Health care staffing crisis hits New York rural counties
Beat Memo
Rural New York counties are facing 'alarming' shortages of primary care doctors, pediatricians, obstetricians and other health care professionals — and those workforce challenges will likely be exacerbated by looming federal funding cuts, according to a report released Thursday by state Comptroller Thomas DiNapoli.
The comptroller's office reviewed the health care workforce in 16 rural counties across the state, finding practitioner shortages in every field, including dentistry and mental health, POLITICO's Katelyn Cordero reports.
The report noted that ten of the 16 counties are federally designated as 'primary care health professional shortage areas,' meaning that the rate of primary care providers per capita is below state and national averages.
'Having access to health care is an essential quality of life issue and helps people live healthier lives,' DiNapoli, a Democrat, said in a statement.
'Addressing gaps in the rural healthcare workforce to alleviate current shortages and plan for future demand will not only positively impact the health of people living in less populated areas of New York, but could also create new jobs and bolster our rural economies,' he said.
The report found that, on average, in the rural counties examined, there are four primary care physicians per 10,000 people. That's far below the state ratio of 8.1 per 10,000 and the national ratio of 8.4.
Mental health was a particular concern highlighted in the report, with all 16 counties facing shortages of mental health practitioners. The ratio of mental health practitioners per capita in those counties is less than half of the state ratio.
Recommendations to address shortages included in the report:
The report comes at a time of great uncertainty for New York's health care industry, as the Trump administration implements Medicaid cuts that were part of the recently enacted GOP megabill, which many experts anticipate will disproportionately impact rural parts of the state with fewer providers.
The package also included a $50 billion federal Rural Hospital Transformation Program, but it's unclear how much of the money will be allocated to New York.
One day after the report was released, Gov. Kathy Hochul announced a $300 million investment towards expanding access to health care statewide. The funding was awarded through the Statewide Health Care Facility Transformation Program, which will be allocated towards 50 projects that expand access to primary, inpatient, behavioral and long-term care.
'This targeted investment will help ensure that every New Yorker — regardless of ZIP code — can access safe, high-quality health care,' Hochul said in a statement. 'By supporting providers that serve vulnerable and underserved populations, we're strengthening the foundation of our health care system and building a healthier future for all.'
IN OTHER NEWS:
— The new CEO of Public Partnerships LLC, Miki Kapoor is speaking out for the first time since taking the helm of the company in recent weeks in an op-ed published in the Times Union. Kapoor bashed advocates and fiscal intermediaries that previously ran the state's consumer-directed personal assistance program for 'exploiting a vulnerable population for political or personal gain.'
PPL, he claimed, 'did not create the problems that have plagued CDPAP for years.'
'We were brought in to fix them,' he wrote.
According to Kapoor, PPL has paid $1.8 billion to 230,000 personal assistants who work for more than 200,000 consumers that completely the transition to the program's new administrative system. He noted that they've rooted out inflated administrative fees from previous fiscal intermediaries that ran the program, and did away with a system of 'fragmented oversight.'
'Let's not pretend challenges don't exist in transitions of this scale,' Kapoor wrote. 'But to suggest this rollout was not a good one, or that it has reduced care for New Yorkers, is simply untrue.'
— Breaking Ground is stationing outreach workers inside the emergency room at New York-Presbyterian's Lower Manhattan Hospital five days a week to connect unsheltered homeless patients to services.
It is an expansion of a program that launched in January 2024 at New York-Presbyterian's Columbia University Irving Medical Center. In the first year, Breaking Ground staff placed 50 people into transitional or permanent housing and made 184 referrals for needed items and connections to care, according to the organization.
MAKING ROUNDS:
— Melody Goodman was named dean of the NYU School of Global Public Health, effective immediately. She has served as the school's interim dean since March 2024 and a faculty member since 2017.
GOT TIPS? Send story ideas and feedback to Maya Kaufman at mkaufman@politico.com and Katelyn Cordero at kcordero@politico.com.
Want to receive this newsletter every weekday? Subscribe to POLITICO Pro. You'll also receive daily policy news and other intelligence you need to act on the day's biggest stories.
What you may have missed
— The state Department of Health adopted a series of changes last week to loosen the regulatory review requirements for major health care projects, POLITICO Pro's Maya Kaufman reported.
Gov. Kathy Hochul had directed the department in 2024 to streamline the process by increasing the financial thresholds that trigger a detailed review, citing a need to 'alleviate strain on both providers and the State.'
Odds and Ends
NOW WE KNOW — Boar's Head plans to reopen troubled deli meat plant, but r eports of sanitation problems persist.
TODAY'S TIP — What to do when you make contact with poison ivy.
STUDY THIS — A Yale study finds that a mobile app designed to deliver suicide-specific therapy reduced suicidal behavior among high-risk patients.
WHAT WE'RE READING
— After years of anger directed at CDC shooting manifests worst fears. (New York Times)
— Claiming to fight waste, the Trump administration slashes potentially cost-saving research. (STAT)
— Patient seeking care at NIH hospital detained by ICE. (Washington Post)
Around POLITICO
— Everything we know about the fatal shooting near CDC headquarters, via Sophie Gardner.
— Lauren Gardner: Industry frets Kennedy's mRNA decisions will curb cancer breakthroughs.
— MAHA gets frustrated with Kennedy ahead of new policy report, Marcia Brown and Lauren Gardner report.
MISSED A ROUNDUP? Get caught up on the New York Health Care Newsletter.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
an hour ago
- Yahoo
Medical debt can still appear on credit reports, judge rules
A federal judge blocked a rule from the Biden-era Consumer Financial Protection Bureau that would have kept medical debt from appearing on credit reports. Mind Your Money host Julie Hyman reports on the latest. To watch more expert insights and analysis on the latest market action, check out more Mind Your Money. A judge has blocked a Biden era ban on medical debt in credit reports. Now, technically, the rule from the Consumer Financial Protection Bureau never took effect, but if it had, it would have stopped medical bills from appearing on credit reports and barred lenders from using that data to make lending decisions. The CFPB says removing medical bill information could have wiped $49 billion off credit reports of about 15 million Americans and increased their credit scores by an average of 20 points. But a judge ruled in favor of two trade associations that argued the CFPB overstepped its authority in issuing that rule. This comes at a precarious time in health care, with millions of Americans expected to lose health insurance by 2034 due to changes in Medicaid under President Trump's new tax bill. So how does medical debt and your credit report work without this rule? Say you get medical care. The provider will send your bill to insurance, and you're responsible for whatever your insurance does not cover. If you don't pay that balance, the provider will likely send you reminders. If you still don't pay, they may send that debt to a collection agency. Once it's with the agency, they own that debt. They'll start calling and sending you letters, and they may report it to credit bureaus. Once reported, it can appear on your credit report. Now, it may not hurt your credit score right away. Medical debt must be one year old before it shows up on your credit report. Debt under $500 is not reported. And 14 states have provisions in place to remove medical collection debt from credit reports. But still, consumers are left with the responsibility to stay on top of changes to their credit as they face mounting bills.
Miami Herald
3 hours ago
- Miami Herald
Even in states that fought Obamacare, Trump's new law poses health consequences
GOP lawmakers in the 10 states that refused the Affordable Care Act's Medicaid expansion for over a decade have argued their conservative approach to growing government programs would pay off in the long run. Instead, the Republican-passed budget law that includes many of President Donald Trump's priorities will pose at least as big a burden on patients and hospitals in the expansion holdout states as in the 40 states that have extended Medicaid coverage to more low-income adults, hospital executives and other officials warn. For instance, Georgia, with a population of just over 11 million, will see as many people lose insurance coverage sold through ACA marketplaces as will California, with more than triple the population, according to estimates by KFF, a health information nonprofit that includes KFF Health News. The new law imposes additional paperwork requirements on Obamacare enrollees, slashes the time they have each year to sign up, and cuts funding for navigators who help them shop for plans. Those changes, all of which will erode enrollment, are expected to have far more impact in states like Florida and Texas than in California because a higher proportion of residents in non-expansion states are enrolled in ACA plans. The budget law, which Republicans called the 'One Big Beautiful Bill,' will cause sweeping changes to health care across the country as it trims federal spending on Medicaid by more than $1 trillion over the next decade. The program covers more than 71 million people with low incomes and disabilities. Ten million people will lose coverage over the next decade due to the law, according to the nonpartisan Congressional Budget Office. Many of its provisions are focused on the 40 states that expanded Medicaid under the ACA, which added millions more low-income adults to the rolls. But the consequences are not confined to those states. A proposal from conservatives to cut more generous federal payments for people added to Medicaid by the ACA expansion didn't make it into the law. 'Politicians in non-expansion states should be furious about that,' said Michael Cannon, director of health policy studies at the Cato Institute, a libertarian think tank. The number of people losing coverage could accelerate in non-expansion states if enhanced federal subsidies for Obamacare plans expire at the end of the year, driving up premiums as early as January and adding to the rolls of uninsured. KFF estimates as many as 2.2 million people could become uninsured just in Florida, a state where lawmakers refused to expand Medicaid and, partly as a result, now leads the nation in ACA enrollment. For people like Francoise Cham of Miami, who has Obamacare coverage, the Republican policy changes could be life-altering. Before she had insurance, the 62-year-old single mom said she would donate blood just to get her cholesterol checked. Once a year, she'd splurge for a wellness exam at Planned Parenthood. She expects to make about $28,000 this year and currently pays about $100 a month for an ACA plan to cover herself and her daughter, and even that strains her budget. Cham choked up describing the 'safety net' that health insurance has afforded her — and at the prospect of being unable to afford coverage if premiums spike at the end of the year. 'Obamacare has been my lifesaver,' she said. If the enhanced ACA subsidies aren't extended, 'everyone will be hit hard,' said Cindy Mann, a health policy expert with Manatt Health, a consulting and legal firm, and a former deputy administrator for the Centers for Medicare & Medicaid Services. 'But a state that hasn't expanded Medicaid will have marketplace people enrolling at lower income levels,' she said. 'So, a greater share of residents are reliant on the marketplace.' Though GOP lawmakers may try to cut Medicaid even more this year, for now the states that expanded Medicaid largely appear to have made a smart decision, while states that haven't are facing similar financial pressures without any upside, said health policy experts and hospital industry observers. KFF Health News reached out to the governors of the 10 states that have not fully expanded Medicaid to see if the budget legislation made them regret that decision or made them more open to expansion. Spokespeople for Republican Gov. Henry McMaster of South Carolina and Republican Gov. Brian Kemp of Georgia did not indicate whether their states are considering Medicaid expansion. Brandon Charochak, a spokesperson for McMaster's office, said South Carolina's Medicaid program focuses on 'low-income children and families and disabled individuals,' adding, 'The state's Medicaid program does not anticipate a large impact on the agency's Medicaid population.' Enrollment in ACA marketplace plans nationwide has more than doubled since 2020 to 24.3 million. If enhanced subsidies expire, premiums for Obamacare coverage would rise by more than 75% on average, according to an analysis by KFF. Some insurers are already signaling they plan to charge more. The CBO estimates that allowing enhanced subsidies to expire will increase the number of people without health insurance by 4.2 million by 2034, compared with a permanent extension. That would come on top of the coverage losses caused by Trump's budget law. 'That is problematic and scary for us,' said Eric Boley, president of the Wyoming Hospital Association. He said his state, which did not expand Medicaid, has a relatively small population and hasn't been the most attractive for insurance providers — few companies currently offer plans on the ACA exchange — and he worried any increase in the uninsured rate would 'collapse the insurance market.' As the uninsured rate rises in non-expansion states and the budget law's Medicaid cuts loom, lawmakers say state funds will not backfill the loss of federal dollars, including in states that have refused to expand Medicaid. Those states got slightly favorable treatment under the law, but it's not enough, said Grace Hoge, press secretary for Kansas Gov. Laura Kelly, a Democrat who favors Medicaid expansion but who has been rebuffed by GOP state legislators. 'Kansans' ability to access affordable healthcare will be harmed,' Hoge said in an email. 'Kansas, nor our rural hospitals, will not be able to make up for these cuts.' For hospital leaders in other states that have refused full Medicaid expansion, the budget law poses another test by limiting financing arrangements states leveraged to make higher Medicaid payments to doctors and hospitals. Beginning in 2028, the law will reduce those payments by 10 percentage points each year until they are closer to what Medicare pays. Richard Roberson, president of the Mississippi Hospital Association, said the state's use of what's called directed payments in 2023 helped raise its Medicaid reimbursements to hospitals and other health institutions from $500 million a year to $1.5 billion a year. He said higher rates helped Mississippi's rural hospitals stay open. 'That payment program has just been a lifeline,' Roberson said. The budget law includes a $50 billion fund intended to insulate rural hospitals and clinics from its changes to Medicaid and the ACA. But a KFF analysis found it would offset only about one-third of the cuts to Medicaid in rural areas. Trump encouraged Florida, Tennessee, and Texas to continue refusing Medicaid expansion in his first term, when his administration gave them an unusual 10-year extension for financing programs known as uncompensated care pools, which generate billions of dollars to pay hospitals for treating the uninsured, said Allison Orris, director of Medicaid policy for the left-leaning think tank Center on Budget and Policy Priorities. 'Those were very clearly a decision from the first Trump administration to say, 'You get a lot of money for an uncompensated care pool instead of expanding Medicaid,'' she said. Those funds are not affected by Trump's new tax-and-spending law. But they do not help patients the way insurance coverage would, Orris said. 'This is paying hospitals, but it's not giving people health care,' she said. 'It's not giving people prevention.' States such as Florida, Georgia, and Mississippi have not only turned down the additional federal funding that Medicaid expansion brings, but most of the remaining non-expansion states spend less than the national average per Medicaid enrollee, provide fewer or less generous benefits, and cover fewer categories of low-income Americans. Mary Mayhew, president of the Florida Hospital Association, said the state's Medicaid program does not adequately cover children, older people, and people with disabilities because reimbursement rates are too low. 'Children don't have timely access to dentists,' she said. 'Expectant moms don't have access nearby to an OB-GYN. We've had labor and delivery units close in Florida.' She said the law will cost states more in the long run. 'The health care outcomes for the individuals we serve will deteriorate,' Mayhew said. 'That's going to lead to higher cost, more spending, more dependency on the emergency department.' KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism.
Politico
4 hours ago
- Politico
Health care staffing crisis hits New York rural counties
Good morning and welcome to the Weekly New York Health Care newsletter, where we keep you posted on what's coming up this week in health care news, and offer a look back at the important news from last week. Beat Memo Rural New York counties are facing 'alarming' shortages of primary care doctors, pediatricians, obstetricians and other health care professionals — and those workforce challenges will likely be exacerbated by looming federal funding cuts, according to a report released Thursday by state Comptroller Thomas DiNapoli. The comptroller's office reviewed the health care workforce in 16 rural counties across the state, finding practitioner shortages in every field, including dentistry and mental health, POLITICO's Katelyn Cordero reports. The report noted that ten of the 16 counties are federally designated as 'primary care health professional shortage areas,' meaning that the rate of primary care providers per capita is below state and national averages. 'Having access to health care is an essential quality of life issue and helps people live healthier lives,' DiNapoli, a Democrat, said in a statement. 'Addressing gaps in the rural healthcare workforce to alleviate current shortages and plan for future demand will not only positively impact the health of people living in less populated areas of New York, but could also create new jobs and bolster our rural economies,' he said. The report found that, on average, in the rural counties examined, there are four primary care physicians per 10,000 people. That's far below the state ratio of 8.1 per 10,000 and the national ratio of 8.4. Mental health was a particular concern highlighted in the report, with all 16 counties facing shortages of mental health practitioners. The ratio of mental health practitioners per capita in those counties is less than half of the state ratio. Recommendations to address shortages included in the report: The report comes at a time of great uncertainty for New York's health care industry, as the Trump administration implements Medicaid cuts that were part of the recently enacted GOP megabill, which many experts anticipate will disproportionately impact rural parts of the state with fewer providers. The package also included a $50 billion federal Rural Hospital Transformation Program, but it's unclear how much of the money will be allocated to New York. One day after the report was released, Gov. Kathy Hochul announced a $300 million investment towards expanding access to health care statewide. The funding was awarded through the Statewide Health Care Facility Transformation Program, which will be allocated towards 50 projects that expand access to primary, inpatient, behavioral and long-term care. 'This targeted investment will help ensure that every New Yorker — regardless of ZIP code — can access safe, high-quality health care,' Hochul said in a statement. 'By supporting providers that serve vulnerable and underserved populations, we're strengthening the foundation of our health care system and building a healthier future for all.' IN OTHER NEWS: — The new CEO of Public Partnerships LLC, Miki Kapoor is speaking out for the first time since taking the helm of the company in recent weeks in an op-ed published in the Times Union. Kapoor bashed advocates and fiscal intermediaries that previously ran the state's consumer-directed personal assistance program for 'exploiting a vulnerable population for political or personal gain.' PPL, he claimed, 'did not create the problems that have plagued CDPAP for years.' 'We were brought in to fix them,' he wrote. According to Kapoor, PPL has paid $1.8 billion to 230,000 personal assistants who work for more than 200,000 consumers that completely the transition to the program's new administrative system. He noted that they've rooted out inflated administrative fees from previous fiscal intermediaries that ran the program, and did away with a system of 'fragmented oversight.' 'Let's not pretend challenges don't exist in transitions of this scale,' Kapoor wrote. 'But to suggest this rollout was not a good one, or that it has reduced care for New Yorkers, is simply untrue.' — Breaking Ground is stationing outreach workers inside the emergency room at New York-Presbyterian's Lower Manhattan Hospital five days a week to connect unsheltered homeless patients to services. It is an expansion of a program that launched in January 2024 at New York-Presbyterian's Columbia University Irving Medical Center. In the first year, Breaking Ground staff placed 50 people into transitional or permanent housing and made 184 referrals for needed items and connections to care, according to the organization. MAKING ROUNDS: — Melody Goodman was named dean of the NYU School of Global Public Health, effective immediately. She has served as the school's interim dean since March 2024 and a faculty member since 2017. GOT TIPS? Send story ideas and feedback to Maya Kaufman at mkaufman@ and Katelyn Cordero at kcordero@ Want to receive this newsletter every weekday? Subscribe to POLITICO Pro. You'll also receive daily policy news and other intelligence you need to act on the day's biggest stories. What you may have missed — The state Department of Health adopted a series of changes last week to loosen the regulatory review requirements for major health care projects, POLITICO Pro's Maya Kaufman reported. Gov. Kathy Hochul had directed the department in 2024 to streamline the process by increasing the financial thresholds that trigger a detailed review, citing a need to 'alleviate strain on both providers and the State.' Odds and Ends NOW WE KNOW — Boar's Head plans to reopen troubled deli meat plant, but r eports of sanitation problems persist. TODAY'S TIP — What to do when you make contact with poison ivy. STUDY THIS — A Yale study finds that a mobile app designed to deliver suicide-specific therapy reduced suicidal behavior among high-risk patients. WHAT WE'RE READING — After years of anger directed at CDC shooting manifests worst fears. (New York Times) — Claiming to fight waste, the Trump administration slashes potentially cost-saving research. (STAT) — Patient seeking care at NIH hospital detained by ICE. (Washington Post) Around POLITICO — Everything we know about the fatal shooting near CDC headquarters, via Sophie Gardner. — Lauren Gardner: Industry frets Kennedy's mRNA decisions will curb cancer breakthroughs. — MAHA gets frustrated with Kennedy ahead of new policy report, Marcia Brown and Lauren Gardner report. MISSED A ROUNDUP? Get caught up on the New York Health Care Newsletter.
