Community Health Center Funding: Critical Updates and Future Outlook

As we begin another year of advancing the mission of making Community Health Centers (CHCs) the Employer, Provider, and Partner of Choice, NACHC thanks all CHC advocates for their engagement through a difficult two years of divided government. Unfortunately, last month, a bipartisan agreement to extend and increase CHC funding fell apart at the last minute due to unrelated concerns. Instead, Congress extended funding at current levels through March 2025, despite how difficult it is for CHCs to plan for their communities' primary care needs.

Collective advocacy from CHCs, NACHC, Primary Care Associations, and Health Center Controlled Networks has been essential to building strong support for funding in a divided Congress. In March 2024, despite the polarization in Congress, advocates secured the largest year-over-year increase to our mandatory funding in a decade.¹ Two key workforce development programs - the National Health Service Corps (NHSC) and Teaching Health Center Graduate Medical Education (THCGME) - also received significant boosts in funding. Congress only provided increased funding through December 31st, 2024, creating a critical year-end deadline.

NACHC Hosts Successful Fly-In for CHC Advocates

To keep up the pressure on Congress, more than 300 CHC advocates flew to DC in early December to attend more than 160 in-person meetings. Across the country, more than 2,200 advocates sent nearly 7,000 e-mails and made nearly 1,000 calls to emphasize the need for action to protect access to primary care in underserved communities.

The strong turnout and strategic timing jumpstarted bipartisan negotiations around extending and increasing CHC and workforce programs as part of a year-end package. On December 17^th, Congressional leadership announced a compromise bill that would have increased the mandatory funding to $4.5 billion in Fiscal Year (FY) 2025 and $4.6 billion in FY 2026.² The final number would have represented a 15 percent total increase over the mandatory funding level at the start of the Congress in 2023. Also, the bill would have increased and extended funding for NHSC and THCGME for two years and five years, respectively. Lastly, it would have enacted common-sense health system reforms, such as payment parity for telehealth services delivered to CHC Medicare patients.

House Members Balk at 1,500-Page Package, Citing Rushed Process and Limited Input

Unfortunately, soon after the package was released, opposition started to build on social media channels about provisions in the bill unrelated to CHCs. A growing number of Representatives in the narrowly divided House objected to the measure because they had not been involved in the drafting process; other lawmakers expressed concern they had not had time to review the entire 1,500 legislation before the vote. Despite the backlash, the CHC-related provisions had previously received strong bipartisan support in the House and Senate.

Two days later, Congress settled on a much-reduced proposal that provided only level funding and short-term extensions for most federally funded programs.³ The reworked legislation extended all discretionary spending, including 30 percent of total CHC funding, through March 14^th, 2024. It extended mandatory funding, which accounts for the other 70 percent of CHC funding, at current levels through March 31^st.

The two deadlines create another layer of uncertainty as CHCs draw up budgets for the rest of the year and cope with growing costs due to inflation and workforce shortages. The situation is increasingly dire as data suggests that CHCs may have already been operating at a potential net loss of -2.2% in 2024 while facing increasing restrictions on other sources of revenue, such as the 340B program.⁴

Advocacy is essential to ensure that Congress stays at the negotiating table and reaches an agreement as quickly as possible. There are key opportunities to engage with Representatives and Senators this month and in February. Representatives will be in their districts and available to tour CHCs and meet their constituents during the weeks of January 27^th, February 17^th, and March 17^th. Hill Day during the Policy and Issues Forum on February 6^th will be another important opportunity to engage with Senators and Representatives in their DC offices.

NACHC will provide resources and materials to support your meetings with elected officials, and our Federal Affairs team is always happy to answer any questions you may have. There is also a P&I Prep Webinar scheduled for January 22 at 3 pm EST. Feel free to reach out to NACHC staff at [email protected] for questions.

1. Consolidated Appropriations Act, 2024. https://www.congress.gov/bill/118th-congress/house-resolution/1061/text ↩︎
2. Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025. https://docs.house.gov/billsthisweek/20241216/CR.pdf ↩︎
3. American Relief Act, 2025. https://www.congress.gov/bill/118th-congress/house-bill/10545/text ↩︎
4. Community Health Centers Grew Through 2023, But Serious Hazards Are on the Horizon. Geiger Gibson Program in Community Health. Policy Issue Brief #72. 2024 Sep. https://geigergibson.publichealth.gwu.edu/72-community-health-centers-grew-through-2023-serious-hazards-are-horizon ↩︎