State Sen. George Borrello, R-Sunset Bay, speaks about hospital spending during state Senate budget debates last week.

An additional $50 million in capital funding for the Nassau University Medical Center is nothing more than a bandaid on the gaping financial wounds hospitals in New York state deal with each year, according to state Sen. George Borrello.

The Sunset Bay Republican was highly critical of both the process and the content of the state’s $254 billion budget approved last week in a series of late-night budget bill votes. One of Borrello’s particular issues was hospital reimbursements and particularly the state’s actions to help the financially struggling Nassau University Medical Center.

The 2026 state budget includes $50 million in capital funding to support the enhancement, modernization and financial stabilization of the Nassau University Medical Center, $25 million in capital projects funding over the next five years to support the modernization and enhancement of the state Health Department’s four veterans’ homes, as well as the Helen Hayes Hospital; and an additional $500 million in operating support for financially distressed hospitals across the state.

“You’ll listen to this debate and even my colleagues explaining your votes, there’s one thing that is for certain – it doesn’t matter if it’s Nassau County or the north country or the city of Buffalo or the five boroughs – health care in New York state is a mess,” Borrello said before voting no on the state’s health care budget bill. “Most hospitals in the state are hemorrhaging money – not bleeding it – by hundreds of millions of dollars. So we have to ask ourselves what has been done in this budget, or just in general in Albany, to fix that. Well unfortunately we have been an accelerant. We have poured gasoline on the fire here in New York state.”

Three out of four respondents to a November 2024 survey by the Hospital Association of New York State reported they do not have the operating margins needed to maintain and improve access to patient care, attract and retain a skilled workforce, invest in technology and research, secure capital funding and modernize their facilities. Hospitals statewide projected a median 0.0% operating margin when they closed their 2024 financial statements. Total labor expenses have increased 36.4% since 2019, exceeding general inflation by more than 13 points, according to the HANYS report. While hospitals report a second year of declining contract labor expenditures, those expenses are double what they were in 2019, as workforce challenges persist, with 97% of survey respondents saying they have a shortage of nurses and 88% of hospitals reporting shortages of non-nursing personnel. Respondents report medications are their fastest rising expense.

“Here in this government, we have brought in millions more people to be on Medicaid,” Borrello said. “In fact we can’t even prove a million of them aren’t eligible for Medicaid, Medicaid’s missing million is what Empire Center calls it. We are wasting billions of dollars a year in waste, fraud and abuse when we allow the people on Medicaid to wander into an emergency room with a non-emergent problem and treat it like their primary care physician and then, to add insult to injury, we don’t reimburse enough those hospitals for caring for that person for that non-emergency.”

Borrello didn’t disagree with the additional money to help hospitals, but called on his fellow state lawmakers to do more to help hospitals like the Nassau University Medical Center or Kaleida Health in Buffalo to operate sustainably. Borrello’s inclusion of Kaleida is of interest locally because Kaleida and the Brooks-TLC Health Systems are partnering to build a state-supported hospital in Fredonia. The project will be supported by $74 million from the State that was previously committed. Kaleida and Brooks-TLC will submit a revised Certificate of Need application to the Department of Health (DOH) which will expedite approval. The new hospital is expected to open within 3 years of approval.

“We have destroyed the healthcare system for whatever reason and now we’re asking ourselves why does Nassau County need hundreds of millions of dollars, why does Kaleida in Buffalo need hundreds of millions of dollars?” Borrello asked. “Because we have made it impossible for them to deliver health care. You haven’t given them enough reimbursement and we allowed nearly half of New Yorkers to be on Medicaid. When I came here five years ago it was about one in four New Yorkers; now it’s over 40% are on Medicaid. We have ruined the system. Look in the mirror if you want to know why health care in New York state is a disaster.”

Borrello said after the budget votes were finished that the budget was a missed opportunity to make New York more affordable and improve public safety. Instead, Borrello criticized the budget’s $254 billion girth that he said will make the state more unaffordable in the future.

The budget wasn’t all bad, according to Borrello, since it expanded on involuntary commitment standards, strengthened Kendra’s Law and paid off the state’s $7 billion unemployment insurance debt to the federal government. All have been priorities for Borrello over the past few years.

“Any goodwill is undermined by one of the most outrageous provisions in the budget: $10 million in taxpayer funds set aside to cover the private legal fees for state officials, including Attorney General Letitia James, if she faces federal prosecution for mortgage fraud,” Borrello said. “The actions being investigated involve a personal financial transaction and have nothing to do with her role as Attorney General. She should pay for her own defense. Taxpayers should never be forced to bankroll the personal legal troubles of political elites. This budget is a monument to mismanagement – a missed opportunity to deliver real reform, real relief, and real results. Every year, Albany excuses a late budget by promising it will be ‘worth the wait.’ This year, once again, it wasn’t.”