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Yahoo
3 days ago
- Business
- Yahoo
Small towns, big stakes: How medicaid cuts threaten health care in the Adirondacks
— This story first appeared in New York Focus, a non-profit news publication investigating New York state politics. Sign up for their stories at newsletter. John Rugge has spent half a century building a network of health clinics in the isolated villages and towns of New York's Adirondack mountains. Now 80 years old, as most of his peers enjoy retirement, the locally celebrated outdoorsman and physician is organizing other rural doctors and community leaders in this strongly Republican part of the state to protect the health care system in the face of proposed cuts to Medicaid under debate in Congress. Rugge says the federal cuts in health care spending — projected at $715 billion over the next 10 years — could have a devastating impact, not just on the New Yorkers who will lose insurance, but also on the rural hospitals, nursing homes, and clinics that rely on Medicaid payments. If a hospital or nursing home is forced to lay off workers or to close entirely, he said, everyone in the community suffers, including those who have private insurance or enough money to pay out of pocket. 'It hurts the institutions, and that means it hurts everybody,' said Rugge. A canoeist and author of The Complete Wilderness Paddler, Rugge founded a clinic in 1974 that has grown into the Hudson Headwaters Health Network, which includes 26 clinics serving 9,400 patients each week. 'What we could see is a medical desert from Glens Falls to Plattsburgh,' a vast area stretching from below the Adirondack Park to the Canadian border some 114 miles away, he said. AGING POPULATION The Adirondack region includes six million acres of protected wilderness, featuring mountains, rivers, and lakes beloved by hikers and canoeists. The Adirondack Park is a checkerboard of public and private land, with 105 villages and towns — some home to just a few hundred people — scattered across rugged terrain. Vacationers crowd the region in the summer. Skiers come in winter. But the year-round population is small, declining, and aging. Many residents patch together part-time and seasonal jobs — work that doesn't come with health insurance. Twenty-eight percent of the residents in the congressional district that includes the Adirondacks rely on Medicaid, the federal-state health insurance program for low-income people. Half of births and two-thirds of nursing home residents are covered by Medicaid. HEALTH CARE CUTS Rural hospitals and nursing homes operate on razor thin margins, and many have been losing money for years. Nearly a third of rural hospitals in New York are at immediate risk of closing, according to the Center for Health Care Quality and Payment Reform, a national policy center. Maternity care is particularly vulnerable. The bulk of House Republicans' planned health care cuts — $625 billion — would come from Medicaid. The remainder would come from changes to the Affordable Care Act, also known as Obamacare, which helps individuals pay for private insurance and also pays for the Essential Plan, New York's free program for people with somewhat higher incomes than Medicaid allows. Governor Kathy Hochul has said the proposed cuts could lead to 1.5 million New Yorkers losing health insurance in the next 10 years, and would cost the state $13.5 billion annually in lost federal revenue. 'No one state can backfill these massive cuts,' she said in a news release last week. Rugge said people of all political stripes have an interest in preserving the Adirondacks' fragile health care system. He leads a nonpartisan group, the Health Care Coalition for the North Country, that has been meeting with local town and county officials and encouraging them to write to their federal representatives, particularly Rep. Elise Stefanik, about the importance of Medicaid to their communities. Stefanik, who won reelection in November with more than 62 percent of the vote, maintains that the Republican bill would 'strengthen and secure' Medicaid by ensuring that only eligible recipients are enrolled. Stefanik spokesman Wendell Husebo pointed to research by the Empire Center for Public Policy, a conservative think tank, suggesting that many people lie about their income to meet the eligibility requirements for Medicaid and that there has been a surge in the number of undocumented immigrants approved for emergency care. NOT AN HONOR SYSTEM Kevin McAvey, managing director of Manatt, a healthcare consulting firm, pushed back at the notion that ineligible people are flooding the Medicaid rolls. 'This is not an honor system,' McAvey said. 'Individuals seeking Medicaid coverage in New York predominantly apply through the state-based marketplace, where their income attestations are checked against federal and state data sources. If such checks cannot be completed, individuals must present documentation that proves their income.' As for the undocumented immigrants receiving emergency room care — as required by federal law — he said the payments help keep hospitals afloat. 'Emergency Medicaid reimbursements in New York state and across the country protect our health care providers,' he said. The bill, narrowly passed by Republicans in the House last Thursday, would make a series of technical changes to how the federal government reimburses states for health care costs. It would impose a penalty on states like New York that use state money to offer care to some undocumented immigrants. (Federal law requires hospitals to offer emergency care to everyone, including undocumented immigrants. New York uses its own funds to provide non-emergency care to undocumented pregnant women and people over 65.) Most significantly, the Republican bill would require working-age Medicaid recipients without children or disabilities to provide documentation each month that shows they have worked at least 80 hours — a requirement that proponents say will prevent abuse and that Medicaid advocates say would add red tape and burdensome administrative costs. NURSING HOMES One of the bill's technical changes could have an immediate impact on the state's hospitals and nursing homes: The Centers for Medicare & Medicaid Services this month rolled back its approval of an obscure mechanism, called an MCO tax, that New York had planned to use to draw down an additional $2 billion this year in federal funds. The state was counting on that money to increase Medicaid payments to hospitals and nursing homes. Heidi Schempp, the administrator of the Elderwood nursing home in the hamlet of North Creek, has been hoping for more state money to help keep her skilled nursing facility afloat. The cost of food and salaries is going up, she said, and reimbursements haven't kept pace. Seventy percent of her patients rely on Medicaid, and the rates set by the state cover less than 70 percent of the cost of care, she said. She can make up some of the difference by offering short-term rehabilitation services to other patients, which are reimbursed at a higher rate, but it's a struggle. 'My goal is to break even,' she said. Elderwood has about 70 residents, mostly elderly, and a staff of about 100. Most of the residents worked and paid taxes for decades and qualified for Medicaid only because they've spent their life savings, she said. Medicare, the federal health care plan for people over 65, does not cover the cost of long-term care, so residents typically pay out-of-pocket until their savings are depleted. Elderwood charges about $11,000 a month. The nearest nursing homes are in Glens Falls, a 45-minute drive south, and Tupper Lake, more than an hour north. 'Can you imagine not being able to see your spouse because they had to move into a nursing home far away?' Schempp said. 'It's just devastating.' 'I'D BE OUT ON THE STREETS' In a bid to ensure Elderwood's survival, Daniel Way, a retired family doctor and photographer, photographed nursing home residents and interviewed them about their lives, posting their stories online. 'If I didn't have Medicaid I'd be out on the streets,' said one resident, 77-year-old JoAnn King. 'I worked a long time, never been in trouble, loved my country all my life. To the politicians threatening to cut Medicaid, shame on yourselves!' Planned Parenthood of the North Country operates seven clinics that serve a vast region stretching 165 miles along two-lane roads, from Plattsburgh on Lake Champlain to Watertown near Lake Ontario. Patients may drive an hour or more to reach a clinic, and nearly half rely on Medicaid. CEO Crystal Collette said Planned Parenthood is the only health care provider for about one-third of their patients, most of whom are young. They rely on Planned Parenthood not only for birth control and abortions, but also to check their blood pressure, screen for cancer, test for sexually transmitted diseases, and treat urinary tract infections. ON THE BRINK Recruiting doctors and nurses to work in rural areas is challenging, Collette said, and Planned Parenthood pays a premium to retain them. Like Schempp at the Elderwood nursing home, Collette said the costs of care 'far outpace' Medicaid reimbursements. Private fundraising helps make up the difference. 'We already have a health care system that's teetering on the brink of collapse,' she said. 'Sweeping cuts to Medicaid is something that I don't think we can fundraise our way out of. There's no possible way for our donors to make up the difference.' The Hyde Amendment has long banned the use of federal funds for abortion, except in cases that endanger the life of the mother or that result from rape or incest. The House bill would go much further; it would cancel all federal funding for Planned Parenthood — including for the routine health care that the organization offers. Although abortions make up only about 3 percent of the services Planned Parenthood provides, the organization has become a lightning rod for anti-abortion groups. The House bill now goes to the Senate for debate, and revisions are expected. The proposal to ban funding for Planned Parenthood may not pass the Senate, where several Republican senators have voiced their support for the organization. WORK REQUIREMENTS Nonetheless, pushing able-bodied people who cannot regularly document their work hours off the Medicaid rolls — as the House bill proposes — would also hurt Planned Parenthood financially. With many North Country residents working part-time jobs with irregular hours, self-employed as carpenters or handymen, or working off-the-books at jobs such as housecleaning, that documentation may be hard to provide, Medicaid advocates say. Without payments from Medicaid, Planned Parenthood would be faced with many more patients who have no ability to pay. Work requirements overload Medicaid recipients with paperwork that they may not be able to complete even if they are eligible, McAvey said. 'What winds up happening is that eligible recipients end up losing coverage,' he said, citing the experience of Arkansas and Georgia. When Arkansas imposed work requirements, 18,000 people lost health insurance and there was no increase in employment; a judge ordered the state to abandon the plan. In Georgia, the administrative costs of verifying employment far outstrip the cost of health care. 'This debate over a work requirement goes back to ideological differences in views about Medicaid,' said Larry Levitt, executive vice president for health policy at KFF, the national health policy group. 'Some people view Medicaid as a welfare program that should only be for the 'deserving poor' and others view Medicaid as a stepping stone towards universal coverage and that access to healthcare should be a right irrespective of work.' As the details about the House plan trickle out, state and county legislators are coming to grips with the implications for their own budgets. In New York, the cost of Medicaid is split three ways, with the federal government, the state and the counties each taking a share. If federal funds decline, the state and the counties must either pick up the slack or make cuts, often by reducing reimbursements to providers or eliminating services that are not required by federal law, such as home care for the elderly or routine care for undocumented immigrants. The state budget passed earlier this month didn't take into account likely federal budget cuts, but the state legislature gave Hochul the authority to institute midyear cuts if necessary. 'It is going to be very difficult to figure out how to fill that gap,' said state Assemblyman Scott Gray of Watertown, a Republican. After meeting with Rugge and other members of the Health Care Coalition for the North Country, Assemblyman Matt Simpson, of Lake George, said he understands the importance of Medicaid to his constituents. 'I look forward to working together on this and other areas of access to health care throughout our shared community,' said Simpson, a Republican. The Health Care Coalition for the North County has also met with town and county officials. Schempp said she met with the Town Board in the mostly conservative town where she lives, Indian Lake, and they agreed to pass a resolution calling on Stefanik and other elected officials to 'exercise caution' when considering budget cuts. Similar resolutions have been passed by the towns of Kingsbury and Schroon Lake, as well as several county boards of supervisors, Rugge said. After meeting with Rugge's group, Essex County manager Mike Mascarenas told his board of supervisors that significant Medicaid cuts would not only hurt 'the population that receives Medicaid, but to those who pay for it.' If counties need to contribute more to Medicaid, they may need to raise property taxes. 'I've been here 25 years, and what I will tell you with certainty is that the (proposed) change to Medicaid is probably the single biggest threat to property tax that I've ever witnessed in Essex County,' he said. Essex County is a swing county, sometimes voting for Republicans, sometimes for Democrats. Rugge is optimistic that his work educating his neighbors about Medicaid is bearing fruit. 'We're making a dent,' he said.
CTV News
4 days ago
- General
- CTV News
Medical students learn in small communities
A sign for the Schulich School of Medicine and Dentistry at Western University in London, Ont. is seen Tuesday, March 16, 2021. (Jordyn Read / CTV News) Medical students are partaking in the 27th annual Discovery Week, learning the field in parts of rural Ontario. Almost 200 first year students at Western University's Schulich School of Medicine and Dentistry are doing work placements in 30 small communities from Strathroy to Owen Sound, and beyond. In nearly 30 years, 3,700 students have partaken in Discovery Week.
CBC
26-05-2025
- Health
- CBC
Lung program's success in rural N.S. leads to expansion
Nova Scotia has some of the highest rates of chronic obstructive pulmonary disease in the country. A researcher at Acadia University started up an online program to make sure lung patients in rural communities get the help they need. Now that pilot program is set to expand across the Maritimes. Carolyn Ray reports.
ABC News
26-05-2025
- Health
- ABC News
By Five Early Years Initiative funding not renewed in Victorian budget
An award-winning health program reducing wait times for rural children to access health specialists has lost its Victorian government funding. The By Five Early Years Initiative was created in 2017 by a group of parents, service providers and community leaders in western Victoria with the aim of improving health outcomes for young children in the last week's state budget, a four-year funding stream allocated to the program in 2021 was not renewed, leaving the future of the service in doubt beyond June. By Five executive officer Jo Martin said she was "gutted" when she heard the news. By Five covers five local government areas: Northern Grampians, Yarriambiack, West Wimmera and Hindmarsh Shires and Horsham Rural City Council. In 2023, it was recognised at the Victorian Early Years Awards for Promoting Children's Health and Wellbeing. Among the programs run by By Five is a paediatric health program connecting young children needing developmental support with specialists at the Royal Children's Hospital Melbourne via telehealth. The program has reduced wait times from several months to see a specialist down to a couple of weeks, leading to earlier diagnoses and treatment for conditions like Attention Deficit Hyperactivity Disorder (ADHD) and dyslexia, according to By Five. Toddler Frank Torney was one of more than 135 children who accessed the service in 2024. His mother, Tessa Torney, said when his maternal health nurse raised concerns about his growth and development, the family was able to go through By Five to speak to a paediatric specialist at the Royal Children's Hospital within a week. "It all happened really quickly, and it's so hard to access paediatric services quickly [in western Victoria]," Ms Torney said. "It's a brilliant, brilliant service." As a local dietician, Ms Torney has also received referrals with the help of By Five and is part of a group called Friends of By Five, rallying to save the program. "I think we're certainly disadvantaged rurally, and I think that there's still a lot of work to be done," she said. Ms Martin said the group had requested $3.5 million from the Victorian government over four years and was now looking for corporate partnerships and other avenues to keep By Five running. In a statement, the Department of Education, which has funded the program until now, said the By Five Early Years initiative "has had a long period of government funding and support to raise community awareness and establish enduring local partnerships". Victorian Health Minister Mary-Anne Thomas and the Department of Health were contacted for comment. By Five's funding ends on June 30.
Yahoo
26-05-2025
- Business
- Yahoo
VSee Health Launches AI-Powered Telehealth to Reduce Maternal Deaths in Remote Philippines
SAN JOSE, Calif., May 16, 2025--(BUSINESS WIRE)--VSee Health, Inc. (Nasdaq: VSEE), a leader in digital health solutions, customized virtual health workflow integration, and real-time health data analytics, announces the launch of Project MAMA (Mom's AI for Maternity Aid), an innovative telehealth initiative to reduce high maternal mortality rates in rural, isolated Philippines communities of Zamboanga Sibugay. Working with maternal care physicians and specialists from Stanford University and Ateneo de Zamboanga University, VSee's technology bridges the gap in prenatal care access, enabling women in underserved areas to receive remote OB-GYN consultations via its comprehensive telehealth platform. The solution features AI chatbots responding in local languages, portable diagnostic devices (e.g. ultrasounds) and electronic health records (EHRs) — all operational within four days of deployment. "Project MAMA exemplifies our commitment to addressing global healthcare disparities through innovative technology," said Dr. Milton Chen, PhD, co-CEO of VSee Health. "This program demonstrates impact by delivering quality prenatal care to mothers who've previously never gotten an ultrasound or been seen by an OB-GYN. We also plan to explore more ways to leverage AI — analyzing patient data trends for early detection of maternal mortality risk." The pilot program represents VSee's broader vision of bringing accessible healthcare to underserved populations worldwide through adaptable, AI-enhanced telehealth solutions. Forward-Looking Statements This press release includes "forward-looking statements" within the meaning of the safe harbor provisions of the United States Private Securities Litigation Reform Act of 1995. Certain of these forward-looking statements can be identified by the use of words such as "believes," "expects, "intends," "plans," "estimates," "assumes," "may," "should," "will," "seeks," or other similar expressions. Such statements may include, but are not limited to, statements regarding the Company's ability to regain compliance with Nasdaq's listing rules within the required timeframe. These statements are based on current expectations on the date of this press release and involve a number of risks and uncertainties that may cause actual results to differ significantly, including those risks set forth in the Company's most recent Annual Report on Form 10-K and any subsequent Quarterly Reports on Form 10-Q and other documents filed with the SEC. Copies of such filings are available on the SEC's website at The Company does not assume any obligation to update or revise any such forward-looking statements, whether as the result of new developments or otherwise. Readers are cautioned not to put undue reliance on forward-looking statements. About VSee Health VSee Health (Nasdaq: VSEE) is a rapidly growing leader in AI-powered telehealth, redefining the $787 billion digital healthcare market with its modular, no-code/low-code platform. Trusted by 1,000+ clients, including NASA, the U.S. Department of Health and Human Services, McKesson, DaVita, and the entire nation of Qatar, VSee Health provides foundational infrastructure for digital healthcare and delivers turnkey solutions to optimize healthcare operations while increasing billable patient visits and provider efficiency. Visit View source version on Contacts VSee HealthAnne Changmedia@ Investor Contact:Dave GentryRedChip Companies1-407-644-4256VSEE@ Sign in to access your portfolio
