Homepage

FOR IMMEDIATE RELEASE

Contact: Amy Simmons Farber, 202-309-0338

The National Association of Community Health Centers (NACHC) has a strong record of working with administrations to support primary care and advance a healthier America. We are grateful for our nonpartisan partnership with the Health Resources and Services Administration, which has ensured millions of Americans have access to affordable, comprehensive, effective primary care nationwide and spearheaded vital training programs for current and future generations of community health center (CHC) clinicians and staff.

CHCs serve 1 in 10 or over 32.5 million people nationwide, including 1 in 5 or over 10 million in rural America, and represent proven models of efficiency and effectiveness in public health with a documented record of saving both lives and healthcare dollars. Despite these successes, the current financial picture of CHCs is challenging. As details emerge about this reorganization and as we learn more about these initiatives, we are committed to working with the Trump Administration to focus on primary care and to assure CHCs have the resources they need to care for their patients. Our focus will be working collaboratively with agency leaders, this new Administration for a Healthy America, and Health and Human Services Secretary Robert F. Kennedy, Jr. to support improvements and restructuring that improves the health of all Americans.

Amid a widespread surge in chronic diseases, the third Primary Care Scorecard highlights how systemic disinvestment in U.S. primary care is posing a grave threat to the wellbeing of communities nationwide. By increasing investment in Community Health Centers (CHCs), the nation’s largest network of primary care providers, policymakers will help to improve health outcomes for Americans while also saving healthcare dollars.

Developed by researchers at the Robert Graham Center for Policy Studies in Primary Care and co-funded by the Milbank Memorial Fund and The Physicians Foundation, The Health of U.S. Primary Care: 2025 Scorecard, tracks key metrics of primary care performance, underscoring critical gaps at the national and state level.

The bottom line is that the U.S. invests less than 5% in primary care.¹ This underfunding weakens preventive care, drives healthcare costs higher, and increases Americans’ reliance on expensive emergency departments, hospitals, and specialty care.  In contrast, states that allocate a greater share of their healthcare spending to primary care experience decreased hospital and emergency department visits.² 

A case in point is Oregon, where every dollar spent on primary care generated $13 in savings.  Even elderly patients on Medicare and dually enrolled beneficiaries (people enrolled in both Medicaid and Medicare) – who often experience complex, high-cost conditions like diabetes and heart disease – experience fewer hospitalizations when they have easier access to primary care.³

Lack of investment in primary care has led to workforce shortages

One in three people struggle to find a primary care doctor.  An estimated 100 million Americans lack access to primary care, particularly in rural and low-income communities. ⁴  The Bureau of Health Workforce projects a shortage of 87,150 primary care physicians by 2037,⁵ and a national survey found that 45% of primary care physicians report burnout – 39% of whom plan to stop seeing patients.⁶  

As the U.S. struggles with rising healthcare costs and primary care shortages, Community Health Centers (CHCs) stand out as a proven, cost-effective solution.  These nonprofit, primary care organizations governed by a patient majority board are legally required to provide care to all patients, regardless of their ability to pay.  In 2023, nearly 1,500 CHCs provided comprehensive care, including behavioral health and substance use disorder services, to 32.5 million patients across nearly 16,000 communities.  Nine in 10 patients have incomes less than 200% of the federal poverty level, and CHCs deliver care through a team-based approach – about 51% of medical visits are provided by a nurse practitioner, physician assistant, or certified nurse midwife.

CHCs are a bright spot in the healthcare system

CHCs expand primary care access and reduce costs. The Congressional Budget Office⁷ has documented that investing CHCs saves taxpayer dollars, while additional studies show CHC patients have lower hospital admission rates and emergency department visits, cutting annual Medicaid expenses by 24%.⁸ CHCs consistently exceed key quality benchmarks in diabetes control, blood pressure management, and cancer screenings, delivering higher-quality care⁹ at lower costs with improved patient outcomes. The Primary Care Scorecard highlights the critical need for increased primary care investment, but CHCs represent more than just another option—they embody a fundamentally different model. Their patient-majority governance, mission-driven approach, integrated service delivery, and proven cost effectiveness set them apart.

“The Primary Care Scorecard underscores the need to expand the Community Health Center program, which is successfully providing access to primary care with a team-based care model that meets patients’ needs in a comprehensive and cost-effective manner,” said Christopher Koller, president of the Milbank Memorial Fund.

“The Primary Care Scorecard underscores the need to expand the Community Health Center program, which is successfully providing access to primary care with a team-based care model that meets patients’ needs in a comprehensive and cost-effective manner.”

The uncertain road ahead

The recent congressional Continuing Resolution (CR) offers temporary financial relief for CHCs, which now serve 1 in 10 Americans.  However, ongoing financial uncertainty limits their ability to expand access, hire staff, and plan.  At the same time, Medicaid’s uncertain future threatens coverage for half of all CHC patients (16 million patients) who rely on the program for their care.

As the Primary Care Scorecard notes, strengthening primary care is essential to improving health outcomes and controlling costs.  CHCs are a key part of this solution, delivering affordable, high-quality, and comprehensive primary care to millions of people who would otherwise go without.  However, without stable funding and a strong Medicaid program, CHCs face significant challenges in meeting the needs of their communities.  Ensuring long-term financial support will allow them to expand services, strengthen the primary care workforce, and improve access to care for those who need it most.

Endnotes:

After months of uncertainty, Congress has passed funding for Community Health Centers through the end of the fiscal year, September 30, 2025. What does this mean for health centers and what are the prospects for long-term funding?

What’s in the Continuing Resolution passed by Congress?

Last week, the House of Representatives passed a Continuing Resolution to fund the government through the end of the federal fiscal year on September 30, 2025. The Senate followed suit on Friday, March 14. The CR extends both mandatory and discretionary funding for Community Health Centers. Specifically, the CR includes the following:

The Community Health Center Fund will be extended at the annualized rate of $4.26 billion.

The National Health Service Corps funding will be extended at the annualized rate of $345 million.

The Teaching Health Center Graduate Medical Education funding will be extended at the annualized rate of $175 million.

It would complete the discretionary appropriations through the rest of the fiscal year at level funding equal to FY 2024.

The bill also extends the current Medicare telehealth flexibilities through September 30.

The daily rate for each item is equal to the funding level that Congress passed in December. The bill does not include congressionally directed spending (community project funding or earmarks) that has supported specific health centers and PCA activities in previous years.

Health centers under strain after years of short-term funding bills

The passage of this CR means that health centers have operated under a series of short-term funding extensions for two years. This uncertainty severely impacts their ability to recruit and retain staff, expand services, and invest in long-term solutions for the communities they serve. Nearly half of health centers operate with unsustainable margins and 42 percent of health centers have only 90 days or less of cash reserves.

Health centers need long-term, sustainable funding to ensure uninterrupted care for 32.5 million patients nationwide.

Support for bipartisan, long-term funding bill in the 118^th Congress

Strong bipartisan support exists for increased funding and a longer-term extension for Community Health Centers. During the 118th Congress, NACHC endorsed three bipartisan bills to deliver this stability.

H.R. 5378, Lower Costs More Transparency, passed the House of Representatives with overwhelming bipartisan support (320-71). The bill would have provided the most significant increases in mandatory funding for health centers since 2015, enacted payment parity for telehealth services delivered to CHC Medicare patients, and extended funding for primary care workforce programs.

S.2840, the Bipartisan Primary Care and Health Workforce Act, passed the Health Education Labor and Pensions Committee mostly along partisan lines (14-7). The bill would have increased mandatory funding for health centers to $5.8 billion for three years, tripled NHSC funding to $950 million per year, and provided $1.5 billion over five years for the THCGME program.

A bipartisan compromise in December would have increased mandatory funding for health centers and increased and extended funding for the National Health Service Corp and THCGME for two and five years, respectively. The bill would have also enacted payment parity for telehealth services delivered to CHC Medicare patients. The negotiated bipartisan, bicameral agreement fell apart after the bill received opposition for provisions unrelated to Community Health Centers.

Congress can send a strong message by extending and increasing health center funding at levels discussed last Congress, as outlined in the three bills above, in the next government funding vehicle.

Continuing to educate members of Congress about health centers

L to R: Patrick Sallee, Vibrant Health; Aaron Todd, Iowa Primary Care Association; Kimberly Mitroka, Christopher Rural Health Planning Corporation; Paloma Hernandez, NACHC Board Chair and Urban Health Plan; and NACHC’s Joe Dunn.

On February 11, NACHC was excited to host a briefing on Capitol Hill to educate congressional staffers about the importance of health center funding. Health center leaders from rural, urban, suburban, mountain, frontier, and island communities traveled to Washington, DC, to describe how health centers save the health system money and provide high-quality care to one in 10 Americans. At this critical time, we must inform Congress how important stable and increased health center funding is to 32.5 million patients nationwide!

*L to R: Teresa Lovelady of HealthCore Clinic , NACHC’s Sonja W. Bachus, MJ; Senator Marshall; and Patrick Sallee of Vibrant Health*.

Representatives and Senators will be in their districts from April 14- April 25. NACHC encourages CHC staff to invite lawmakers to tour CHCs, meet staff, and emphasize the need for long-term funding. Factsheets and supporting materials can be found on NACHC’s fly-in page.

To assist CHC staff, NACHC Federal Affairs and Grassroots Advocacy created a toolkit to make hosting your representative as easy as possible.

To join NACHC’s efforts to educate lawmakers about the important role health centers play in the healthcare system, sign up for the Washington Update.

Washington, DC – Community Health Center supporters from around the country have sent more than 20,000 calls and emails to Congress urging for action to pass funding on behalf of the millions who need affordable primary care services.

“Given the expiration of health center funding in a matter of days, NACHC recognizes the pending Continuing Resolution extending health center and primary care workforce funding,” said Joe Dunn, NACHC’s Chief Policy Officer. “However, any short-term extension presents challenges since it does not provide the certainty necessary to plan, retain or recruit staff, or increase funding to serve the 32.5 million patients who count on health centers for care. Health centers face significant financial challenges, with nearly half operating with unsustainable margins and 42 percent of health centers operating on 90 days of cash reserves or less. NACHC urges Congress to come together on a bicameral, bipartisan basis to advance legislation that provides longer-term and increased health center and primary care workforce funding, as you did in the December 2024 health package.”

In a Capitol Hill briefing this week, health center leaders and members of Congress described how health centers save the health system money and provide high-quality care to one in 10 Americans.

As the nation’s largest network of primary care providers, health centers are poised to play a key role in solving America’s healthcare problems, said Sen. Roger Marshall (R-KS).

“Community Health Centers are part of the solution,” said Marshall, noting the importance of coaching patients in areas like better nutrition and management of chronic disease.

U.S. Rep. Danny K. Davis (D-IL) a co-chair of the bipartisan Community Health Center Caucus in the House of Representatives, underscored the importance of fighting for sustained and reliable funding for health centers, and expressed gratitude to the CHCs from around the country who traveled to Capitol Hill to press lawmakers for action. “Thank you for your advocacy,” he said.

“Deployed well, the Community Health Center model is the gold standard for cost-effective, high-quality primary care,” said Aaron Todd, CEO of the Iowa Primary Care Association.

The panel described how health centers are a healthcare lifeline in rural America. In Illinois, where the Christopher Rural Health Planning Corporation is located, President and CEO Kim Mitroka said it has taken decades for her health center to expand services into 10 different counties, where some communities do not even have a grocery store. She credits telehealth with increasing access to critical services, saying, “Our patients have additional resources that would otherwise be unavailable.”

“Nationally, health centers continually produce higher quality outcomes at a lower cost. And we find that health center patients make fewer visits to emergency rooms and hospitals,” said Patrick Sallee, President and CEO of Vibrant Health in Kansas City. Sallee explained how health centers deliver care that is both cost efficient and high quality, in part due to their collaborative model, where all care teams work together.

NACHC’s Board Chair Health Paloma Izquierdo-Hernandez, who is also the President and CEO of  Urban Health Plan in New York, emphasized that health centers need longer-term funding to effectively plan and care for 32.5 million Americans.

“Health centers need not only continued funding at the current level but increased funding for longer periods of time,” explained Hernandez. “It’s really hard to run an organization when you’re not sure where your next dollar is coming from or for how long.”

House lawmakers passed a Continuing Resolution yesterday that extends health center and primary care workforce funding until the end of September. The Senate now has until this Friday to pass the measure or risk a government shutdown.

The United States is currently facing a maternal health crisis. Nearly two out of every three adult women enrolled in Medicaid are in their reproductive years (ages 19-44), and Medicaid currently finances about 42% of all births in the United States. With the rising maternal mortality rates and significant racial and socioeconomic disparities, now is the time to prioritize solutions that will advance maternal health outcomes. One promising solution is making sure new moms have adequate postpartum coverage.

Before recent policy advancements, women with pregnancy-related Medicaid coverage would lose their benefits 60 days after the end of their pregnancy. With previous federal leadership there was a strong commitment to addressing the growing maternal mortality crisis by implementing policies to improve the overall experience of pregnancy, birth, and postpartum for women across the country.

One of the many tools for addressing the current maternal health crisis is utilizing Section 1115 of the Social Security Act, known as 1115 Medicaid waivers. In recent years the federal government has encouraged the use of 1115 waivers to increase patient access to and coverage of comprehensive, high-quality maternal health services from 60 days to 12 months postpartum to address the maternal health crisis.

Medicaid 1115 waivers allow states to tailor coverage to their needs

A 1115 waiver is a policy tool used by states to expand Medicaid coverage in a way that best fits their state residents. It allows states to test new approaches in Medicaid to expand access to services for certain populations to improve health by providing preventive and primary care services that are tailored to meet the unique needs of each patient that is served.

Community Health Centers (CHCs) serve a diverse set of populations, including one in four racial and ethnic minorities, with over one in three health center patients identifying as Hispanic, 13% as Black, 6% as Asian, and 59% as White and non-Hispanic. It is important to note pregnancy-related mortality rates among Black and Asian, Indian, and Alaskan Native women are over three and two times higher, respectively, compared to the rate for White women. Black, Asian, Indian, Alaskan Native, Native Hawaiian, and other Pacific Islander women also have higher shares of preterm births, low birthweight births, or births for which they received late, or no prenatal care compared to White women.

Under the Biden Administration, the American Rescue Plan of 2021 gave states the option using a 1115 waiver to extend Medicaid postpartum coverage from 60 days, a period often inadequate for addressing complications that arise later, to a full 12 months. This is crucial as common pregnancy-related complications can require care over a longer period such as postpartum depression, which can sometimes take six months or more to appear after giving birth.

Nearly all states offer postpartum coverage through Medicaid 1115 waivers

Currently, many states have embraced this opportunity: 47 states have extended postpartum coverage, two states have pending state actions, and one state has a pending federal action. Arkansas remains the only state that has not taken any action toward extending postpartum care coverage. In contrast, Virginia is a leading example by utilizing this opportunity to offer continuous postpartum care to its residents.

Virginia’s implementation includes coverage, population, and benefits under its postpartum extension through the Section 1115 waiver regardless of change in income which ensures continuous eligibility. In addition, the state of Virginia offers increased access to medical and behavioral health care services and treatments for women in the postpartum period that address health-related social needs for postpartum Medicaid and CHIP-enrolled women. This unrestricted coverage in Virginia ensures that mothers have access to essential healthcare services that address postpartum complications and lead to improved maternal health. Comprehensive healthcare coverage without limitations can help reduce maternal deaths by providing timely access to necessary care.

The maternal health crisis in the United States demands immediate and sustained action, with extending postpartum coverage being a crucial step toward improving maternal health outcomes. It is important for each state to maximize 1115 waivers to its full capabilities to address the ongoing issue of our maternal health crisis. Expanding health care coverage allows health centers to provide the best service for their patients. Having comprehensive health insurance allows the ability to receive preventative services and treatments that reduce health risks during the postpartum period. With health centers leading in primary care and being trusted providers, they are positioned to cater to postpartum needs and overall wellbeing of mothers.

3/10 Update: Budget negotiations continue in Washington, D.C., with all federal funding for Community Health Centers expiring this month. Over the weekend (March 8), the House Republican Majority released a new continuing resolution (C.R.) to fund health centers at level funding through September 30, 2025. Additionally, the funding for primary care workforce programs (National Health Service Corps and Teaching Health Center Graduate Medical Education program) would continue through September, along with extending the current Medicare telehealth flexibilities. While these extensions are a relief, health centers need longer-term and increased funding to effectively plan and care for 32.5 million Americans.

Community Health Centers rely heavily on Medicaid funding to serve millions of patients. As Congress moves forward with the budget reconciliation process, cuts to Medicaid funding could impact their patients’ access to primary care.

Budget reconciliation provides a fast track for certain legislation

The budget reconciliation process allows for expedited consideration of certain tax, spending, and debt limit legislation. Reconciliation allows bills to pass the Senate with a simple majority, bypassing the filibuster. To proceed, the House and the Senate must adopt the same budget resolution that sets spending goals and directs committees to produce spending or savings.

Congressional Republicans aim to use reconciliation to pass President Trump’s priorities, including extending the 2017 tax cuts, increasing border and defense funding, and reducing federal spending. However, the chambers are currently divided on the strategy to pass the budget: House leaders and President Trump prefer bundling everything into one large bill, while Senate leaders favor splitting them into two smaller bills.

Senate advances its two-bill strategy

On February 21, the Senate moved forward with its preferred two-bill strategy, passing the first budget resolution mostly along party lines 52-48, except for Sen. Rand Paul (R-KY), who voted no. The resolution, championed by Senate Budget Committee Chairman Sen. Lindsay Graham (R-SC), focuses on national security and immigration. Senate Republicans have said their resolution would have minimal impact on Medicare, Medicaid, and the Community Health Center Fund.

House advances one-bill strategy

Separately, the House began moving forward with its one-bill strategy. The resolution, championed by Budget Committee chairman Rep. Jodey Arrington (R-TX), includes tax cuts and instructs the House Committee on Energy and Commerce to produce at least $880 billion in savings over 10 years. Reaching such a large amount would almost certainly require cuts to Medicaid, which is in the committee’s jurisdiction.

The House floor vote on February 25 was a nail-biter. Speaker Mike Johnson (R-LA) could only afford to lose a handful of votes while balancing concerns from moderate Republicans about possible cuts to Medicaid and opposition from conservative Republicans that the proposed cuts did not go far enough. After an intense whipping operation, the House adopted the resolution narrowly along party lines, 217-215, with only conservative Thomas Massie (R-KY) opposing.

House and Senate must agree on one budget resolution

While both chambers have adopted resolutions, they still must agree on an identical resolution before they can begin to consider an actual bill. Senate Majority Leader John Thune (R-SD) said that Senate Republicans “will want to do some things” with the House’s resolution, which did not provide any instructions to Senate Committees. This means each Chamber will have to vote again on whatever compromise their leadership agrees to.

Growing resistance to Medicaid cuts

Concerns about changes to Medicaid through reconciliation are real for all Community Health Centers because Medicaid is such an important payor for our patients. In 2023, Medicaid accounted for 43% of health center revenue and covered 50% of health center patients, compared to 19% of the overall U.S. population. Cuts to Medicaid could result in health center patients losing access to cost-effective primary care.

There is clear political reluctance within the Republican party to make significant Medicaid cuts through the reconciliation process. President Trump has repeatedly said there will be no cuts to Medicaid. Speaker Mike Johnson and Energy and Commerce Chairman Brett Guthrie (R-KY) downplayed the extent of cuts his Committee would allow in the eventual reconciliation legislation. Instead, they said Congress would focus on eliminating waste, fraud, and abuse in the program.

NACHC and health centers mobilizing to protect Medicaid

Health centers are working hard to protect Medicaid. Earlier this week, NACHC posted a statement urging lawmakers to oppose any cuts to Medicaid that would impact access to essential health services for millions of Americans. NACHC is also hosting a fly-in on March 11 to continue educating lawmakers about Medicaid’s importance to health centers and their patients. More details on the fly-in and policy papers focusing on Medicaid can be found on NACHC’s fly-in page.

Legislators return to their districts the week of March 17, which presents another opportunity for advocacy on health center priorities. NACHC has developed a toolkit to support these efforts, which is available on the Health Center Advocacy Network website.

Employer of Choice

Provider of Choice

Partner of Choice