State of the District: Eight Hospitals on a Federal At-Risk List, 28 Pharmacies Gone Since 2023, and a Congressman Who Says They 'Aren't Going Anywhere'

Why this matters for NY-23

This is a baseline. It sets down, from public records, what the district has for health care and food, what it has lost recently, and what independent analysts say is at risk under the Medicaid reductions in the One Big Beautiful Bill Act (H.R. 1, Public Law 119-21), which Rep. Langworthy voted for on July 3, 2025. It makes no new claim about him. The claims it measures against are the ones already documented on this site: that the district’s rural hospitals “aren’t going anywhere,” and that the federal rural health fund “delivers on that promise.”

One clarifier up front, the same one the county profiles carry: counties administer these systems; the federal government funds a large share of them. Losses described here have different causes, and each is dated so a reader can tell which is which. Two Rite Aid bankruptcies closed pharmacies. Hospital finances turn on Medicaid. Food insecurity turns on wages, prices, and benefit rules. Only the forward-looking material, the at-risk analyses, is explicitly modeled on the federal cuts.

A. Care: ten hospitals, eight on the at-risk list

The Fiscal Policy Institute’s June 27, 2025 report lists every New York hospital that draws more than 25 percent of its net patient revenue from Medicaid and government appropriations, the threshold at which it judges closure risk “in the case of severe cuts to Medicaid.” Its headline finding: “8 hospitals at risk of closure, the most of any district in the state, are in New York’s 23rd district.”

Source: FPI, “New York Hospitals will Close Under ‘One Big Beautiful Bill Act’,” June 27, 2025, hospital table; retained in research/sources.

What has already closed. The New York State Nurses Association’s list of hospital closures since 2000 contains two in the district: Salamanca Hospital (2000) and Lakeshore Hospital in Silver Creek (2020). (Our Lady of Victory in Lackawanna, 1999, is in Erie County but outside the district.)

What closure would mean. The Cornell Program on Applied Demographics defines an “emergency care desert” as living 30 minutes or more from a hospital that provides emergency care, and finds that if the hospitals on FPI’s at-risk list closed, New York’s emergency-care-desert population “would almost double (+182%; 708,633 people),” with upstate “disproportionately impacted.” Cornell did not publish a district-level figure, and this entry does not estimate one.

In plain language: two of the district’s hospitals have closed in this century. Eight of the ten that remain on FPI’s table depend on Medicaid and state support for more than a quarter of their revenue, one of them for nearly all of it. An analyst at Cornell has modeled what happens to emergency access if that list closes; the answer for upstate is measured in hundreds of thousands of people.

B. Pharmacies: 102 open, 28 closed since 2023, six places with none left

The New York State Education Department registers every pharmacy in the state. Its registry, pulled in full on September 8, 2026, records each establishment’s status and, for closed ones, the date its registration ended. Counting only community pharmacies (excluding hospital, nursing-home, infusion and clinic pharmacies by name), and only the parts of Erie and Niagara counties inside the district (by geocoding):

The closures are not evenly spread over time: one in 2023, three in 2024, and 24 in 2025. Twenty-two of the 2025 closures are Rite Aid registrations ending between June 6 and October 23, 2025, as the chain closed its stores under its second Chapter 11 filing. The other two 2025 closures are independents: The Apothecary at Cottrill’s in Orchard Park (February) and Alfred Pharmacy in Alfred (December).

Where the last one closed. In six ZIP codes, a closure since 2023 left no active community pharmacy registered in that ZIP:

A ZIP with no pharmacy is a proxy, not a drive-time measurement; Lancaster in particular borders ZIPs with several. The rural cases are the ones that matter: Mayville is the Chautauqua County seat, Alfred is a university town, and Silver Creek lost its hospital in 2020 and its pharmacy in 2025.

In plain language: the district lost about one pharmacy in five over three years, almost all of it in one summer, and almost all of it one company’s bankruptcy. That is a corporate event, not a federal policy event, and this entry does not attribute it to any vote. What the federal record bears on is what replaces it: the district’s remaining independents, hospitals, and clinics are the ones whose finances the at-risk analyses describe.

Source: NYSED Office of the Professions pharmacy-establishment registry via its public verification API, pulled Sept. 8, 2026; method, definitions, every record, and eleven unresolved addresses disclosed in research/data/pharmacies-2026-09-08/README.md.

C. Food: one in seven, in every county

Feeding America’s Map the Meal Gap (2025 release, 2023 data) puts the overall food-insecurity rate in every NY-23 county between one in eight and one in six:

In plain language: the spread across the district is under three points. The map’s shading, which puts Cattaraugus and Allegany in a darker band, is an artifact of a 13.5 percent bin boundary, not a different order of hardship. The SNAP changes in the same July 2025 law, and what they mean for these counties, are documented in the SNAP rural impact summary.

What is still unaddressed

The representation gap

Everything in this section is already documented in its own entry; this profile only lines it up against the baseline above.

• The vote. Roll Call 190, July 3, 2025: Yea on H.R. 1, the One Big Beautiful Bill Act, which cuts federal Medicaid spending in rural areas by roughly $137 billion over ten years nationally and creates the $50 billion rural health fund that KFF finds offsets about 37 percent of it, with 64 percent of the cuts landing after the fund expires. What Medicaid cuts mean for NY-23 healthcare.
• “Pure fiction.” His October 2025 dismissal of closure warnings, against the state’s own at-risk count. Rural hospitals: calling closure warnings ‘pure fiction’.
• “These hospitals aren’t going anywhere.” June 2026 town hall: “every rural hospital that I’ve met is not on the verge of closure no matter what people are trying to sell you.” Eight of them are on the list above. At his June town hall, he contradicted it himself three minutes later.
• The fund, announced three times. The $212 million first-year award, announced December 30, again July 15, and as “$76 million” on September 4, with no NY-23 facility named. The December announcement and what it left out, the Centralus repeat.
• Schuyler’s hospital. On the federal at-risk list; he voted for the bill behind it twice. Schuyler County’s hospital is on a federal at-risk list.
• Nursing homes. Three Chautauqua County closures and the staffing floor his vote blocked. Three nursing home closures in Chautauqua County.
• Pharmacies. His stated approach is the CHECK Act’s pharmacy-benefit disclosure provisions; the bill has no cosponsors and no committee action. A price tag is not a price cut.

The fair reading

Rural hospital and pharmacy loss is national and decades old; none of it began with this Congress, and the two Rite Aid bankruptcies would have closed those 25 stores under any representative. The Rural Health Transformation money is real, New York’s first-year award is the twelfth largest in the country, and NY-23 organizations have applied for it. He has said publicly that he wants the district’s hospitals to survive, and there is no record of him wanting otherwise. The documented gap is narrower than the losses above and sharper: he voted for the law the at-risk analyses are modeled on, he has told constituents the hospitals on that list are not at risk, and he has announced the offset fund’s money three times without a facility to show for it.

Questions this raises

1. Eight NY-23 hospitals are on FPI’s at-risk table, one drawing 97 percent of its revenue from Medicaid and public appropriations. Which of them has his office asked the state to prioritize for Rural Health Transformation funds, and has any been told it will receive money?
2. Mayville, Silver Creek, Eden, and Alfred now have no registered community pharmacy. Has his office been contacted by any of those communities, and what federal tools does he believe apply?
3. His June statement was that every rural hospital he has met “is not on the verge of closure.” Does that statement stand for Brooks-TLC, Bertrand Chaffee, Cuba Memorial, and Westfield Memorial specifically?
4. Cornell’s model says closing the at-risk list would nearly double New York’s emergency-care-desert population. Has his office requested a district-level estimate from CMS, the state, or the authors?

Related fact-checks

• Steuben County rural impact summary
• Tioga County federal impact
• What Medicaid cuts mean for NY-23 healthcare
• SNAP rural impact summary

Sources

Hospitals

• Fiscal Policy Institute, Emily Eisner and Michael Kinnucan, “New York Hospitals will Close Under ‘One Big Beautiful Bill Act’: 70 hospitals at risk of closure from federal Medicaid cuts,” June 27, 2025: https://fiscalpolicy.org/new-york-hospitals-will-close-under-the-one-big-beautiful-bill-act (PDF: https://fiscalpolicy.org/wp-content/uploads/2025/07/2025.06.27-hospital-closures-FINAL.pdf; retained copy: research/sources/state-of-district-2026-09/fpi-hospital-closures-2025-06-27.pdf)
• New York State Nurses Association, “Hospital Closures Since 2000”: https://www.nysna.org/resources/hospital-closures-2000 (retained: nysna-hospital-closures-since-2000.pdf)
• Leslie Reynolds, Cornell University Program on Applied Demographics, “Access Denied: Hospital Closures and Emergency Care Deserts in New York State,” 2026 (retained: leslie-reynolds-consequences-of-hospital-closures.pdf)
• KFF, “A Closer Look at the $50 Billion Rural Health Fund in the New Reconciliation Law”
• House Clerk, Roll Call 190, July 3, 2025: https://clerk.house.gov/Votes/2025190

Pharmacies

• NYSED Office of the Professions, Online Verification Search, Pharmacy Establishment (020): https://eservices.nysed.gov/professions/verification-search (full registry pull, method, and derived tables: research/data/pharmacies-2026-09-08/)
• GoodRx Research, “Healthcare Deserts” white paper: https://www.goodrx.com/healthcare-access/research/healthcare-deserts-80-percent-of-country-lacks-adequate-healthcare-access (definitions: pharmacy desert = most residents more than 15 minutes’ drive; hospital desert = more than 30 minutes) (retained: goodrx-healthcare-deserts-white-paper.pdf)
• WGRZ, “Rite Aid closing list nears 500 locations,” June 3, 2025, and Newsweek, “Rite Aid Announces Further Closures,” July 9, 2025 (retained: research/data/)

Food

• Feeding America, Map the Meal Gap, county pages for the eight NY-23 counties (2025 release, 2023 data), saved Sept. 8, 2026: research/sources/state-of-district-2026-09/feeding-america-mmg-2023/

Note: This entry documents publicly available information. It attributes no closure to any vote; the pharmacy losses described are the result of corporate bankruptcies and independent closures, dated as such. It does not allege any unlawful conduct. Rep. Langworthy’s office has not been asked for comment as of this writing, and any response will be published in full.

Last updated: September 8, 2026