The National Association of Community Health Centers (NACHC) is working proactively with our legal and policy experts to understand the impact of the HHS decision to formally rescind a 1998 interpretation of the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA). Federal law (42 USC 254b(a)(1)) requires Community Health Centers (CHCs) to accept “all residents of the area served by the center.” NACHC will continue to work with experts and lawmakers to ensure CHCs have the information and resources needed to serve over 32.5 million patients who rely on CHCs for care – representing 1 in 10 people across the U.S. and 1 in 5 residents of rural America.

The “One Big Beautiful Bill” puts millions of Americans at risk of losing their health coverage, including patients of Community Health Centers (CHCs). CHCs provide high-quality and cost-effective primary and preventive health care to over 16 million patients insured through Medicaid. Medicaid funding is vital, and changes of this magnitude will have an immediate and devastating impact on CHC patients and the financial stability of CHCs. We strongly urge the House to reject this legislation.  

NACHC estimates the Senate version of the legislation will lead to approximately $7 billion per year in higher costs from uncompensated care for new and existing CHC patients and increased operational costs to ensure compliance with new policies. Even under normal circumstances, CHCs operate on razor-thin margins - but these are far from normal times for an essential primary care network that serves at least 10% of the U.S. population, including at least 20% in rural communities. Many CHCs are already making tough decisions about cutting back services, reducing essential staff, and closing sites. The financial uncertainty faced by CHCs is further compounded by the fact that CHC funding expires at the end of September, in just a few short months. Rather than compounding these challenges with policies that reduce coverage and access for patients insured through Medicaid, Congress should prioritize investing in primary care and expanding access to more Americans, including the 100 million people currently struggling to access affordable, life-saving primary care. 

We appreciate the thoughtful efforts of bipartisan Senate champions to mitigate some impact of the harmful provisions. They heard the voices of tens of thousands of CHC advocates who reached out with in-person meetings, in-district meetings, phone calls, and emails to protect Medicaid—a program that has partnered with CHCs to save lives and tax dollars for decades. NACHC will continue to work with CHC champions in Congress to seek better solutions for our nation’s health, and we strongly urge the House to vote “No” on this version of the “One Big Beautiful Bill”. This is not the right path to build better solutions for a stronger, healthier America. 

About NACHC

NACHC’s mission is to champion Community Health Centers delivering affordable, effective, comprehensive primary care that is community-driven and improves health for all.

The National Association of Community Health Centers (NACHC) today responded to the Senate Finance Committee’s release of proposed changes to the budget reconciliation bill titled the “One Big Beautiful Bill Act.” NACHC is reviewing the legislation to assess its impact on Community Health Centers (CHCs) and the at least 32.5 million patients or 1 in 10 they serve nationwide, including 16 million people insured through Medicaid and at least 1 in 5 in rural America.

As lawmakers in the House and Senate deliberate changes to Medicaid, NACHC has led CHC advocates from around the country to educate Congress on how the partnership between CHCs and Medicaid saves lives and taxpayer dollars. Advocates have sent over 36,000 emails and calls and met with congressional lawmakers on Capitol Hill and in their districts.

 CHCs provide cost-effective services that keep Medicaid patients healthy, prevent costly Emergency Department visits and hospitalizations, and reduce the need for specialty care. A new peer-reviewed study published in Health Services Research analyzing data from more than 3,100 U.S. counties confirms a direct correlation between communities that lose CHCs and increased mortality rates. In 2023, while CHCs provided care to at least 18% of all Medicaid beneficiaries, CHC payments made up only 2.3% of total Medicaid spending.

 The Trump administration recognized the unique value of CHCs in battling chronic disease and keeping America healthy in the President’s Budget Administration for a Healthy America Congressional Justification released earlier this month. It focused on CHCs’ ability to deliver high-quality primary care, improve health outcomes, and lead on Trump administration Make America Healthy Again (MAHA) initiatives. The administration cited several studies showing that CHCs’ model of integrated primary care lowers the cost of care for adult and pediatric Medicaid patients related to other primary care providers. 

 NACHC is closely monitoring the reconciliation process and working to influence the best outcome for CHCs and the at least 32.5 million patients or 1 in 10 they serve, including at least 1 in 5 in rural America. 

 Any changes the Senate makes to the reconciliation bill will have to be considered and passed by the House. The bill’s supporters hope to send the final legislation to President Trump’s desk in July.

About NACHC

NACHC’s mission is to champion Community Health Centers delivering affordable, effective, comprehensive primary care that is community-driven and improves health for all.

Community Health Centers (CHCs), which serve 32.5 million patients nationwide, have a proud tradition of ensuring access to affordable, high-quality care for all in the communities we serve regardless of ability to pay – and that includes life-saving medications like insulin and injectable epinephrine. 

For over 30 years, the 340B program has enabled CHCs to deliver affordable and comprehensive primary care to patients who need it most. By law, regulation, and mission, every penny that CHCs save through 340B discounts is used to make medication affordable for low-income patients and to expand access to preventive care services. Unfortunately, in recent years CHCs have lost critical resources from the 340B program, jeopardizing patients’ access to affordable medications and comprehensive primary care. 

We are grateful that Health and Human Services Secretary Robert F. Kennedy and the Trump Administration have publicly expressed their support for CHCs’ 60-year-record of fighting chronic disease and lowering healthcare costs. We cannot emphasize enough how vitally important the 340B program is for the working families who need affordable medications and depend on CHCs for care, and we are concerned that proposals outlined in the Order could inadvertently limit these patients’ access to comprehensive primary care. 

As safety-net providers committed to ensuring affordable access to prescriptions and to primary care, CHCs are already part of the solution – not the problem. America’s CHCs look forward to working with the Trump Administration to reform the program and improve our ability to make Americans healthy through comprehensive, affordable medicines and care for the patients we serve.

Follow this link to read the Executive Order.

The National Association of Community Health Centers (NACHC) will host a Capitol Hill briefing featuring congressional champions and Community Health Center (CHC) advocates from around the country. The briefing will focus on the urgent need to pass funding for CHCs before it expires this month.  

Just this past weekend (March 8), the House Republican Majority released a new continuing resolution (C.R.) to fund health centers at level funding through September 30th, 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.

WHEN: Tuesday, March 11, 9-10:00 AM 

WHERE:  Capitol Visitors Center, SVC-212-10  

SPEAKERS:

Senator Roger Marshall (R-KS)

Representative Danny Davis (D-IL)

Paloma Izquierdo-Hernandez, Board Chair, NACHC, President & CEO, Urban Health Plan, New York

Aaron Todd, CEO, Iowa Primary Care Association

Patrick Sallee, President & CEO, Vibrant Health, Kansas

Kim Mitroka, President & CEO, Christopher Rural Health Planning Corporation, Illinois 

OPEN TO PRESS. Coffee and refreshments will be served.  

RSVP to nachcmedia@rokksolutions.com no later than Friday, March 7. 

CHCs are the largest primary care network in the country, providing cost-effective primary care to one in 10 Americans (32.5 million people) while representing just 1% of U.S. healthcare spending. The Congressional Budget Office confirms that health centers generate significant savings through reduced hospitalizations and improved health outcomes. With a track record of saving lives and taxpayer dollars, CHCs have longstanding bipartisan support on Capitol Hill.