What Medicaid Cuts Mean for NY-23 Healthcare
Why This Matters for NY-23
Six hospitals in NY-23 are operating at negative margins, some losing 30-59 cents on every dollar. Many get 30-40% of their revenue from Medicaid. When the CBO projects 10 million Americans will lose health insurance under the bill Langworthy voted for, and the Kaiser Family Foundation estimates $155 billion in rural Medicaid cuts, the math for these hospitals is existential — not “pure fiction.” If Cuba Memorial closes, every resident of northern Allegany County loses their nearest hospital.
What Medicaid does in NY-23
In a rural district where the nearest specialist might be two counties away and the local hospital is the largest employer in town, Medicaid is not a partisan issue. It is the revenue stream that keeps hospital doors open, the coverage that lets an elderly parent stay in a nursing home, and the reason a family with a disabled child can access therapy without driving to Rochester.
Langworthy says “not a single person” will lose coverage and calls closure warnings “pure fiction.” The CBO projects 10 million will lose health insurance. Six hospitals in his own district are operating at deeply negative margins. Here is what the numbers show.
Three ways the bill threatens rural healthcare
1. Coverage losses — including protected populations
The CBO projects 10 million people will lose health insurance by 2034 under the One Big Beautiful Bill Act. 7.5 million will lose Medicaid specifically and become uninsured. This includes 1.3 million dually eligible seniors and disabled people — the exact populations Langworthy says are protected.
The bill exempts these groups from work requirements. It does not exempt them from the eligibility verification changes, provider cuts, and administrative procedures that actually cause most coverage losses.
What this means locally: In Chemung County, where 36% of residents are enrolled in Medicaid, coverage losses cascade. Fewer insured patients means less revenue for hospitals that are already losing money. Governor Hochul’s office projects 1.5 million New Yorkers will lose Medicaid coverage.
2. Hospital viability — six district hospitals already in crisis
Six NY-23 hospitals are operating at deeply negative margins, and most depend on Medicaid for more than a quarter of their revenue:
| Hospital | County | Operating Margin | Medicaid Revenue |
|---|---|---|---|
| Westfield Memorial | Chautauqua | -59.1% | High |
| Olean General | Cattaraugus | -31.1% | High |
| Schuyler Hospital | Schuyler | -23.1% | High |
| UPMC Chautauqua | Chautauqua | -17.4% | 37% |
| Cuba Memorial | Allegany | Negative | 42% |
| Arnot-Ogden | Chemung | Negative | 42% |
KFF estimates federal Medicaid spending in rural areas will decline by $155 billion over 10 years. The $50 billion Rural Health Transformation Program Langworthy celebrated replaces only 37% of what was cut — and it’s temporary (5 years). The Medicaid cuts are permanent.
What this means locally: When Cuba Memorial gets 42% of its revenue from Medicaid and federal Medicaid is cut by $155 billion in rural areas, closure isn’t “pure fiction” — it’s arithmetic. And if Cuba Memorial closes, every resident of northern Allegany County — not just Medicaid patients — loses their nearest hospital.
3. The jobs behind the hospitals
Hospitals are not just healthcare providers in rural NY-23. They are economic anchors:
- Arnot-Ogden in Chemung County: 2,200 employees — one of the county’s largest employers
- Cuba Memorial in Allegany County: ~100 employees in a community with few alternatives
- Westfield Memorial in Chautauqua County: A major employer in a small community
Healthcare Association of New York State projects 34,000 lost hospital jobs statewide from OBBBA Medicaid cuts.
What this means locally: When a rural hospital cuts staff or closes, there is no equivalent employer to absorb the workforce. The ripple effect — lost property tax revenue, reduced local spending, families leaving for employment — is the kind of economic damage that rural communities don’t recover from quickly.
What Langworthy said vs. what the data shows
| Langworthy’s Claim | What the Data Shows |
|---|---|
| “Not a single person” will lose coverage | CBO: 10 million lose insurance; 1.3 million dually eligible lose Medicaid |
| Hospital closures are “pure fiction” | NY is #1 in the nation for at-risk rural hospitals; 6 district hospitals at negative margins |
| RHTP is “one of the largest federal investments” | RHTP replaces only 37% of cuts; temporary vs. permanent |
| Westfield is “expanding its mission” | Westfield closed its inpatient unit; patients transfer 30 miles to PA |
What is still unaddressed
| Need | Status |
|---|---|
| Long-term rural hospital funding | $50B RHTP expires after 5 years; $155B in cuts are permanent |
| Hospital closure prevention plan | No legislation specific to at-risk NY-23 hospitals |
| Medicaid coverage protection | Representative voted for the bill causing losses |
| Arnot-Ogden workforce stability | 2,200 jobs dependent on a hospital at negative margin |
| Westfield inpatient restoration | Hospital converted to REH; no plan to restore overnight beds |
| Cuba Memorial sustainability | 42% Medicaid-dependent with negative margin |
The bottom line
Medicaid is not a separate issue from hospital access, employment, and rural economic survival in NY-23. When Medicaid is cut by $155 billion in rural areas and the temporary offset replaces only a third of the reduction, hospitals already losing money face an existential threat — and the communities that depend on them face consequences far beyond healthcare.
Langworthy’s claim that no one will lose coverage and that closure warnings are fiction is contradicted by every independent analysis available — from the nonpartisan CBO to healthcare finance analysts to the state’s own projections.
Verdict: FALSE — The CBO, KFF, Fiscal Policy Institute, and state agencies all document coverage losses and hospital vulnerability that contradict both claims.
For complete sourced analyses, see:
- Medicaid: Claiming ‘Not a Single Person’ Will Lose Coverage
- Rural Hospitals: Calling Closure Warnings ‘Pure Fiction’
- Rural Hospitals: Praising Temporary Fix After Voting for Permanent Cuts
Sources
- Congressional Budget Office: OBBBA Coverage Estimates (July 2025)
- KFF: “Allocating CBO’s Estimates of Federal Medicaid Spending Reductions” (2025); “How Might Federal Medicaid Cuts Affect Rural Areas?” (2025)
- Fiscal Policy Institute: “New York Hospitals will Close under the OBBBA” (June 2025)
- Center for Healthcare Quality and Payment Reform: Rural Hospital Analysis (2025)
- Becker’s Hospital Review: States at Risk of Rural Hospital Closures (August 2025)
- Healthcare Association of New York State: Hospital job loss projections
- Center on Budget and Policy Priorities: “By the Numbers” analysis (2025)
- Governor Hochul’s office: OBBBA state-level impact projections
- Observer Today: Westfield visit and hospital funding commentary (October-December 2025)
- FactCheck.org: “Rural Health Fund Falls Short of Estimated Medicaid Cuts” (September 2025)
- The Arc of the United States: Statement on OBBB (2025)
Note: This summary draws from multiple sourced fact-checks on Medicaid coverage and rural hospital impacts. All findings are based on CBO data, state agency analysis, and independent healthcare research.
Last updated: February 9, 2026