Wyoming Medical Center laid off 58 employees today and announced it will not fill another 57 positions due to the region’s declining economy. The 9 percent reduction to Casper’s second-largest employer will trim an estimated $7.2 million in annual expenses.

Employees who were let go were notified this morning and offered a severance package that includes up to 60 days of pay.

Chief financial officer Yvonne Wigington said the hospital is simply serving more patients and getting paid less. Reimbursements from Medicare and Medicaid continue to decrease. Seventy-one percent of patients rely on coverage that does not meet their full cost of service — a situation that will likely get worse as continuing layoffs in Wyoming’s energy sector leave more people without health coverage.

The hospital’s uncompensated care increased this fiscal year by $4 million, on track to total $55.1 million.

“We don’t, today, see that reimbursement from Medicare is going to increase, and we don’t see that we’re going to have a significant change in our economy for the better in the near future,” Wigington said.

At a press conference, CEO Vickie Diamond said hospital leadership had to take the painful action of laying off employees because of the “moral, ethical and legal” obligations as Natrona County’s only nonprofit hospital to provide care for all persons in the county.

“No patient care services are being cut,” Diamond said. “We are taking this action so we can remain healthy and strong for the years to come.”

Wyoming lawmakers this winter refused to expand Medicaid for the fourth year in a row — an action that would have added about $268 million for health care providers and patients statewide, according to the state’s top health experts. Diamond said if the Legislature had expanded Medicaid it might have added $2 million to the hospital’s fiscal year revenue.

Asked whether there’s anything Wyoming lawmakers could do to help the hospital’s fiscal situation in the near term, Diamond said probably not. “The horse is out of the barn.”