Study: Three Mid-Hudson hospitals at risk from Medicaid cuts

A new analysis put Bon Secours Community Hospital in Port Jervis and Montefiore St. Luke’s Cornwall Hospital on a statewide list of hospitals most exposed to Medicaid cuts, a warning that could ripple through emergency rooms, inpatient beds and specialty care across Orange County.

Public Citizen said 446 hospitals nationwide were at heightened risk of closing or reducing services if federal Medicaid and CHIP cuts take effect, including 45 in New York. The group said those hospitals collectively had about 69,000 beds, served about 6.6 million patients in 2024 and employed roughly 275,000 direct patient care workers. Its analysis relied on Centers for Medicare & Medicaid Services hospital financial data from 2022 through 2024 and covered about 95% of U.S. hospitals.

The group defined an at-risk hospital as one that got at least 20% of its payer revenue from Medicaid and CHIP and spent more money than it brought in, on average, over the three-year period. Public Citizen said the list was descriptive rather than predictive, meaning it identified the hospitals most financially vulnerable but did not forecast exactly which ones would close.

That distinction matters in Orange County, where Bon Secours Community Hospital is one of the area’s most visible community hospitals and Montefiore St. Luke’s Cornwall serves residents in Cornwall, Newburgh and across the northern and central parts of the county. Garnet Health Medical Center was also named in the report, adding another major local provider to the list of hospitals facing pressure. Garnet Health said on Oct. 15, 2025, that it had signed a letter of intent to pursue an affiliation with Montefiore Health System, a move it said was intended to strengthen services and long-term sustainability for more than 500,000 residents across Orange and Sullivan counties and surrounding areas.

The federal law at the center of the warning, the One Big Beautiful Bill Act, would cut $911 billion in federal Medicaid and CHIP spending over 10 years, according to Public Citizen. State and hospital-group estimates cited in related reporting say New York hospitals could lose about $13.5 billion a year, with roughly 34,000 hospital jobs and 29,000 additional health-related jobs at risk statewide. The Healthcare Association of New York State has said about half of New York hospitals are already operating in the red, while the Greater New York Hospital Association said the measure could take about $8.5 billion out of hospital revenues.

The local political reaction was immediate. Senator James Skoufis said the region’s already strained health-care system was about to face unprecedented federal cuts, while Senator Rob Rolison said the funding shift deserved serious scrutiny. For Orange County, the stakes are immediate: fewer dollars can mean fewer services, delayed expansion and more pressure on the hospitals neighbors rely on when a regular clinic visit turns into an emergency.