The Iroquois Healthcare Association (IHA) and our Upstate and rural hospitals and health systems are grappling with significantly negative operating margins, ever escalating costs, and a long-enduring staffing shortage. This is why IHA has been urging state leaders to build on the rate increases included in the last budget cycle to stabilize healthcare in these communities. Just weeks ago, the Hochul administration publicly promised to preserve Medicaid spending. Jarringly, this budget proposal fails to reflect that promise, and it fails to recognize the fiscal crisis our hospitals are facing. The Governor and the Legislature must eliminate these proposed budget cuts. IHA calls on State leaders to reject proposed cuts and build upon the path to recovery they charted in last year’s budget to close the State’s Medicaid Gap. To do otherwise will lead to loss of access to care and threats to quality of care and health equity in Upstate and rural communities.