Latest news with #Adirondacks
Telegraph
14-06-2025
- Telegraph
Why the ‘real' New York has nothing to do with Manhattan
Whether you date the moment of birth to the seizure and rechristening of Dutch outpost 'New Amsterdam' in 1664, the founding, in the same year, of a British colony whose name referenced the king's brother (the Duke of York) – or its secession to the USA in 1788 as the 11th state in a new national jigsaw – there have long been two 'New Yorks'. One, of course, is the mega-city which swallowed the island of Manhattan, and now spreads its tentacles, famously, to 'Five Boroughs'. The other is the broader state of New York – which encompasses its metropolitan namesake, but is also a very different animal. So different that their shared existences look incongruous. The state of New York is the USA's fourth most populous (behind California, Texas and Florida). But of its 20 million residents, 14 million (70 per cent of the total) reside in 'the city', on Long Island, or in the urban hubs in the southern half of the Hudson Valley – including the capital, Albany. What remains – stretching to the Canadian border – has little in common with the stores of Fifth Avenue or the Empire State Building. It is quiet, even silent in parts; lushly forested, thrillingly rugged – the mountains of the Adirondacks and the Catskills rising mightily. Spend time in one of the New Yorks, and you could never deceive yourself into thinking you were in the other. So much is clear when I leave the 'first' New York for the 'second'. The road-signs along my route read like the lyrics to Chattanooga Choo Choo, albeit with a north-easterly quaintness, indicating possible stops in Tarrytown and Hopewell Junction, Lagrangeville and Pleasant Valley, Rhinebeck and Stottville. Only Albany feels like an interruption, shoving its rush-hour traffic and its comparative sprawl into my path. There at the heart of it, on Empire State Plaza, the New York Capitol adds an extra layer of surreality by resembling a grand, turreted Swiss hotel, rather than a classic domed American government building. But I am not looking for epic out-of-context 19th century neo-Renaissance architecture. I am looking for the shadows beyond the street lights; for 'the other New York'. And I find it, emphatically, some 200 miles north of Manhattan – at the bottom of Lake George. While the River Hudson, ebbing through Albany 60 miles to the south, ultimately drains into the Atlantic as it passes Manhattan, Lake George sends its currents in the opposite direction, pouring its soul into the border-spanning Lake Champlain – and eventually, into the St Lawrence. This is not the only hint as to the northerliness of my location. There at the lake's south edge, Fort William Henry is a timely link to American literature. It was built in 1755; a British bastion in the colonial push into the higher reaches of North America, designed to stymie France in its identical ambitions. In this, it failed. It haunted the shore of Lake George for just two years before, in the summer of 1757, it was destroyed by Gallic and Huron troops in a bloody chapter of what became known as the 'French and Indian War'. Yet it enjoys a strangely enduring afterlife. The existing structure, a 1950s replica, receives a steady stream of visitors as the Fort William Henry Museum. In part, this is because it is to Fort William Henry that the key characters are travelling, across wild and perilous terrain, in The Last Of The Mohicans – the James Fenimore Cooper novel which, though it uses the fighting of 1757 as its deadly backdrop, was published in 1826, and is celebrating its bicentenary this year. Lake George has moved on, but only a little, from that era of siege and massacre. The tree-defined landscape around it may no longer be dangerous, but it is certainly still wild. And beautiful. For a while, at the turn of the 20th century, it became a magnet for the era's financial elite; wealthy figures such as Spencer Trask and George Foster Peabody crafted homes as palatial as those on Long Island along the lake's west flank, in what was jauntily called 'Millionaires' Row'. Inevitably, in an era of private jets and Caribbean playgrounds, things are not as chic as they once were, and the town of Lake George now makes its living out of motels, T-shirt shops, amusement arcades and candy-floss stands. But the majority of the tourists who inflate the local population from 3,500 to more than 50,000 during the hottest months still come for the scenery, and the area's closeness to nature – the water still refreshingly cold during the heat of August, the Adirondacks bothering the horizon away to the north-west. But if Lake George seems to embrace the warmest season as a temporary arrangement, other corners of upstate New York seem never entirely to escape the winter. At Lake Placid, another 80 miles north, this is partially the point. Indeed, you can hardly move a metre along Main Street without noticing reference to the two occasions – 1932, 1980 – when it hosted the Winter Olympics. Supporting evidence is everywhere – Whiteface Mountain, the ski resort, 10 miles up the road, where the downhill events were held in 1980; the Lake Placid Olympic Museum, which salutes both games with medals and memorabilia. And the Olympic Ski-Jumping Complex is as close as 'Upstate' comes to skyscrapers, its twin towers piercing the treeline. Thrill-seekers can ride down from on high via a zipline. Rather confusingly, the water feature on which the town largely sits is not Lake Placid (which lies directly to the north), but Mirror Lake. An appropriate name. By now, my journey has brought me into the grip of the Adirondacks, and the lake's smooth surface captures the mountains in gentle reflection; a wholly pretty picture, whatever the season. A century or so ago, travellers came this way for more than such vistas. Saranac Lake, 10 miles to the west, blossomed not as a rich man's plaything, but as a sanctuary for the sick. The catalyst was the arrival, in 1876, of Edward Livingston Trudeau, a New York City doctor and tuberculosis sufferer who had ventured to the Adirondacks in search of the fresh air and cool climate he hoped would heal his condition. Revived by mountain life, he decided to stay, and opened a sanatorium for the treatment of fellow TB victims in 1884. Transport links came with this boom – the New York Central Railroad rolled into the town in 1877. These unlikely 'good times' could not last. Within 50 years, advances in medical science had rendered Saranac Lake's treatment centres obsolete. But it has fought back gradually against irrelevance, as a haven for fishing and boating. To that list can now be added hiking and cycling. The last train departed in April 1965. But while part of the line – a 108-mile stretch from Utica to Tupper Lake – has been preserved as a heritage operation, the Adirondack Railroad, the 34-mile section which links Tupper Lake to Lake Placid via Saranac Lake has been stripped of its track and relaunched as a space for adventures by foot and pedal – the Adirondack Rail Trail, which will be fully open by the end of 2025. It definitely feels like a useful addition as I cycle along it on a breezy afternoon, through thick patches of forest, finally reaching the town's former station – another sturdy relic that will be restored, with cafes and a gift shop, as part of the trail experience. I am a long way – almost 300 miles – from New York, as I stand on the decommissioned platform. The New York of subway trains and yellow cabs, that is. The 'other' New York – of fir trees and granite peaks; of rivers, lakes, and mossy tranquillity – is all around me. Essentials Airlines including British Airways, Virgin Atlantic and American Airlines fly to New York from various British airports. Lodges at Cresthaven, Lake George starts at £147 per night. Mirror Lake Inn, Lake Placid has rooms from £306 per night.
Skift
13-06-2025
- Business
- Skift
Tripadvisor Is Turning 25. Here's What Its CEO Says About Its Future
Tripadvisor has come a long way in 25 years, but CEO Matt Goldberg did a lot more than just reflect on the past in this episode of the Skift Travel Podcast. Editor-in-Chief Sarah Kopit and Head of Research Seth Borko talk travel every week. Editor-in-Chief Sarah Kopit and Head of Research Seth Borko talk travel every week. Learn More Tripadvisor is turning 25, and CEO Matt Goldberg joined Editor-in-Chief Sarah Kopit and Head of Research Seth Borko to discuss the company's evolution in this episode of the Skift Travel Podcast. Goldberg also offered his insights on the competitive landscape he sees, the role of AI in enhancing user experience, the importance of consumer trust in the travel industry, and more. Listen Now Apple Podcasts | Spotify | YouTube | RSS Five Key Points Focus on Experiences as a Growth Driver: Viator, Tripadvisor's platform for booking local experiences, has become the 'strategic and financial center' of the company. Experiences now outpace hotels as the company's primary area of expansion. Resilience of Travel Demand and Shift in Traveler Behavior: Despite economic uncertainty, travelers continue to prioritize experiences, showing strong discretionary spending resilience. Goldberg emphasizes a shift to more local, drive-to, and second-tier destinations (e.g., Lake George, the Adirondacks), which not only meets evolving traveler interests but also supports sustainability by dispersing tourism beyond major hotspots. Airbnb's Entry Validates the Market, Not a Threat: Goldberg said he isn't concerned about Airbnb's relaunched experiences product, adding that multiple players can thrive in the sector. Viator's Advantage: Focused Marketplace + Strategic Partnerships: Viator benefits from its exclusive focus on experiences, deep supply penetration, and partnerships with major travel brands like Expedia, Amazon, and thousands of travel agents. These partnerships bring in incremental customers without high marketing costs, helping Viator scale profitably and globally. AI is a Game-Changer for TripAdvisor and Viator: Tripadvisor is integrating AI across all its brands, using it for trip planning, review summarization, product listings, recommendations, and B2B tools. Goldberg says AI is seen as a foundational, transformative force that will optimize operations, enhance customer experience, and reshape the business model. Episode Summary Tripadvisor CEO Matt Goldberg reflected on the company's journey from its humble beginnings during his chat with Editor-in-Chief Sarah Kopit and Head of Research Seth Borko. Goldberg explained how Tripadvisor was able to solve the challenge of finding trustworthy travel information, which sparked a revolution in democratizing travel advice. Goldberg outlined how Tripadvisor has been able to build experiences marketplaces through brands like Viator and The Fork. He also expressed admiration for Airbnb for relaunching its experiences product. However, he said his company, with its deep category focus on experiences through Viator and Tripadvisor, is better positioned than horizontal platforms like Airbnb to thrive in the sector. Goldberg also talked about what he calls a culture of experimentation and agility within Tripadvisor, likening the current moment to a startup era driven by a renewed sense of purpose and innovation.
Yahoo
08-06-2025
- Health
- Yahoo
Wildfire smoke from Canada prompts air quality health advisory
NEW YORK (WWTI) – New York DEC Commissioner Amanda Lefton and DOH Commissioner Dr. James McDonald are issuing an Air Quality Health Advisory for fine particulate matter on June 7, 2025, due to wildfire smoke from Canada. Air quality alert issued for much of New York State The pollutant of concern is: Fine Particulate Matter The advisory will be in effect 10 a.m. through 11:59 p.m. The Air Quality Health Advisory regions consist of: Adirondacks, which includes Clinton, Essex, Franklin, Hamilton, northern Herkimer, Lewis, St. Lawrence, and Warren counties; Eastern Lake Ontario, which includes northern Cayuga, Jefferson, Monroe, Oswego, and Wayne counties; Central New York, which includes Allegany, Broome, southern Cayuga, Chemung, Chenango, Cortland, Delaware, southern Herkimer, Livingston, Madison, Onondaga, Oneida, Ontario, Otsego, Tioga, Tompkins, Schuyler, Seneca, Steuben, and Yates, and Western New York, which includes Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, and Wyoming counties. DEC and DOH issue Air Quality Health Advisories when pollution levels, like ozone or PM2.5, are expected to exceed an AQI value of 100, indicating health risks. Fine particulate matter (PM 2.5) consists of tiny particles or droplets in the air, measuring 2.5 microns or less. These particles can come from combustion sources like vehicle exhaust, power plants and fires, as well as chemical reactions in the atmosphere. Exposure to PM 2.5 can lead to short-term health issues such as eye, nose and throat irritation, coughing, sneezing, and shortness of breath. It may also worsen conditions like asthma and heart disease, particularly affecting sensitive groups like those with heart or breathing problems, children, and the elderly. To reduce exposure during elevated outdoor levels, staying indoors can help, although indoor sources like tobacco or cooking fumes can still keep levels high. Recommendations include minimizing sources of PM 2.5 and avoiding strenuous activities in polluted areas. More information is available on DEC's and DOH's websites. Bongino, Patel defend ICE amid unrest over Los Angeles raids Ohio girl with brain injury from flu complications returns home Simone Biles rails against 'sore loser' conservative activist over trans athletes Protesters confront immigration agents, deputies during raid in Los Angeles County Streaming services next steps: What are Mubi, Tubi, and more? Additional information on PM 2.5 is available on DEC's website and on DOH's website (PM 2.5). A new DEC fact sheet about the Air Quality Index is also available on DEC's website or by PDF download. To stay up-to-date with announcements from DEC, sign up to receive Air Quality Alerts through DEC Delivers: DEC's Premier Email Service. A toll-free Air Quality Hotline (1-800-535-1345) was also established by DEC to keep New Yorkers informed of the latest air quality situation Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Daily Mail
01-06-2025
- Health
- Daily Mail
Hikers high on mushrooms when they mistakenly reported pal had died on trail
Two hikers who called 911 to report one of their party had died on the trail - only for him to be found alive and oblivious - were high on magic mushrooms, it turns out. The trio had been trekking in upstate New York when they found themselves lost. Believing their friend was deceased, the distressed pair called for help and reported their location near Lake Placid. But after rescuers arrived at the trailhead they got a phone call from the 'dead' pal - very much alive, unharmed, and seemingly unaware of the unfolding chaos. The trio were celebrating Memorial Day Weekend with a hike through the Cascade Mountain in North Elba when the nightmare unfolded on May 24. At around 9am, Forest Ranger Praczkajlo received an emergency call from distressed hikers on Cascade Mountain, part of the Adirondack High Peaks range, according to the state's Department of Environmental Conservation (DEC). During the call, the two hikers reported that their friend had died while on the trail. They also told authorities they had encountered a Cascade Summit Steward earlier and admitted they were lost. 'The steward determined the hikers were in an altered mental state,' the agency said in a press release. Ranger Praczkajlo eventually reached the trailhead, where an ambulance was already waiting, and escorted the two panicked hikers back to the vehicle. However, as they made their way back, a single phone call changed the entire situation - turning a straightforward rescue into something far more confusing. On the other line was the 'dead' friend - alive, unharmed and seemingly unaware of the chaos unfolding around him. According to the release, the group had allegedly eaten hallucinogenic mushrooms during their hike. The effects of the drug are highly unpredictable and heavily influenced by the user's mindset and the environment in which it's taken, as reported by Desert Hope Treatment Center. Given the unforeseeable nature of the drug, users may endure 'bad trips' - intense, distressing reactions that can be both frightening and disorienting. Intense hallucinations, anxiety, panic and fear are just a few of the possible effects during a 'bad trip', often triggered by unfamiliar or chaotic surroundings. Thankfully reunited, all three friends were escorted back to their campsite, where they could finally find safety and calm after their odd ordeal. Bad trips leading people to behave in wild or erratic ways are not an uncommon experience with mushrooms, though the intensity can vary greatly from person to person. For some, a 'bad trip' might mean intense anxiety and a pounding heart - unpleasant but bearable - while others unfortunately end up in dangerous or painful situations. Last year, a man on vacation in Austria who took these 'magic mushrooms' entered psychosis that led him to amputate his penis and store it in a snow-filled jar. Doctors labeled the heart-stopping incident as the first case of its kind - and a harrowing reminder of the dangers of psychedelic drugs. The 37-year-old man ate four or five mushrooms before blacking out and taking an axe to his penile shaft - ultimately chopping it into several pieces. As he came to, he staggered out of the home and dragged himself down a nearby street, bleeding profusely, searching for help. In the middle of the night, around 2am, a passerby picked him up and brought him to the nearest village, and then to the closest hospital. He was immediately carted to the operating room, where doctors got the bleeding under control and disinfected the myriad pieces of the man's penis in the snow and soil-filled jar. Some damaged parts had to be removed, but the head of the penis and shaft were intact. After cleaning the wound, doctors successfully reattached the penis, despite it having been without blood flow for about nine hours in total (five hours warm and four hours cold). After inserting a catheter, the surgeon reconnected the tissues of the penis using dissolvable stitches. The scrotal skin was then sewn back to the cleaned skin of the amputated part. Some of the skin on the tip of the man's newly reconstructed penis started to die about a week later - a condition called necrosis due to lack of oxygenated blood flow there - but doctors were able to treat it and reverse the damage. Despite all this, the man was still experiencing hallucinations, even trying to break out of the hospital at one point. Doctors found he had smuggled mushrooms into his hospital room, finding a handful of them in his nightstand in the urology ward.
Yahoo
31-05-2025
- Business
- Yahoo
Small towns, big stakes: How medicaid cuts threaten health care in the Adirondacks
— This story first appeared in New York Focus, a non-profit news publication investigating New York state politics. Sign up for their stories at newsletter. John Rugge has spent half a century building a network of health clinics in the isolated villages and towns of New York's Adirondack mountains. Now 80 years old, as most of his peers enjoy retirement, the locally celebrated outdoorsman and physician is organizing other rural doctors and community leaders in this strongly Republican part of the state to protect the health care system in the face of proposed cuts to Medicaid under debate in Congress. Rugge says the federal cuts in health care spending — projected at $715 billion over the next 10 years — could have a devastating impact, not just on the New Yorkers who will lose insurance, but also on the rural hospitals, nursing homes, and clinics that rely on Medicaid payments. If a hospital or nursing home is forced to lay off workers or to close entirely, he said, everyone in the community suffers, including those who have private insurance or enough money to pay out of pocket. 'It hurts the institutions, and that means it hurts everybody,' said Rugge. A canoeist and author of The Complete Wilderness Paddler, Rugge founded a clinic in 1974 that has grown into the Hudson Headwaters Health Network, which includes 26 clinics serving 9,400 patients each week. 'What we could see is a medical desert from Glens Falls to Plattsburgh,' a vast area stretching from below the Adirondack Park to the Canadian border some 114 miles away, he said. AGING POPULATION The Adirondack region includes six million acres of protected wilderness, featuring mountains, rivers, and lakes beloved by hikers and canoeists. The Adirondack Park is a checkerboard of public and private land, with 105 villages and towns — some home to just a few hundred people — scattered across rugged terrain. Vacationers crowd the region in the summer. Skiers come in winter. But the year-round population is small, declining, and aging. Many residents patch together part-time and seasonal jobs — work that doesn't come with health insurance. Twenty-eight percent of the residents in the congressional district that includes the Adirondacks rely on Medicaid, the federal-state health insurance program for low-income people. Half of births and two-thirds of nursing home residents are covered by Medicaid. HEALTH CARE CUTS Rural hospitals and nursing homes operate on razor thin margins, and many have been losing money for years. Nearly a third of rural hospitals in New York are at immediate risk of closing, according to the Center for Health Care Quality and Payment Reform, a national policy center. Maternity care is particularly vulnerable. The bulk of House Republicans' planned health care cuts — $625 billion — would come from Medicaid. The remainder would come from changes to the Affordable Care Act, also known as Obamacare, which helps individuals pay for private insurance and also pays for the Essential Plan, New York's free program for people with somewhat higher incomes than Medicaid allows. Governor Kathy Hochul has said the proposed cuts could lead to 1.5 million New Yorkers losing health insurance in the next 10 years, and would cost the state $13.5 billion annually in lost federal revenue. 'No one state can backfill these massive cuts,' she said in a news release last week. Rugge said people of all political stripes have an interest in preserving the Adirondacks' fragile health care system. He leads a nonpartisan group, the Health Care Coalition for the North Country, that has been meeting with local town and county officials and encouraging them to write to their federal representatives, particularly Rep. Elise Stefanik, about the importance of Medicaid to their communities. Stefanik, who won reelection in November with more than 62 percent of the vote, maintains that the Republican bill would 'strengthen and secure' Medicaid by ensuring that only eligible recipients are enrolled. Stefanik spokesman Wendell Husebo pointed to research by the Empire Center for Public Policy, a conservative think tank, suggesting that many people lie about their income to meet the eligibility requirements for Medicaid and that there has been a surge in the number of undocumented immigrants approved for emergency care. NOT AN HONOR SYSTEM Kevin McAvey, managing director of Manatt, a healthcare consulting firm, pushed back at the notion that ineligible people are flooding the Medicaid rolls. 'This is not an honor system,' McAvey said. 'Individuals seeking Medicaid coverage in New York predominantly apply through the state-based marketplace, where their income attestations are checked against federal and state data sources. If such checks cannot be completed, individuals must present documentation that proves their income.' As for the undocumented immigrants receiving emergency room care — as required by federal law — he said the payments help keep hospitals afloat. 'Emergency Medicaid reimbursements in New York state and across the country protect our health care providers,' he said. The bill, narrowly passed by Republicans in the House last Thursday, would make a series of technical changes to how the federal government reimburses states for health care costs. It would impose a penalty on states like New York that use state money to offer care to some undocumented immigrants. (Federal law requires hospitals to offer emergency care to everyone, including undocumented immigrants. New York uses its own funds to provide non-emergency care to undocumented pregnant women and people over 65.) Most significantly, the Republican bill would require working-age Medicaid recipients without children or disabilities to provide documentation each month that shows they have worked at least 80 hours — a requirement that proponents say will prevent abuse and that Medicaid advocates say would add red tape and burdensome administrative costs. NURSING HOMES One of the bill's technical changes could have an immediate impact on the state's hospitals and nursing homes: The Centers for Medicare & Medicaid Services this month rolled back its approval of an obscure mechanism, called an MCO tax, that New York had planned to use to draw down an additional $2 billion this year in federal funds. The state was counting on that money to increase Medicaid payments to hospitals and nursing homes. Heidi Schempp, the administrator of the Elderwood nursing home in the hamlet of North Creek, has been hoping for more state money to help keep her skilled nursing facility afloat. The cost of food and salaries is going up, she said, and reimbursements haven't kept pace. Seventy percent of her patients rely on Medicaid, and the rates set by the state cover less than 70 percent of the cost of care, she said. She can make up some of the difference by offering short-term rehabilitation services to other patients, which are reimbursed at a higher rate, but it's a struggle. 'My goal is to break even,' she said. Elderwood has about 70 residents, mostly elderly, and a staff of about 100. Most of the residents worked and paid taxes for decades and qualified for Medicaid only because they've spent their life savings, she said. Medicare, the federal health care plan for people over 65, does not cover the cost of long-term care, so residents typically pay out-of-pocket until their savings are depleted. Elderwood charges about $11,000 a month. The nearest nursing homes are in Glens Falls, a 45-minute drive south, and Tupper Lake, more than an hour north. 'Can you imagine not being able to see your spouse because they had to move into a nursing home far away?' Schempp said. 'It's just devastating.' 'I'D BE OUT ON THE STREETS' In a bid to ensure Elderwood's survival, Daniel Way, a retired family doctor and photographer, photographed nursing home residents and interviewed them about their lives, posting their stories online. 'If I didn't have Medicaid I'd be out on the streets,' said one resident, 77-year-old JoAnn King. 'I worked a long time, never been in trouble, loved my country all my life. To the politicians threatening to cut Medicaid, shame on yourselves!' Planned Parenthood of the North Country operates seven clinics that serve a vast region stretching 165 miles along two-lane roads, from Plattsburgh on Lake Champlain to Watertown near Lake Ontario. Patients may drive an hour or more to reach a clinic, and nearly half rely on Medicaid. CEO Crystal Collette said Planned Parenthood is the only health care provider for about one-third of their patients, most of whom are young. They rely on Planned Parenthood not only for birth control and abortions, but also to check their blood pressure, screen for cancer, test for sexually transmitted diseases, and treat urinary tract infections. ON THE BRINK Recruiting doctors and nurses to work in rural areas is challenging, Collette said, and Planned Parenthood pays a premium to retain them. Like Schempp at the Elderwood nursing home, Collette said the costs of care 'far outpace' Medicaid reimbursements. Private fundraising helps make up the difference. 'We already have a health care system that's teetering on the brink of collapse,' she said. 'Sweeping cuts to Medicaid is something that I don't think we can fundraise our way out of. There's no possible way for our donors to make up the difference.' The Hyde Amendment has long banned the use of federal funds for abortion, except in cases that endanger the life of the mother or that result from rape or incest. The House bill would go much further; it would cancel all federal funding for Planned Parenthood — including for the routine health care that the organization offers. Although abortions make up only about 3 percent of the services Planned Parenthood provides, the organization has become a lightning rod for anti-abortion groups. The House bill now goes to the Senate for debate, and revisions are expected. The proposal to ban funding for Planned Parenthood may not pass the Senate, where several Republican senators have voiced their support for the organization. WORK REQUIREMENTS Nonetheless, pushing able-bodied people who cannot regularly document their work hours off the Medicaid rolls — as the House bill proposes — would also hurt Planned Parenthood financially. With many North Country residents working part-time jobs with irregular hours, self-employed as carpenters or handymen, or working off-the-books at jobs such as housecleaning, that documentation may be hard to provide, Medicaid advocates say. Without payments from Medicaid, Planned Parenthood would be faced with many more patients who have no ability to pay. Work requirements overload Medicaid recipients with paperwork that they may not be able to complete even if they are eligible, McAvey said. 'What winds up happening is that eligible recipients end up losing coverage,' he said, citing the experience of Arkansas and Georgia. When Arkansas imposed work requirements, 18,000 people lost health insurance and there was no increase in employment; a judge ordered the state to abandon the plan. In Georgia, the administrative costs of verifying employment far outstrip the cost of health care. 'This debate over a work requirement goes back to ideological differences in views about Medicaid,' said Larry Levitt, executive vice president for health policy at KFF, the national health policy group. 'Some people view Medicaid as a welfare program that should only be for the 'deserving poor' and others view Medicaid as a stepping stone towards universal coverage and that access to healthcare should be a right irrespective of work.' As the details about the House plan trickle out, state and county legislators are coming to grips with the implications for their own budgets. In New York, the cost of Medicaid is split three ways, with the federal government, the state and the counties each taking a share. If federal funds decline, the state and the counties must either pick up the slack or make cuts, often by reducing reimbursements to providers or eliminating services that are not required by federal law, such as home care for the elderly or routine care for undocumented immigrants. The state budget passed earlier this month didn't take into account likely federal budget cuts, but the state legislature gave Hochul the authority to institute midyear cuts if necessary. 'It is going to be very difficult to figure out how to fill that gap,' said state Assemblyman Scott Gray of Watertown, a Republican. After meeting with Rugge and other members of the Health Care Coalition for the North Country, Assemblyman Matt Simpson, of Lake George, said he understands the importance of Medicaid to his constituents. 'I look forward to working together on this and other areas of access to health care throughout our shared community,' said Simpson, a Republican. The Health Care Coalition for the North County has also met with town and county officials. Schempp said she met with the Town Board in the mostly conservative town where she lives, Indian Lake, and they agreed to pass a resolution calling on Stefanik and other elected officials to 'exercise caution' when considering budget cuts. Similar resolutions have been passed by the towns of Kingsbury and Schroon Lake, as well as several county boards of supervisors, Rugge said. After meeting with Rugge's group, Essex County manager Mike Mascarenas told his board of supervisors that significant Medicaid cuts would not only hurt 'the population that receives Medicaid, but to those who pay for it.' If counties need to contribute more to Medicaid, they may need to raise property taxes. 'I've been here 25 years, and what I will tell you with certainty is that the (proposed) change to Medicaid is probably the single biggest threat to property tax that I've ever witnessed in Essex County,' he said. Essex County is a swing county, sometimes voting for Republicans, sometimes for Democrats. Rugge is optimistic that his work educating his neighbors about Medicaid is bearing fruit. 'We're making a dent,' he said.
