Heartland Health Services weathering the storms from Washington

Since the country's first Community Health Centers opened in the 1960s, the non-profit, community-based clinics have grown to about 1,500 federally funded centers serving millions of low-income people.

Such community health centers (CHCs) provide primary care and other services free or at reduced rates –34 million coast to coast, according to the National Association of Community Health Centers (NACHC).

In Peoria, Heartland Health Services provides care for about 22,000 patients a year at its 10 locations in the metro area. That translates to about 260 patient visits each day.

Nationwide, recent changes at the federal level mean some centers could face cuts, difficulties in recruiting and retaining staff, or even closing – leaving patients in need to do without or to turn to hospital emergency rooms for critical care. One change stems from Congressional Republicans voting to not renew the tax credits that help U.S. citizens pay for health insurance under the Affordable Care Act – the reason behind Democrats’ filibuster to block all funding until a compromise on the issue could be reached leading to the 43-day government shutdown.

“Upcoming changes to Medicaid and ACA subsidies may affect both our funding and the patients we serve,” says a Heartland Health Systems spokesperson. “When there are coverage or reimbursement changes at the federal level, it can create real challenges for families seeking care. While many of these policy shifts are still taking shape, we’re closely monitoring their progress and preparing to respond in ways that keep care accessible and affordable for our patients.”

But cutbacks or staffing issues aren’t foreseen at Heartland Health Services (HHS), the spokesperson says.

“Every challenge is serious when it impacts people’s health and stability, but we are resilient,” Heartland says. “Heartland Health Services continues to operate daily with a clear mission: to provide high-quality, affordable health services and remove inequities to improve the lives of all. No matter what changes come, our focus will always remain on serving our patients and our community with compassion and consistency.”

For CHCs, federal funds come in two ways: some reimbursements for patients helped by Medicaid and similar assistance, and grants from the federal Community Health Center Fund. Congress has approved that funding in small doses. This spring, lawmakers extended CHC funding until Sept. 30, but that ended with the government shutdown, when the Supplemental Nutrition Assistance Program (SNAP) also was delayed.

The first government action affecting CHCs was an Executive Order issued by President Trump in January, when he froze domestic funding. The next was the GOP’s tax and spending measure dubbed its “Big Beautiful Bill” passing restriction on the Supplemental Nutrition Assistance Program (SNAP) and cutting some SNAP costs to shift payments to states.

“Roughly 60% of our patients rely on SNAP benefits to feed their families, and with those benefits halted as of November 1, it will be a very difficult time for many in our community,” Heartland says. “Our Community Health Workers have been preparing to help connect patients to available local food resources, though those resources are limited. This is a time when our mission to support the most vulnerable becomes even more critical.”

The Big Beautiful Bill also was where Congress failed to extend ACA tax credits. The consequences is monthly ACA costs expected to increase by a median (or midpoint) of 18% based on proposed rates by private insurers, KFF health news says. However, the amount many individuals pay could go much higher – even doubling if the current tax credits expire as scheduled this month. Without the credits, premiums for those receiving the largest subsidies could increase by more than 70%. For example, enrollees in their 50s and early 60s – who already pay a lot for coverage – will probably have to pay much more, according to Cynthia Cox, KFF’s director of the Program on the ACA, who said an older couple making $85,000 a year could see their premiums skyrocket by more than $20,000 a year.

Such an increase could lead to major sacrifices for many people, from cutting back on other necessities, to just giving up health-insurance coverage.

In addition to that, the “Big Beautiful Bill” is cutting Medicaid by more than $880 billion, according to the nonpartisan Congressional Office, which estimated that that alone “will increase the number of people without health insurance by 7.5 million in 2034.” In 2023, Medicaid reimbursements meant 43% of CHC’s $46,7 billion in revenue, according to KFF – about $20 billion.

Outside of Washington, D.C., health care is the most important matter for Americans, according to a new poll from Reuters/Ipsos, which shows that, when asked “Which everyday expense do you want Congress to prioritize,” 31% of U.S. adults named health care. (Food and housing were next, both at 22%.)

Last year, the United States’ CHCs together got $4.4 billion in federal grants (The NACHC recommends $5.8 billion in yearly grants.) Long-term funding would give CHCs financial stability, and options could include state or local help.

“We’re not aware of specific state-level funding assistance, but we actively seek philanthropic and private donations to support our mission,” Heartland says. “Anyone interested in helping can visit our website to learn more about how to donate or partner with us to strengthen access to care.”

Some states, including Illinois, are trying to fill the gap. In June, Gov. JB Pritzker signed the state’s FY26 budget, which approved $40 million in General Revenue Funds for an increase in its Medicaid Prospective Payment System. This funding should help CHCs continue tp provide care for individuals who may lose health coverage or face other barriers to access.

Also, some centers are looking for other stakeholders such as physicians, clinics and insurers to support their mission.

Meanwhile, federal changes could mean directly or inadvertently throwing people off health coverage.

“Emergency rooms should not be the front line for primary care,” Heartland says, “but when people lose coverage or can’t afford to see a doctor, they often have no other choice.

“We never turn anyone away based on their ability to pay,” Heartland adds. “We will continue working to ensure patients have access to affordable, quality care and that we help reduce unnecessary ER visits whenever possible.”