The massive cuts to the Medicaid program proposed in the so-called Big Beautiful Bill currently in the U.S. Senate and passed by the House would have a devastating impact on upstate New York rural hospitals. Gov. Hochul estimates the annual loss to New York state鈥檚 health care sector will be $13.5 billion. Rural hospitals will be disproportionately impacted by the loss. There is no question that some already financially fragile hospitals will close.
Rural hospitals serve a captive population. Patients who because of age, poverty, lack of insurance or lack of transportation cannot access health care services in larger urban centers. Most rural hospitals get 65%-80% of their reimbursement from Medicaid and Medicare. Under current Medicaid and Medicare reimbursement, our rural hospitals already experience financial distress and are losing millions of dollars. New York state has provided support to essential rural hospitals for years. Some have been converted to critical access hospitals permitting cost-based reimbursement. The reduction in Medicaid dollars to our state will certainly reduce the state鈥檚 ability to continue that support.
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Beyond providing essential health care, I would also emphasize these hospitals are typically the major employers in their areas.
The current financial challenges that rural hospitals face in our state are well-known. So it is striking that Republican House members from upstate New York overwhelmingly voted for the House version of the bill. Elise Stefanik, NY-21, has no less than five hospitals in her district and Claudia Tunney, NY-24, has three. All of the hospitals in their districts already are currently experiencing financial distress. This bill will certainly cause some to close. Why a congressperson would undermine health care for their own voters is hard to understand.
Prior to our retirement, my partner and I spent many years consulting with rural hospitals, including some in NY-21 and NY-24. They have always faced serious challenges but they are essential to our health care system and to New York鈥檚 most vulnerable residents. This bill is bad for them and bad for New York.
Jane O'Connell lives in Cazenovia.
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