During my tenure in Congress, I have strongly advocated for delivering high-quality rural healthcare for our families and seniors. A primary concern not only for my constituents across New York’s 21st Congressional District, but for millions of Americans living in rural communities across our country, is access to quality and affordable healthcare. These communities depend on their local hospitals to provide lifesaving care and treatments for their families yet the unique challenges of serving remote areas have led an increasing number of rural hospitals to shut down over the past decade.

In fact, according to data from the University of North Carolina’s Cecil G. Sheps Center for Health Services Research, 191 rural hospitals have closed or converted to emergency or outpatient care over the last 18 years. These providers face the uniquely difficult task of providing excellent care despite immense financial challenges that have only been exacerbated in recent years. Rising costs paired with low-patient volume and a greater reliance on federal and state funds has led many rural hospitals to struggle to remain financially viable.

These barriers led the Centers for Medicare and Medicaid Services (CMS) to develop several payment program options that allow for higher reimbursements for certain services provided by qualifying rural hospitals. Of the numerous CMS payment programs, the Critical Access Hospital (CAH) designation has proven to be highly effective in reducing the financial vulnerability of rural hospitals and increasing access to care throughout medically underserved regions. CAHs receive higher reimbursements for their Medicare services provided, allowing them to remain open and keep essential healthcare services in rural communities. Across NY-21, Lewis County General Hospital, Carthage Area Hospital, River Hospital, University of Vermont Health Network - Elizabethtown and Alice Hyde Medical Center, Clifton-Fine Hospital, Massena Hospital, and Gouverneur Hospital all maintain a CAH designation.

I have long since advocated for the CAH designation as I understand its importance to hospitals across my district. In January 2021, I recognized an error in CMS’s certification policy that unjustly narrowed the eligibility criteria for hospitals to certify or recertify as a CAH. In response, I authored the bipartisan Protecting Rural Access to Care Act to protect hospitals at risk of losing their designation. Then in June 2021, I called on CMS to reverse this harmful policy and brought this concern to the Department of Health and Human Services on behalf of vulnerable hospitals at risk of losing their CAH statuses. I was proud to see that following my advocacy CMS decided to reverse its disastrous policy and as a result, Carthage Area Hospital in NY-21 was able to maintain its designation.

Not only did my critical legislation and constant pressure force CMS to reverse course and allow Carthage Area Hospital to keep its CAH status, but it also opened the door for other hospitals across the region to qualify as well. I was pleased to see that in November 2023, Alice Hyde Medical Center of Malone received their CAH designation as a direct result of my efforts as well. I also sent a letter of support to CMS on behalf of Massena Hospital in December 2023 and I am happy to report that they were recently granted their CAH status as a result. My office is supporting other hospitals in the region as they navigate the application process with CMS and I look forward to continuing to advocate on their behalf.

As the representative for NY-21, I remain steadfast in my commitment to ensuring our hospitals have the resources necessary to expand access to care throughout Upstate New York and the North Country.