ROCHESTER, N.Y. — New York’s budget season is underway. Gov. Kathy Hochul’s budget proposal includes investments in health care, among many other areas for New Yorkers to keep an eye on. In terms of health, food security, rural health, expanding the workforce and vaccination are all focuses, this year, for the state Department of Health.
Dr. James McDonald, the commissioner of the department, says nutrition is an important factor in keeping New Yorkers healthy. It’s why he says access to food is worth the investment. He notes over $1 billion in food security funds in the budget. The money goes toward making sure food banks are stocked, meals at child care centers continue and Supplemental Nutrition Assistance Program (SNAP) benefits are funded.
“If you think about nutrition, really one of the drivers of chronic diseases, obesity, food insecurity. People just don’t have access to food. And that actually drives obesity because people are eating whatever they can find. And often they’re not eating nourishing food,” McDonald explained. “What we would like people to eat is real foods, fruits, vegetables, lean meat. Those foods are nutrient dense. When people have food insecurity, they’re often eating processed food, which is calorie dense. You know, there’s an old expression, ‘Apple a day keeps a doctor away’, well, a Twinkie a day? Not so much. But this is why really healthy eating is so important.”
The longest government shutdown in U.S history lasted more than 40 days back in October. During that time, SNAP benefits were paused for many New Yorkers, which forced families to make difficult decisions.
“When you think about food or people need is affordability,” McDonald explained. “When you look at the food strategy for New York state, we have a very broad, comprehensive strategy. It includes SNAP, temporary assistance if needed for family, WIC, child adult day care food program, as well as Nourish New York Hunger Prevention Nutrition Asisstance Program. So we really help whether you need a food bank or whether you need some help at the grocery store, there’s a lot in this budget to help anyone.”
The 2025 government shutdown strong over disagreements regarding the Affordable Care Act. Many New Yorkers were worried their health insurance would be put at risk without subsidies. Next year, the state is anticipating Medicaid cuts, which would revert the department back to an essential plan. McDonald says these changes are going to leave 450,000 New Yorkers just out of reach of affordable health care.
“When I talk about the essential plan, that’s health insurance for working New Yorkers. They make too much money for Medicaid, but they don’t get offered insurance health benefit by their employer. We have a very nice thing going in New York with that, that we had a wonderful partnership with the federal government. H.R. 1 interrupted that. But what we’re we’re doing what we can to maximize number of people still covered and minimize adverse impact to New Yorkers,” he said.
However, he says the state will notify New Yorkers via text, email or mail, if they would be impacted. The Department of Health’s website can also be used as a resource to see health insurance breakdowns, and help prepare health insurance customers on their next steps.
Another highlight from the budget proposal was the rural health transformation. McDonald says health care deserts across the state are struggling to recruit providers.
“When I think of rural health care, the first thing that crosses my mind is health care worker shortage. Because when I go throughout rural New York looking at what we see in rural health care, I see a lot of great federally qualified health centers, a lot of good hospitals, see a lot of good health care. So what everybody tells me is we need health care workers,” McDonald said. “The Rural Health Transformation Program. That’s another new investment specifically targeting rural New Yorkers. But there’s another investment in there, too, another partnership with the federal government, where we can actually use some money from the federal government, as well as ours, to recruit nurses to rural nursing homes. So there’s a lot going on in this year’s budget, because I think the health care workforce issue is the issue for rural health care.”
He says he’s spoken with medical professionals about what it would take to keep them in the health care industry, including previous legislation regarding violence in the workplace. McDonald says there’s also new programs that will work on attracting more people to the industry, like high school students, then training and retaining the workers.
“The nursing shortage is the largest area of concern. One of the things to about New York state is we have a lot of nurses, only about half they’re involved in direct patient care. Part of this because a nursing degree is an amazing degree. A lot of people take that nursing degree, go into leadership, go into any number of different things,” he said. “This year we have 24 different programs the Department of Health is administering. It’s a $415 million investment this year in recruiting health care workers of all types. Now, it’s not just helping a doctor or nurse with loan repayment. We’re doing that. That’s important. But it’s actually also getting high school students interested in health care.”
However, the state’s Department of Health is looking into new ways to use health care workers that are already here in New York, too.
“One of the things in this year’s budget is acknowledging that nurse practitioners have independent practice. But PAs, so one of the things the government is putting forward is, again, let’s see if we can get PA to practice independently. And I think they’ve earned that. And there’s some criteria in the budget that will allow us to see that we’re comfortable with PA practicing independently. I think that’ll be a nice way of expanding health care to rural communities in particular,” McDonald said.
The budget is also supporting continued vaccination efforts across the state.
“The federal government recommends a vaccine schedule, individual states, mandates, schedules. This difference between federal authority and state authority. So in New York state, we have strong vaccine mandate laws and we have strong regulations. We intend those just to stay the same,” he said. “What we want to change is the authority of where do we get our recommendations from in the past. New York state, like other states, got the recommendations from the Advisory Committee on Immunization Practices, part of the CDC. It’s clear we can’t do that anymore. So we need to get our recommendations from the American Academy of Pediatricians, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, as well as the New York State Department of Health. We have our own expertise. So really, it’s relying on our own authority and going to credible national bodies as opposed to dealing with the political world.”
The New York state budget is constitutionally mandated to be passed by April 1, which marks the start of the state’s fiscal year.
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