FQHC Funding Cliff Dec 2026

The Community Health Center Fund that supplies 70% of Section 330 grant dollars to 1,400 health centers expires December 31 - and with CHC net margins already at -2.1%, the countdown clock is running out of time.

Community health center waiting room

On December 31, 2026, the Community Health Center Fund (CHCF) expires. That single date sits at the intersection of two simultaneous pressures squeezing the 1,400 Federally Qualified Health Centers (FQHCs) that serve 32.7 million Americans who otherwise have nowhere to go.

The CHCF is not a rounding error. It supplies roughly 70 percent of all Section 330 federal grant dollars and represents approximately 12 percent of total FQHC revenue nationally. It funds behavioral health integration, dental services, pharmacy access, and the capital costs that keep rural and underserved clinics open. Congress has not begun formal reauthorization debate.

At the same time, Medicaid now represents 42 percent of FQHC revenue on average, with further cuts possible under proposed federal budget reconciliation packages. NACHC data shows CHC net margins averaging negative 2.1 percent nationally. For many FQHCs, the financial deterioration is already reflected in FY2024 a…