ALBANY — As hospitals across New York and the nation face the possibility of steep revenue drops thanks to federal Medicaid cuts, Governor Kathleen C. Hochul and the state health commissioner are expressing frustration that the state’s Department of Education and legislature aren’t signing on to a plan that could cut costs for some health care operators and address the state’s nursing shortage.

In the Capitol on Thursday, Gov. Hochul and most of her cabinet of state agency and department directors spoke with reporters about the anticipated impacts of the federal budget cuts included in the “One Big Beautiful Bill” signed into law earlier this month.

As they discussed concerns over potential challenges for rural hospitals, Hochul and Health Commissioner Dr. James V. McDonald said they were frustrated that New York hasn’t been able to make changes to the rules over what licensed medical professionals can and cannot do, and said existing state law just isn’t the right fit.

State officials have been sounding the alarm for months as Republicans built the federal spending bill and debated it. They’ve warned that the impacts of Medicaid and SNAP cuts, plus more eligibility verification requirements and work requirements, will kick thousands of needy New Yorkers and Americans off the benefits that help them make ends meet.

On Thursday, Hochul said she was concerned about hospital closures, resulting from lower revenues for the state’s rural hospitals that have a majority of their patient mix covered by Medicaid or other publicly funded insurance.

“If that hospital, perhaps one of five in the North Country, closes, you and your family don’t have anywhere to go,” she said.

But when asked what the state may be able to do to backstop revenue cuts at hospitals that serve significant numbers of Medicaid patients, Hochul said the state can’t do it. She directed reporters to ask the state’s Republican lawmakers about how they plan to address the issue, suggesting those questions haven’t been asked.

A spokesperson for Stefanik told the Watertown Daily Times in late June that the Congresswoman does not acknowledge the predictions that the federal changes will hurt rural hospitals.

“Republicans want to strengthen and secure Medicaid for eligible citizens as it is an indispensable lifeline for our nation’s most vulnerable,” the spokesperson said. “However, far left Democrats continue to fearmonger because they know President Trump is delivering results for the American people.”

Even as the Governor deflected, McDonald said the Hochul administration has eyed a handful of changes to state law that could lead to savings for health care providers.

This year, the Hochul administration put forward a plan in the state budget that would have let New York join the Nurse Licensure Compact to allow out-of-state registered nurses to practice in New York more easily, and would have allowed certified nursing assistants to administer medications and vaccinations without a direct nursing supervisor with them.

CNAs are currently restricted by the state’s “scope of practice” rules that limit what they’re able to do in the workplace. McDonald said 38 U.S. states have passed some sort of “scope” reform, and 49 other states allow CNAs to administer vaccines. He also noted that New York is planning to spend $700 million over the next two years on workforce development to try to get more nurses working in the state.

The state legislature did not approve the Hochul administration’s changes and negotiated them out of the final agreement.

On Thursday, Hochul also expressed frustration with the state Department of Education for not signing onto those changes.

“This is an enormous source of frustration for me, that we can’t get the legislature and the Department of Education to sign on to what other states are doing, which is to allow highly trained individuals to take on just one more activity, instead of us having to hire two people to do that activity,” she said.

“I’m just fed up with the absurdity of some of these policies, to be honest with you. There’s no reason why we should not be leaning hard into finding all the ways we can support healthcare,” she continued.

Hochul said she intends to continue her push on that topic, but said she needs “more cooperation” from the state legislature and the Education Department.

State Education Commissioner Betty D. Rosa was not in attendance at Thursday’s press conference, even as the federal budget bill makes wide-ranging changes to federal education policy and loan regulations, and as the Trump administration lays off half of the U.S. Department of Education’s staff. The only people present for the Thursday meeting were those appointed by the Governor directly.

The state Education Department is not a direct offshoot of the state Executive Chamber — Hochul doesn’t appoint the department’s commissioner; rather, the commissioner is appointed by the state Board of Regents, who themselves are appointed by the state legislature.

Daylight frequently appears between the Governor and the state Education Department; most recently, the issue was over the Governor’s plan to take over a renovation of the state museum in Albany, removing the museum from the state Education Department’s control.

A spokesperson for the state Education Department did not return a request for comment from the Watertown Daily Times on Thursday.