To the editor:

During my 30-year career as a family physician, I have worked through two great crises in healthcare: the arrival of HIV during the 1980s and, more recently, the COVID pandemic. I now see a third crisis on our threshold: that caused by the slashing of the Medicaid budget, along with the nonrenewal of the ACA subsidies, and what that will do to our hospitals, clinics and millions of patients nationwide. Unlike HIV and COVID, this crisis will be uniquely American, and most disturbing, it will be entirely preventable.

Legislation that was passed earlier this year by Rep. Stefanik and the Republican majority is slated to make enormous cuts to Medicaid. Who will be affected? Working people, mothers, children, veterans, low-income seniors and many nursing home residents. For many, health care will become unaffordable. Routine health screenings and management of chronic conditions such as COPD, high blood pressure, diabetes and heart failure will be delayed or skipped entirely.

The collateral damage to our communities will be enormous as once manageable health conditions become unmanageable, and eventually, medical emergencies. Without Medicaid and the ACA subsidies, emergency rooms and hospitals will not be paid for the care that they are obligated to provide. Many upstate rural hospitals rely on Medicaid payments to remain solvent. The cuts to Medicaid for which our Representative Elise Stefanik voted are putting Massena Hospital and at least nine other rural hospitals at risk of closing.

What happens when rural hospitals close? Rural hospitals are often among the largest employers in small upstate towns, and their closure will leave their staff of technicians, nurses, doctors, janitors, kitchen staff and others without work. People will have to travel further to access the medical care they need, likely delaying care and increasing the cost of care. People may die needlessly from conditions for which timely care would have been lifesaving.

The most imminent threat to health care is the refusal of the Republican congress to extend enhanced subsidies for Affordable Care Act premiums. Without congressional action, these subsidies will expire at the end of the year, and people who access their health care through the marketplace will see their premiums rise by an average of 75%. Here in NY’s 21st Congressional District, 7,000 people receive tax credits to help make their insurance more affordable. Without these subsidies, these people may be forced to abandon their health care coverage entirely to pay for other, more immediate necessities such as food and housing.

Between these expiring tax credits and the Medicaid cuts that Rep Stefanik supported, New York state could see 860,000 people become uninsured. This will be devastating for our families and communities.

We must call on our Rep. Stefanik to reverse the cuts to Medicaid, and we must call on Congress to continue the ACA subsidies at the end of the year.

This will be a health care crisis that will have been entirely preventable.

As we all know, prevention is the best medicine.

Christopher Hyson MD

Lake Placid