Jonathan VanScoy, 54, who lives in a small town in the Finger Lakes, relies on Medicaid for drug and alcohol treatment. Phil, 58, a carpenter in the Adirondacks, uses his health insurance for preventive care, such as a skin screening for cancer or a colonoscopy. Jorge, 32, a construction worker in White Plains, has regular doctor visits and uses an inhaler to keep his asthma under control.

Jon, Phil, and Jorge are among the millions of New Yorkers who receive free or low-cost health insurance subsidized by the federal government. Now, they fear they will lose their coverage if Republicans in Congress follow through with their plan to cut hundreds of billions of dollars from Medicaid, the federal-state health insurance that covers 6.9 million New Yorkers.

That’s more than one-third of the state’s residents, including 42 percent of all births and 63 percent of nursing home residents.

A House plan to shave $880 billion from Medicaid over the next decade could force New York to make gut-wrenching choices: end health care coverage for some 2 million residents, trim benefits such as home care for the disabled and elderly, cut other parts of the budget such as education, or find more than $7 billion a year in new taxes.

The debate over Medicaid costs has put New York’s seven Republican members of Congress in a tight spot: They are pressured by their leadership to impose budget cuts, but they are aware that a large proportion of their constituents rely on Medicaid.

In recent weeks, we’ve been reporting on a shady health insurance company, Leading Edge Administrators, and its founders, Barbara and Jerry Weissman. The company has faced lawsuits after failing to pay for health care and used a creative scheme to help employers keep money meant for low-wage health care workers.

We’re looking into the company because starting May 1, they’ll be providing bare-bones health insurance to thousands of New York’s home health aides — people who care for elderly and disabled New Yorkers through a state-funded home care program known as CDPAP. Our stories highlighted that Leading Edge’s insurance won’t cover many basic medical needs and could leave home care workers in deep medical debt.

But something else also caught our attention. Barbara and Jerry Weissman control a nonprofit that since 2022 has given away $4.3 million — and hasn’t disclosed who received any of it. This defies laws that require nonprofits to report their donations, and it raises concerns about whether the foundation is truly using its funds for charitable purposes.

“If you are actually promoting charitable work, there is no reason to hide the recipients of your charitable grants,” said Tania Ibanez, a lawyer who served as the chief charity regulator for California’s Attorney General until 2023.

Nick Spano faced potential ruin when he was sentenced to prison in 2012. Clients fled his scandal-scarred, Albany-based lobbying firm.

But 120 miles down the Hudson River, his younger brother, Mike, had just been elected mayor of New York’s third-largest city.

In the years since, as Mike Spano has overseen Yonkers’s revival, Nick’s lobbying firm has been resurrected, too. His client list has swelled with nearly two dozen companies and interest groups that have business before his brother’s administration.

A New York Focus investigation has found that Nick Spano has interacted with a top city official and sat in on meetings with Mike Spano. A lobbyist at Nick’s firm requested a sit-down between a client and his own wife, a senior city official, to secure a tax break. After such meetings, Mayor Spano’s administration has taken action that directly benefited both Nick’s lobbying clients and the real estate brokerage where Nick holds a side job as a salesperson.

These findings “suggest a high level of conflict of interest and corruption risk,” said John Kaehny, executive director of the government reform group Reinvent Albany, and “should be investigated by the State Attorney General's office of public integrity as soon as possible.”

A health insurance company founded by a man convicted of insurance-related felonies doesn’t sound like a recipe for success.

But since its founding in 2010, insurer Leading Edge Administrators has flourished despite the checkered past of its founder, Jerry Weissman, who in 1997 was convicted of obstructing a congressional investigation into Empire Blue Cross and Blue Shield, then the nation’s largest medical insurer, where he served as CFO.

On May 1, Leading Edge will begin offering two bare-bones insurance plans to hundreds of thousands of low-wage home health aides in New York. As New York Focus previously reported, one of these plans will fail to cover many basic health needs — like doctor’s visits, maternal care, and hospitalization — for the workers who provide state-funded care to elderly and disabled people across the state.

Home health aides might have difficulty getting Leading Edge to pay for even the services it claims to cover. A New York Focus review of lawsuits against Leading Edge show it has a record of backing out of paying for covered health procedures — using tactics that experts say went far beyond standard industry practices — and trying to leave patients with the bill.

As President Donald Trump’s administration rounds up hundreds of immigrants it claims are gang members and expels them to a notorious Salvadoran prison, New York state is quietly feeding federal authorities gang intelligence that could fuel the deportation machine.

The New York State Police maintain a database of more than 5,100 people they’ve designated as members of criminal gangs — and funnel the information into a federal database used by US Immigration and Customs Enforcement, a New York Focus investigation has found.

The statewide gang database has been in operation for 20 years, though it has garnered almost no outside attention or scrutiny. State Police staff designate people as gang members — including people who may never have been charged with a crime — using highly speculative criteria like where they spend their time, whom they talk to, what clothing they wear, and what tattoos they have.