Scraps of Time

Monday, September 21, 2026

Time running out for Chemung County

Driving around Breesport in the 5th District after an afternoon of door-knocking, Amy and I came across a county-owned cemetery and then a curious, abandoned red-brick building, which I later learned had been part of the Breesport Almshouse for the poor.

The original poorhouse had been built in 1837, and the red-brick building had been built in 1888 to provide medical care. The need for poorhouses in this country slowly declined with the establishment of the Social Security Act of 1935, and the services provided were divided among federal, state and county agencies. In 1971, the last 100 residents were transferred to the recently built Chemung County Nursing Facility and the building was closed and abandoned.

Star-Gazette article

But seeing the Breesport Almshouse was a reminder of the county's legacy of providing care to those existing at the very bottom rung of society. Changes at the federal level will put the county under ever increasing pressure to provide that care.

Providing social services has been a key part of the county mission, but also one of the biggest challenges. Under the 2026 budget, the county is paying $45 million in for a range of services such as Medicaid, child welfare, special education, etc that are required by state or federal law but without reimbursement. An additional cost is on the way.

SNAP, or Supplemental Nutrition Assistance Program, provides food benefits to low-income families to supplement their grocery budget. About 13,000 Chemung County residents (about 16% of the population) are on the program. The program is administratively run through the counties, but until now the benefit costs had been split 50-50 between the federal government and the states. Typically, SNAP benefits are worth about $332 a month to recipients.

Under the "Big Beautiful Bill," the federal share will drop to 25%, leaving the states to pick up the rest. And it appears NY state will be passing along that extra expense to the counties.

If nothing else is done, this extra cost of $780,000 will hit Chemung County in the Fall of 2027. U.S. Senator Chuck Schumer and other Democrats have been lobbying to include a two-year delay on the SNAP transition into this year's Farm Bill. But the Senate version only includes a one-year delay, and it is unclear whether any delay will be included in a final version, which will likely not be resolved until after the mid-term elections in November.

This squeeze is especially difficult for Chemung County, which has a high poverty rate for such a small county. With 80,000 residents, Chemung County is 29th in total population among counties (counting NYC as one.) But it is 20th in amount of SNAP benefits received and 22nd in number of residents receiving SNAP benefits.

But if the county does not pick up the extra cost:

More people will struggle for food, pushing them closer to homelessness and destitution. This creates a worse problem for the county to solve.
More kids will go without enough food. This will impact their education, development and potential for success as adults.
Local grocery stores will take a hit in revenue.

The federal and state government have stepped back, as if by spending less on SNAP will make the need for SNAP go away. But the county still has an obligation to care for those at the bottom of the ladder.

One of my followers on Facebook writes: "Rather than lament the lack of funding from 'above', the county ought to be making an attempt to raise more Chemung County residents OUT of poverty....thus reducing the NEED for social services expenditures."

Yes, well-paying jobs are the answer, but the county has been struggling with this question for years. It would be difficult to find the answer before these cuts hit.

Somehow we need to turn Chemung County into the kind of place that higher-paying employers would want to locate to. We need to draw companies here for reasons better than offering a tax deal. I don't know what that would be, but finding the answer to that question would solve many of the issues facing the county.

But in the meantime, we need to do what we can to save those dangling from the precipice. To let them fall, would mean our recovery as a county will take that much longer.

Friday, August 14, 2026

Single-payer health care would save lives, money

Facebook page

"Parents shouldn't have to go bankrupt to get care for their children," said Susan Beckley, one of three speakers at last night's forum by the Campaign for New York Health.

The New York Health Act has been proposed in Albany since 1991 and has failed to get passed despite its potential to save New Yorkers billions in health insurance costs and give everyone access to the medical services they need. It would end the need for chicken-dinner fundraisers for sick kids or GoFundMe campaigns to pay for emergency surgeries.

The forum at the Chemung Democrats Headquarters laid bare the tragedy and contradictions of our health care system for anyone who attended or watched on Facebook.

"What's wrong with our health care system now?" Beckley asked. "Well, we pay more than twice the average per capita in this country for medical coverage and our life expectancy is less than most developed nations. We rank 31st."

Furthermore, the life expectancy numbers become more stark when comparing the wealthiest Americans with the poorest, according to a chart Beckley presented. Between 1980 and 2010, life expectancy dropped 4 years for the poorest U.S. residents, from 82.3 years to 78.3 years. Meanwhile, the richest Americans, who have easier access to health care, saw an increase in life expectance from 86.3 to 91.9 years.

The insurance companies get in the way of patients getting the care they need with bureaucracy, denials of treatment and prescriptions, billing and rebilling, co-pays and deductibles. The New York Health Act would get rid of all that, streamline the system and create a single-payer system.

A single-payer system, which I blogged about in 2018, would eliminate private health insurance and instead create a single public fund, paid for by some Federal money but also by taxpayers. Patients could go to any doctor they wanted, and the doctor would get paid directly out of that central fund.

"How are we going to pay for that?" a woman said to me once when I knocked on her door during a campaign.

The question is really, "How can we afford the system we have now?"

"Insurance companies exist to make a profit," said Dr. Cori Marshall, a family medical practitioner in Sayre, Pa., who got hit with a $6,000 medical bill when she needed treatment while pregnant with twins. Since her hospital didn't have a NICU, she was forced to go to an out-of-network hospital and got hit with that excessive bill despite having the "good" insurance.

The current system is also why it took 8 years for one of her patients to get a much-needed hip replacement.

This factoid from the presentation demonstrates one example of why the U.S. health care system is so bloated and costly.

Duke Medical Center

• 957 beds in 3 hospitals

• 1600 billing clerks.

Toronto University Health Network (under the Canadian single-payer system)

• 1,272 beds in 5 hospitals

• 7 billing clerks

Now, think about this -- How much do you pay each year for your medical care? Consider the premiums, the deductibles, the co-pays. Depending on what you need and the plan you have, it could be $10,000 or more.

The presentation included a chart of estimate payoll rates for New Yorkers under the single-payer plan. A self-employed worker making $62,400 a year would pay only $214 a month. If employed by a company, the employee would pay only $43 and the employer would pay $171. (20/80 split)

That's not a guarantee that the payments would be exactly that if the Health Act went into effect, but the point is this may be the kind of savings we would save were we to get rid of insurance companies and their bureaucracy, profit margins and CEO bonuses.

The Health Act would also provide coverage for every New York state resident without requiring employment with a large company or the need to be married to an employee of a large company. People will be free to leave jobs and start a small business, confident they and their employees will be covered.

Perhaps we would feel like human beings rather than a commodity to be financially exploited. Put the care back into health care, as Marguerite Uphoff, a retired pediatrician put it.

But the benefits go far beyond that. Pragmatic, no-nonsense, budget-conscious public officials need to wake up to the potential here. Chemung County is under a unfunded mandate to pay nearly $20 million in Medicaid costs. They also pay nearly $35 million for employee health insurance. The single-payer plan would see that $55 million in costs greatly diminished. This is a savings that every municipality and government entity should really look at and consider as a means to cut taxes or provide better services to their constituents.

This bill has been presented to the legislature in Albany for years. It passed the Assembly 4 years in a row and one year failed to pass in the Senate by 1 vote. For now, it is stuck in committee and the advocates for this bill are pleading for the public to get involved and contact their local representatives.

"We don't have money, but we have a voice," Beckley said.

My state Senator is Tom O'Mara and the state Assemblyman is Chris Friend, but neither have shown any interest in advancing this bill. However, Friend's opponent in this year's election, Andy Fagan, recently attended another forum on the Health Act and told me, "It seems the way to go."

If it does not get voted on this year, it would be resubmitted next year.

But every year we wait costs us money and lives.

It is worth it to watch the entire presentation:

Financial analysis