New blog: Nearly 5.6 million CHC patients could lose Medicaid coverage as a result of work requirements


May 30, 2025

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The budget reconciliation bill passed in the U.S. House of Representatives on May 22 will require  all states to adopt  work requirements as a condition of Medicaid  enrollment  for low-income   working-age people who gained  coverage based on the Affordable Care Act Medicaid expansion. What could  these mandatory  work requirements mean for community health centers (CHCs) and those they  serve?  

In a   new blog post   for  The Commonwealth Fund’s to the Point, we  look beyond the "working-age adult " Medicaid population generally and focus on people known to receive care at community health centers. CHCs provide care to all regardless of their ability to pay and their largely low-income patients - including those with Medicaid coverage - tend to have complex medical and social needs. These  challenges, and the limitations of state-based  reporting systems, will make it especially  difficult for CHC patients to navigate the  processes required to document  their  work  or exemption status needed to retain coverage. As a result, Medicaid work requirements could  cause  nearly 5.6 million community health center patients nationally to lose  coverage over 5 years. Health center revenue losses could reach up to $32 Billion, threatening the viability of this essential backbone of primary care in underserved communities.

Medicaid  is the  largest health center revenue source, accounting for 43 percent of all CHC revenue.  This analysis underscores the critical  importance of Medicaid to community health center patients  and the  disruptions to coverage, access and health center services  that are  likely to result  from mandatory Medicaid work requirements.

Read, Nearly 5.6 Million Community Health Center Patients Could Lose Medicaid Coverage Under New Work Requirements, with Revenue Losses Up to $32 Billion

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