The proposed 2026–2027 New York State Executive Budget includes a provision that would eliminate Medicaid “crossover payments” for ambulance services. For Sand Lake Ambulance, this would mean losing an estimated $20,000–$25,000 per year.
Unlike police and fire departments, Sand Lake Ambulance is not fully taxpayer funded. We are an independent nonprofit organization. Only a portion of our operating budget comes from municipal support. The majority of our funding comes from insurance reimbursements, Medicare, Medicaid, and donations.
Every time we respond to a 911 call, it costs approximately $900 to provide care. For Medicaid patients, we are reimbursed around $250. That is less than 30 cents on the dollar. We absorb that gap because reliable emergency medical care is not optional.
Crossover payments help offset a portion of that shortfall for low-income Medicare beneficiaries who also qualify for Medicaid. Under the current system, Medicaid covers the remaining balance after Medicare pays its share. The proposed budget would eliminate that coverage, shifting the financial loss directly onto ambulance providers.
For Sand Lake Ambulance, that represents roughly two percent of our annual patient service revenue. While two percent may not sound dramatic, in a nonprofit EMS system where margins are already tight, it directly impacts staffing, equipment, and long-term sustainability.
In 2025 alone, we answered 1,181 calls, expanded service to Poestenkill, increased our coverage population by more than 40 percent, and maintained strong response times. We operate with 35 paid EMTs and paramedics to ensure 24/7 in-house coverage. Sustainable funding is essential to keeping that standard of care in place.
Statewide EMS organizations strongly oppose this proposed cut and are advocating for fair reimbursement rates that better reflect the true cost of delivering emergency medical care. We remain committed to serving this community with professionalism and readiness. We also believe our community deserves transparency about policies that impact emergency services.
When you call 911, we will be there. Ensuring we can continue to do so requires responsible funding decisions at every level.
How You Can Help Protect EMS Funding
The New York State Volunteer Ambulance & Rescue Association (NYSVARA) and the United New York Ambulance Network (UNYAN) have launched a statewide grassroots advocacy effort urging elected officials to reject this proposed Medicaid cut.
It takes less than two minutes to make your voice heard!
Your outreach can help protect emergency medical services not only in Sand Lake and Poestenkill, but across New York State.
Click the link below to complete the advocacy request, and please consider sharing it with friends and family. The more voices our representatives hear, the stronger the message that EMS funding matters.
Reject Proposed Medicaid Crossover Cut for Ambulance Services
Sand Lake and Poestenkill, thank you for standing with us. Together, we save lives.