going to get. We're just in a wait-and-see period.' SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
14-04-2025
- General
- Yahoo
Can a local fishing panel make a difference in offshore wind projects? We're about to find out.
A fisherman fishes off rocks at Sachuest Point in Middletown. An advisory panel of fishermen is set to review SouthCoast Wind's proposal to snake a pair of underwater transmission lines up the Sakonnet River, east of Sachuest Point, then run them underground across the northern tip of Portsmouth and out Mount Hope Bay to make landfall at Brayton Point in Somerset Mass. (Getty image) When the Rhode Island Coastal Resources Management Council (CRMC) put out a public call for volunteers to revive a state fishing advisory panel, a former panel member warned Jim Riggs against joining. Riggs, a 75-year-old recreational fisherman and retired electrician who lives in Westerly, applied anyway. 'I feel that in order to have your voice heard when it comes to fisheries management, you're either on the table or on the plate,' Riggs said in an interview. 'I prefer to be at the table.' His seat at the table is now secured; he is one of nine new members the CRMC named to its Fishermen's Advisory Board (FAB) after a single, unanimous vote on April 8. The advisory panel has been inactive since all of its former members resigned together in August 2023 to protest what they viewed as the CRMC's kowtowing to offshore wind project developers at the expense of local fishermen. Will the same frustrations bubble up? The first test comes this week, as the new panel begins negotiations with SouthCoast Wind, which has applied for a permit to run transmission lines from its wind turbines up the Sakonnet River and out Mount Hope Bay. Rich Hittinger, a former FAB member who led the mass resignation effort two years ago, isn't optimistic. 'We were asked to review a lot of applications and give input that took a lot of time and effort, but then the council really did not care what our input was,' said Hittinger, who is first vice chair of the Rhode Island Saltwater Anglers Association. He had discouraged Riggs from joining the panel. 'I think nothing has changed structurally at the CRMC, so I told him that most likely, you will spend a lot of time on these projects and your input will not be considered,' Hittinger said. Marisa Desautel, the attorney hired to represent the fishing advisory panel in prior negotiations with offshore wind developers, felt the same way. 'The process is the same as it was then — there's no policy in place other than the language written in the [CRMC rulebook],' Desautel said. But Desautel said she would be interested in serving as the attorney for the FAB again if she were asked. The CRMC through its Ocean Special Area Management Plan (SAMP), created in 2011, requires input from fishing representatives on any large-scale offshore development. The advisory panel is meant to minimize negative impacts to fishing habitats by offering input on project locations, construction schedules, and other details. And, it can request an attempt to negotiate compensation from developers to offset projected losses to commercial and recreational fishermen from their projects. But federal regulations limit what the state coastal agency, and its advisory bodies, can do about offshore wind. The CRMC can affirm whether or not a federal offshore wind project complies with state regulations, but the real control lies with the U.S. Bureau of Ocean Energy Management, which dictates where projects are built, environmental and economic impacts, and construction and operating plans. Jeffrey Willis, executive director for the CRMC, acknowledged in an interview that state coastal regulators often had little authority over matters the FAB brought to the council in the past. Prior interactions between citizen volunteers and deep-pocketed international companies behind wind projects felt off-balance to Jim Boyd, who served 22 years at CRMC before retiring as its deputy director in 2022. 'It felt like there was a stacked deck, if you will,' Boyd said. Rhode Island coastal regulators can't change federal lease and mitigation policies. But they can reduce friction by having FAB members attend fewer meetings for negotiations on offshore wind projects, Willis said. 'With the old FAB, those guys were super-involved,' Willis said. 'They would come every Thursday night for a couple of hours and put their hearts and souls into it, and in the end, they felt they weren't getting their point across,' Willis said. 'We didn't want to repeat that burnout.' Willis acknowledged that this won't fix the difficult-to-calculate financial piece of wind negotiations, which rely on federal fishery landings data that typically does not capture the lived experience of local recreational and commercial fishermen. 'Compensation is one of the hardest discussions to have,' he said. The new board members are preparing to wade into that difficult discussion on the SouthCoast Wind project, a 147-turbine wind farm planned off the coast of Martha's Vineyard. The CRMC in December 2023 approved the broad strokes of a plan to run the wind farm's power lines through Rhode Island waters to reach land at Brayton Point in Somerset, Massachusetts. Cables would extend up the Sakonnet River and out Mount Hope Bay — much closer to local fishing grounds than the turbines off the coast of Martha's Vineyard. The former fishing advisory board members had already resigned by the time of its decision, so there was no attempt to determine compensation to offset fishing losses. The CRMC is now reviewing a separate permit application related to the SouthCoast underwater cable lines. An initial meeting between the project developers, the CRMC and the new FAB members is planned for this week, though no date had been confirmed yet, Willis said. 'When the Ocean SAMP was adopted 15 years ago, the whole emphasis was on the offshore impacts,' Boyd said. 'There was no consideration of inshore fisheries because there was so much unknown. But now, we know that the SouthCoast export cables are going to be coming into our waters. We need to have representation for that.' In a statement, SouthCoast Wind welcomed the restoration of the FAB. 'SouthCoast looks forward to meeting with the new FAB members in the coming weeks and continuing to move forward with the Rhode Island CRMC permitting process,' Rebecca Ullman, a company spokesperson, said in an email Friday. Willis originally reached out to two different area fishing groups to see if they were interested in joining FAB. Both declined. A series of emails to industry listservs earlier this year yielded more success — 12 applicants, including one proposed alternate. 'I was pleasantly surprised,' Willis said. 'I was worried about the possibility that, given the history of what happened with the old FAB, we would have a hard time.' Unlike fellow recreational fisherman, Riggs sees the benefits to offshore wind development. He claims the underwater foundations and cables for other projects near Block Island have increased his catch. 'It creates a structure for fish to congregate to and feed at,' Riggs said. I feel that in order to have your voice heard when it comes to fisheries management, you're either on the table or on the plate. I prefer to be at the table. – Jim Riggs, 75, a Westerly recreational fisherman and new member of the Rhode Island Fishermen's Advisory Board A self-proclaimed conservationist, Riggs hoped his experience on the water, as well as his avid consumption of news about the wind industry, would help protect Rhode Island's prized ocean ecosystem. Other volunteers who applied to join the advisory panel also expressed their interest in protecting the state coastal environment, according to letters and emails submitted to the CRMC. The agency's regulations allow for up to 20 members on the fishing advisory panel, including up to two representatives each for six categories of fishing; up to two representatives of seafood processing facilities; and up to six Massachusetts fishermen who fish in waters subject to Rhode Island coastal regulations. All 12 applicants, including the one alternate, were approved as new members, except for one initial candidate who withdrew his name prior to the confirmation, Laura Dwyer, a CRMC spokesperson said. One of the 11 people confirmed Tuesday, Isaiah Alvarez, subsequently decided not to continue as a board member, he said in a text message Thursday night. Alvarez did not respond to questions about his decision. Half of the applicants identified as recreational or commercial fishermen, including several with former military experience in the U.S. Navy or U.S. Coast Guard. Another, Patrick Dowling, managing partner at D'Amico Burchfield LLP in Providence, has a bachelor's degree in environmental science from the University of Rhode Island and concentrated in environmental law at the Vermont Law School, he said in an email to the council. Jennifer Scappatura-Harrington, owner of Quonnie Siren Oyster Company in Charlestown, hopes to offer a voice for the state's aquaculture industry and women in fishing, she wrote in an email to the council. Dowling and Scappatura-Harrington did not return calls for comment. One of the 10 board members who was confirmed on April 8 dropped out, leaving nine. Wayne Banks, a recreational fisherman, retired electronics engineer for the Naval Undersea Warfare Center in Newport, and former member of the Jamestown Harbor Commission Richard Corrente, a recreational fisherman and owner of Portside Tavern in Bristol Patrick Dowling, a recreational fisherman and managing partner at D'Amico Burchfield LLP in Providence who has a bachelor's degree in environmental science from the University of Rhode Island Jeff Grant, a commercial fisherman and representative of the Rhode Island Shellfisherman's Association; Mike McGiveney, association president, will serve as an alternate if needed Steve Langley, a recreational lobster fisherman who served five years in the U.S. Coast Guard James Riggs, a retired electrician and recreational fisherman Jennifer Scappatura-Harrington, an oyster farmer who owns Quonnie Siren Oyster Co. in Charlestown local oyster farm owner Adam Silkes, co-owner of North Kingstown-based shellfishing company, American Mussel Harvesters John Walker, a native Newport resident and commercial fisherman who formerly served on the Newport Waterfront Commission SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
10-04-2025
- Politics
- Yahoo
RI lawmakers debate multiple Coastal Resources Management Council reform bills
PROVIDENCE, R.I. (WPRI) — Some state legislators want to restructure the council that oversees Rhode Island's coastline, but there's a debate over how it should be reformed. The Coastal Resources Management Council (CRMC) was created in the early 1970s. According to its website, the council is responsible for the 'preservation, protection, development and where possible the restoration of the coastal areas of the state' through policy development, planning and permitting. It also manages public access to those areas. The state agency is made up of 10 volunteer members appointed by the governor, who currently include a lawyer, a podiatric surgeon and a mandatory representative from the R.I. Department of Environmental Management (DEM). LEARN MORE: What is the CRMC? A bill proposed by state Rep. John G. Edwards, D-Tiverton, would replace CRMC with the Division of Coastal Resources Management, which would operate under DEM. 'Many of the issues that have plagued CRMC for years — chronic delays in making simple permitting decisions, lack of members and frequent missed/cancelled meetings, and the increasing number of flawed decisions being overturned by the courts — are caused by CRMC's politically-appointed board,' Edwards said in a press release. The council hasn't had a full 10 members since 2019. Currently, it only has six seats filled, which is the minimum needed for a quorum, state Sen. Victoria Gu, D-Westerly, noted during a senate hearing last week. RELATED: Save the Bay accuses CRMC of power abuse for canceling controversial seawall meetings In the meantime, members of the Senate Committee on Environment & Agriculture are proposing a different way to reform the CRMC. State Sen. Mark McKenney, D-Warwick, introduced Bill 775, which would change the council's structure and operation. Under his proposal, the CRMC would remain its own entity, with a setup similar to DEM. However, the nine politically appointed members would be removed and decision-making power would be shifted to a cabinet-level director who answers to the governor. Advocates, including the R.I. Attorney General's Office, nonprofit Save the Bay, and former CRMC members were present at last week's hearing to voice their support. Gu said she believes that allocating more budgetary resources to the CRMC is critical in the face of ongoing environmental issues. 'Future permitting and planning decisions by the CRMC or the Department of Coastal Resources will absolutely need to take into account the best science we have on sea level rise and beach erosion,' Gu explained. 'A professionalized agency will have the expertise to make these difficult decisions and help preserve our shoreline amidst rising seas and stronger storms.' MORE: RI Beach Erosion Commission considering solutions as state loses 2 feet of land each year Edwards agrees that CRMC needs more structure, but told 12 News that having the agency work within DEM would save money and prevent overlap. CRMC is a quasi-state entity, meaning it can perform government functions, but is not directly part of state government. 'Most quasis exist only because of their ability to bond outside of the state's financial obligations,' Edwards said. 'CRMC does not have any bonds nor do they anticipate applying for any in the future.' Edwards' bill, which would take effect upon passage, has already been referred to the House State Government and Elections Committee, which is expected to review the legislation this week. McKenney's bill was held for further study. Laura Dwyer, spokesperson for the CRMC, declined to comment on the proposed legislation. Download the and apps to get breaking news and weather alerts. Watch or with the new . Follow us on social media: Close Thanks for signing up! Watch for us in your inbox. Subscribe Now Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
02-04-2025
- Health
- Yahoo
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.'
