The Wyoming Supreme Court began the year 2026 with a landmark decision in State v. Johnson, 2026 WY 1, delivering a ruling with implications that extend far beyond its immediate outcome. While headlines will focus on the Court’s decision to strike down Wyoming’s comprehensive abortion restrictions—the Life is a Human Right Act (“Life Act”)[1] and the Medication Ban[2]—as unconstitutional, the true significance lies elsewhere. The Court held that Wyoming’s constitutional amendment guaranteeing adults the right to make their own healthcare decisions is a fundamental right protected by the highest level of judicial scrutiny.

This holding may ultimately have more far-reaching consequences, setting the stage for future challenges to a wide range of healthcare regulations across Wyoming.

Much of the Court’s decision is devoted to constitutional analysis, in which the court finds that Art. 1, §38 of Wyoming’s constitution, guaranteeing competent adults the right to make their own health care decisions “subject to reasonable and necessary restrictions”, is a fundamental right. As a result, the Court then held that any governmental restriction, such as those presented by the Life Act and the Medication Ban, is subject to “strict scrutiny,” the highest level of judicial review. Under this standard, the State bears the burden of proving not only a compelling governmental interest, but also that the law is necessary and narrowly tailored to achieve that interest, using the least restrictive means available. The Court emphasized that the State “may not simply declare an interest as compelling,” but must provide concrete evidence and legislative facts to justify its position, requirements the Life Act and Medication Ban failed to meet.

However, while the Court’s finding that these specific laws are unconstitutional is important,[3] its recognition that the constitutional right to make healthcare decisions is a fundamental right is even more significant. This right is subject to the highest level of protection and could have greater long-term impact.

As the Court’s majority opinion admits, “medical and health care is highly regulated in Wyoming, which means there are many statutes subjected to Article 1, §38’s protection of an individual’s right to make his or her own health care decisions.”  However, as Justice Gray’s dissent points out, few of the statutes regulating health care in Wyoming have been subject to constitutional scrutiny, let alone the highest level of constitutional analysis. While the Court’s majority opinion rightly states that this issue is one for another day, Justice Gray’s dissent lists numerous healthcare statutes and regulations that may now be subject to constitutional challenge, including mandatory vaccination requirements, disease reporting, controlled substance prescribing limits, and involuntary mental health commitment statutes – none of which have previously been subject to strict scrutiny. 

Whether the Court’s decision in Johnson v. State leads to the “unintended consequence” of an increase in litigation over the constitutionality of healthcare statutes, as the Court puts it, remains to be seen. Several healthcare statutes flagged by Justice Gray as being on ‘constitutional life support’ could still withstand judicial scrutiny. Nonetheless, Wyoming’s Legislature would be well served to heed the Court’s footnoted admonition the next time it considers proposing constitutional amendments or enacting new healthcare regulations:

It should come as no surprise that one of the consequences of amending the constitution to create a new individual right will be additional legal challenges. This is a reason amendment of the constitution should be pursued with caution and sufficient forethought.

[1] Wyo. Stat. Ann. §§ 35-6-120 to 35-6-138.

[2] Wyo. Stat. Ann. § 35-6-139.

[3] There are numerous other interesting aspects of the Court’s opinion, including its frequent mentions of “fetal life,” and its definition of “health” as “the condition of being sound in body, mind, and spirit”.  However, discussion of these issues, and their impact on Wyoming’s healthcare legal framework, will have to wait.