Medicaid Cuts Hit FQHCs Hard

The One Big Beautiful Bill will cost community health centers $7 billion a year in new costs - and 11.8 million Medicaid patients are at risk of losing coverage.

The Medicaid cuts nobody is talking about will gut community health.

Right now, across America, federally qualified health centers are running the numbers. The reconciliation bill is signed. The cuts are law. And the question is no longer whether FQHCs will feel it. The question is how many will survive it.

The One Big Beautiful Bill Act (H.R. 1), signed into law on July 4, 2025, represents the largest restructuring of Medicaid in decades. Over ten years, the law is projected to cut $911 billion from federal Medicaid spending. The Congressional Budget Office estimates that 11.8 million Americans will lose Medicaid coverage as a result. Work requirements, more frequent eligibility redeterminations, and the end of enhanced federal matching rates combine to create a revenue cliff for the safety-net providers who can least afford it.

For FQHCs, the math is punishing. Medicaid accounts for 43% of community health center operating revenue nationwide. More than 16 million of the 34 million pati…