New Analysis: Community Health Centers Face Financial Crisis Amid Policy Shifts

WASHINGTON (November 10, 2025) — As Congress debates critical decisions on the future of the Affordable Care Act premium tax credits and faces mounting pressure over the government shutdown, a new report from George Washington University’s Geiger Gibson Program in Community Health warns of a looming crisis among the nation’s community health centers - the backbone of the primary care safety net.

Key findings from the report, “Widening Holes in the Safety Net: Community Health Centers at Risk” include:

• Over 32 million people relied on community health centers (CHCs) for care in 2024, but the number of uninsured patients is climbing.
• More than half of CHCs are operating in the red. Nationwide losses totaled $1.1 billion last year, with some states posting double-digit deficits.
• Major policy shifts like the potential expiration of enhanced ACA subsidies, restrictive immigration rules, and looming Medicaid work requirements threaten to push millions more patients off insurance rolls, devastating CHC finances and forcing cuts to care.
• Critical federal grant funding for CHCs expires soon but renewal is stalled in Congress, putting many centers at risk of closures or service reductions as early as next year.

Community health centers serve one in ten Americans, across rural areas and underserved urban neighborhoods. These nonprofits not only deliver high-quality primary care but save the federal government money by reducing ER visits and hospitalizations, the authors say..

Leighton Ku, director of the Center for Health Policy Research at GW, is available to discuss the findings, how the crossroads of federal policies is straining the health safety net, and what’s at stake if federal funding isn’t urgently extended.

Feygele Jacobs is the director of the Geiger Gibson Program in Community Health and professor of Health Policy and Management at the GW Milken Institute School of Public Health.

If you would like to schedule an interview, please contact Kathy Fackelmann, kfackelmanngwu [dot] edu (kfackelmann[at]gwu[dot]edu).

-GW-