Rural Hospitals: Calling Closure Warnings 'Pure Fiction' While NY Leads Nation in At-Risk Hospitals
Why this matters in a rural district
In NY-23, the nearest hospital isn’t a convenience — it’s the margin between life and death. When Arnot-Ogden in Elmira employs 2,200 people in a county where good jobs are scarce, and Cuba Memorial in Allegany County has 100 employees with no alternatives nearby, hospital closures don’t just affect patients. They collapse local economies.
Langworthy called concerns about rural hospital closures “pure fiction.” New York leads the nation in at-risk rural hospitals, and six facilities in his own district are operating at deeply negative margins.
Statement
Source: Press Event, Westfield, NY, October 2025 Reported by: Observer Today, Post-Journal
Langworthy dismissed warnings about rural hospital closures as “pure fiction” and described Westfield Memorial Hospital as “expanding its mission.”
He promoted the $50 billion Rural Health Transformation Program as “one of the largest federal investments in our history to support rural healthcare.”
A. The Hospital Crisis: What the Data Shows
Independent analysts, CBO projections, and state agencies all contradict the “pure fiction” characterization. This is what they found.
New York Leads the Nation
Center for Healthcare Quality and Payment Reform (CHQPR) Analysis:
| Metric | New York Data | National Rank |
|---|---|---|
| Rural hospitals at immediate risk | 45% (23 hospitals) | #1 in nation |
| At risk within 6-7 years | 57% (29 hospitals) | Among highest |
| NY-23 safety net hospitals | 7 hospitals | — |
Becker’s Hospital Review (August 2025):
- 25 rural hospitals in NY (51%) are financially vulnerable
- 16 (33%) expected to close within 2-3 years
In plain language: New York has more rural hospitals in immediate danger than any other state. Nearly half could close. This isn’t a projection from political opponents — it’s from healthcare finance analysts who track hospital viability for a living.
NY-23 Hospitals Already in Crisis
Fiscal Policy Institute identified 8 of 12 NY-23 hospitals as dependent on Medicaid for more than 25% of net patient revenue:
| Hospital | County | Operating Margin | Medicaid Dependency |
|---|---|---|---|
| Westfield Memorial | Chautauqua | -59.1% | High |
| Upper Allegheny/Olean General | Cattaraugus | -31.1% | High |
| Schuyler Hospital | Schuyler | -23.1% | High |
| UPMC Chautauqua (Jamestown) | Chautauqua | -17.4% | 37% |
| Cuba Memorial | Allegany | Negative | 42% (~100 employees) |
| Arnot-Ogden | Chemung | Negative | 42% (2,200 employees) |
These hospitals are already operating at deeply negative margins before additional Medicaid cuts take effect.
In plain language: Six hospitals in the district are losing money on every patient they see. Some depend on Medicaid for nearly half their revenue. Cutting Medicaid further doesn’t just stress these facilities — it threatens their ability to keep the doors open.
B. The Westfield Contradiction
Langworthy called Westfield “expanding its mission.” Westfield closed its inpatient unit.
What Actually Happened at Westfield Memorial
- January 2025: Hospital announced conversion to Rural Emergency Hospital (REH) status
- Closed: 4-bed inpatient unit entirely
- Result: Patients requiring hospital stays exceeding 24 hours must now transfer to St. Vincent’s in Erie, PA (approximately 30 miles away)
- Added: Mobile MRI services
Administrator Rodney Buchanan: “Maintaining a 24/7 inpatient unit is costly, and the expenses aren’t warranted by the volume we see.”
Closing inpatient services while adding diagnostic imaging represents an altered mission, not an expansion.
Operating margin: -59.1% — the worst in the district.
In plain language: When a hospital closes its beds and sends patients 30 miles to another state for overnight care, that is not expansion. The administrator himself said they couldn’t afford it. The -59.1% margin tells the story the “pure fiction” comment doesn’t.
C. The Math Problem: $155B in Cuts vs. $50B in Temporary Relief
Langworthy voted for the cuts, then celebrated the partial fix.
OBBBA Impact
CBO Scoring of H.R. 1 (One Big Beautiful Bill Act):
| Category | 10-Year Impact |
|---|---|
| Medicaid/CHIP cuts | $1.02 trillion |
| Dually eligible losing Medicaid | 1.3 million people |
| Rural Medicaid spending decline | $155 billion |
Healthcare Association of New York State projects:
- $8 billion in cuts to New York hospitals
- 34,000 lost hospital jobs statewide
The Rural Health Transformation Program
What the $50B RHTP actually does:
- Created specifically to partially offset cuts from OBBBA that Langworthy voted for
- Temporary: 5 years of funding
- Permanent: Medicaid cuts continue indefinitely
The math:
- Spread across ~2,086 rural hospitals nationally
- Averages roughly $4.5M per hospital per year for five years
- Compare to Westfield’s -59.1% operating margin
KFF Analysis:
- RHTP offsets only 37% of the $137 billion in rural Medicaid spending cuts over a decade
- Federal Medicaid spending in rural areas estimated to decline by $155 billion over 10 years under OBBBA
- RHTP represents about $50 billion temporary offset
Observer Today columnist Andrea Hatfield: “Langworthy called the $50 Billion Rural Health Transformation Program ‘one of the largest federal investments in our history to support rural healthcare.’ Why was this bill necessary? Because the One Big Beautiful Bill Act, a bill Langworthy voted for, made drastic cuts to Medicaid.”
In plain language: Langworthy voted for a bill that cuts $155 billion from rural healthcare, then celebrated a $50 billion temporary program that replaces only a third of what was cut. When the temporary money runs out, the permanent cuts remain. This is not a rescue — it’s a down payment on a problem his vote created.
District Impact by County
| County | Key Hospital | Risk Factors |
|---|---|---|
| Chemung | Arnot-Ogden (2,200 jobs) | 36% Medicaid enrollment; 12% proposed tax increase |
| Chautauqua | UPMC, Westfield | Two hospitals at deeply negative margins |
| Cattaraugus | Olean General | -31.1% margin; limited alternative employers |
| Allegany | Cuba Memorial | ~100 employees with few alternatives |
| Steuben/Schuyler | Schuyler Hospital | -23.1% margin |
Assessment
The characterization of hospital closure concerns as “pure fiction” is not supported by:
- CBO projections
- Fiscal Policy Institute analysis
- Healthcare Association of New York State estimates
- Center for Healthcare Quality and Payment Reform data
These independent analyses project $8 billion in cuts to New York hospitals and 34,000 lost jobs statewide.
The $50B Rural Health fund partially offsets but does not reverse the structural Medicaid reduction. RHTP is temporary (5 years); Medicaid cuts are permanent.
Whether individual hospitals close depends on multiple variables, but the fiscal pressure on already-negative-margin facilities is documented, not fictional.
Verdict: MOSTLY FALSE — Data from CBO, state agencies, and independent analysts directly contradicts the “pure fiction” characterization.
For a shorter summary of what Medicaid changes mean for NY-23 healthcare access, see: What Medicaid Cuts Mean for NY-23 Healthcare
Sources
- Observer Today: “Langworthy discusses health care in Westfield visit” (October 2025)
- Observer Today: “Rural hospital funding far from restored” - Commentary (December 2025)
- Post-Journal: “Rural Needs: Langworthy Discusses Healthcare In Westfield Visit” (October 2025)
- WGRZ: “New ‘rural emergency hospital’ status for Westfield Memorial” (January 2025)
- Buffalo News: “Westfield hospital to end inpatient services” (January 2025)
- Fiscal Policy Institute: “New York Hospitals will Close under the OBBBA” (June 2025)
- Governor Hochul’s office: Hospital impact analysis (governor.ny.gov)
- Center for Healthcare Quality and Payment Reform: Rural Hospital Analysis (2025)
- Becker’s Hospital Review: States at Risk of Rural Hospital Closures (August 2025)
- KFF: “How Might Federal Medicaid Cuts Affect Rural Areas?” (2025)
- FactCheck.org: “Rural Health Fund Falls Short of Estimated Medicaid Cuts” (September 2025)
- CBO: H.R. 1 (One Big Beautiful Bill Act) scoring
- Related: Medicaid Coverage Cuts
- Related: Rural Hospitals: Praising Temporary Fix
Note: This entry documents publicly available information from official reports and news sources. Readers may draw their own conclusions.
Last updated: February 9, 2026