You have to hand it to U.S. Rep. Nick Langworthy. Not everyone would be willing to go out in the rain and stand in front of a microphone to tell us temporary funding for rural hospitals that offsets only one-third of permanent funding cuts is a win.

Langworthy called the $50 Billion Rural Health Transformation Program (RHTP) “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, an important funding source for hospitals and nursing homes in our area. RHTP temporarily replaces only one-third of funding lost to permanent cuts. “According to a Kaiser Family Foundation analysis, federal Medicaid spending in rural areas is estimated to decline by $155 billion over a decade.”

Even if $50 billion were enough, the Centers for Medicare and Medicaid Services (CMS) press release reveals glaring flaws with how funds will be distributed. It’s a subjective process ripe for waste and fraud.

Half of RHTP funds”will be awarded to approved states based on individual state metrics and applications that reflect the greatest potential for and scale of impact on the health of rural communities.” The other half of RHTP funds, lets call it Part 2, will be evenly distributed to all states with an approved application.

Who decides which applications are accepted or rejected? What if NYS gets none of the RHTP Part 2 funds or RHTP funds get clawed back as has happened with some funding already approved by Congress? Even if politics and favoritism didn’t exist it’s still an inequitable way to distribute federal funds. Theoretically Wyoming, population about 587,000, could get the same amount of money from RHTP Part 2 as NYS, population around 20 million. In 2023, New Yorkers paid about $89 billion more to the federal government than what we got back. This is yet another raw deal for NY taxpayers, this time courtesy of the Trump administration.

Langworthy’s response to AOC’s claim that AHN Westfield Memorial Hospital and UPMC Hospital in Jamestown could both close due to cuts to Medicaid was; “Make no mistake, that’s all pure fiction. Beckers Hospital Revue estimated 25 rural hospitals in NYS (51%) are at risk of closing, 16 of them (33%) within 2-3 years.

One of their sources is Center for Healthcare Quality and Payment Reform’s (CHQPR) most recent analysis which was submitted to Centers for Medicare & Medicaid Services (CMS). The report titled Payer Mix and Margins at Rural Hospitals shows payment sources and margins for hundreds of rural hospitals data as of August 2025, before the impact of OB3 funding cuts.

AOC may have cited a Fiscal Policy Institute report which used data from 2023, at the end of the pandemic and before UPMC got an infusion of funds from the state. Still, the data is concerning when you see the operating margins and percentage of revenue from Medicaid for hospitals in our region. Even a slight drop in Medicaid funding could push hospitals into the red and lead to the closure of hospitals already in the red before the cuts.

“They’re expanding their mission here,” Langworthy said of Westfield Memorial Hospital. Westfield Hospital consistently showed up on all risk of closure reports but closure has thankfully been averted, for now, by its designation as an Rural Emergency Hospital (REH), a process Westfield Hospital started in January 2025. Converting to a REH alters the mission. The trade off is that while Westfield gains MRI, it has to close their inpatient unit. Anyone needing a hospital stay of more than 24 hours will be transferred to St. Vincent’s in Erie. Converting to an REH may not be feasible for rural hospitals to our East, many of which are also at risk of closure.

The threat of hospital closures isn’t new and state and local governments and hospitals have worked for years to stay ahead of the demographic and fiscal bus off in the distance but headed our way. The Big Beautiful Bill floored the gas pedal on the timing of the cuts, making it more a Budget Busting Bus with the Rural Health Transformation Program being a bicycle helmet that’s supposed to lessen the impact. What will be the damage to healthcare systems and the communities they are in? How many rural hospitals won’t survive? Are state and local governments ready for the aftermath?

Andrea Hatfield is a Jamestown resident.