Congressman Nick Langworthy’s recent Weekly Update and quotes from his Westfield appearance featured in the October 8th edition of the Post-Journal, demonstrate that he continues to fail to tell us the rest of the story. Instead, his rhetoric echoes usual talking points designed to inflame rather than inform the constituents of our district. Langworthy’s comments are designed to raise alarm about government healthcare dollars supposedly supporting undocumented immigrants during the shutdown. Reality, and the actual paperwork needed to apply for health care programs, tell an entirely different story. Below, you will find some of the rest of the story that he isn’t sharing.

Federal law and official application forms clearly state that Medicaid, Medicare, and ACA Marketplace insurance are off-limits to undocumented immigrants. Actual enrollment processes in New York, Pennsylvania, and nationwide demand hard proof of U.S. citizenship or qualifying legal immigration status. If you don’t have the right documents, you don’t get coverage. That’s not a partisan opinion, that’s fact.

Medicaid: Citizenship and immigration status are double-checked against federal databases. Only U.S. citizens and a limited list of “qualified non-citizens” (green card holders, refugees, asylees, and sometimes only after a five-year wait) can enroll. Undocumented immigrants are categorically excluded; except for emergency-only services (think: ER care for heart attacks, serious injuries, or complicated childbirth situations).

Medicare: Available strictly to citizens and lawful permanent residents who’ve lived here at least five continuous years. Applications require supporting documents and Social Security verification.

ACA/Marketplace Coverage: Whether it’s HealthCare.gov or a state run exchange, all applicants must submit documentation of lawful presence. The eligible lists don’t include “undocumented” anywhere.

Check any actual health coverage application, Medicaid, Medicare, or the ACA Marketplace, and you’ll find a clear checklist of requirements, with proof of citizenship at the very top. States use secure federal systems like DHS SAVE to digitally verify every detail at every step.

Despite what Langworthy implies, federal dollars for Medicaid and Affordable Care Act Marketplace coverage do not go to undocumented immigrants. The laws, forms, and verification systems are designed specifically to stop anyone without citizenship or qualifying documentation from getting benefits. The only exception is federal law requiring hospitals to treat emergencies regardless of immigration status are life-threatening illness/accident or delivery in labor. That’s not health insurance, and it isn’t a loophole for full coverage.

Even now, in the midst of a government shutdown, no emergency spending proposal or bill from either party changes these hard-edged eligibility rules. No one is advancing legislation to give full federal health care to undocumented immigrants. The real challenges at rural hospitals like Westfield Memorial and UPMC Chautauqua have nothing to do with immigration status. Their issues stem from chronic underfunding, workforce shortages, and shrinking populations. Despite what you might read in Congressman Langworthy’s latest email newsletter–where he claims, “Democrats’ bill guts our Rural Health Transformation Fund… a program we recently enacted designed to keep small-town hospitals open and modernize and enhance rural healthcare delivery… but their bill guts this funding and diverts those dollars to provide healthcare benefits for illegal immigrants. That is a non-starter, period. I will never allow American citizens to go to the back of the line behind people who broke our laws to come here”–the reality is that even with federal appropriations, blue states like New York might not receive Rural Health Transformation Fund (RHTF) dollars under current program rules.

Here’s what’s missing from the rest of his story: under existing regulations for the RHTF, local governments, hospitals, universities, nonprofits, federally recognized Tribes, and even individuals often cannot apply directly for these funds. The RHTF program earmarked $50 billion over five fiscal years (2026-2030), with $10 billion to be distributed each year:

50% of these funds are split equally among all approved states, not all states by default.

The other 50% is distributed by CMS based on factors like rural population, the proportion of rural health facilities, the situation of certain hospitals in each state, and other criteria that CMS will specify in its Notices of Funding Opportunity (NOFO).

So, despite Congressman Langworthy’s heated rhetoric, there’s a good chance New York and its rural hospitals could be passed over for these dollars, especially since New York is often viewed as a blue state–and with no clear definition yet of what makes an “approved state,” it’s anyone’s guess whether we’ll ever see those funds at all. Divisive language about “back of the line” and blaming immigrant access ignores the complicated reality rural providers face and does nothing to solve our area’s urgent healthcare crisis.

Let’s stop being distracted by fear mongering and finger pointing. The rest of the story is clear: federal law, application protocols, and eligibility systems are built to exclude those without citizenship or qualifying documents. We need leaders who address rural health care’s actual problems, not those who peddle politically convenient myths. Before you believe the rhetoric, take a moment to look for the rest of the story. That’s where you’ll find the truth and that’s where our focus ought to be.

Leslie LaBarte is a Jamestown resident.