Health Center Reauthorization

On average, Federally Qualified Health Centers (FQHCs) receive the majority of their operating expenses through reimbursements (see chart at right). A smaller, but vital, source of funding is the 330 grant, often called the Health Center Fund. The Health Center Fund comes from about 1/3 annual discretionary appropriations and 2/3 mandatory funding.

Annual discretionary appropriations are adopted by Congress each year, and the Health Center Fund is included in the Departments of Labor, Health and Human Services, and Education Appropriations bill. The first five years of mandatory funding was included in the Affordable Care Act and has been extended several times since the passage of that bill in 2010. Both the mandatory and annual discretionary portions of the Health Center Fund were set to expire on September 30, but they have been extended via a Continuing Resolution through January 19 and February 2, respectively.

The House and Senate Committees that have oversight over the mandatory portion of the Health Center Fund have very different approaches for the extension. On the House side, H.R. 5378, the Lower Costs, More Transparency Act includes a 2 year and 3-month extension of the Health Center Fund with 10% increases annually. This bill was scheduled for a vote on the House floor in September but was never voted on. The Senate Health, Education, Labor, and Pensions (HELP) Committee has approved S. 2840, the Bipartisan Primary Care and Health Workforce Act, which would extend the Health Center Fund for 3 years with a 45% increase. It is not clear if S. 2840 will come up for a vote on the Senate floor as a standalone bill.

Both H.R. 5378 and S. 2840 also include extensions of the National Health Service Corps mandatory funding and the Teaching Health Center Graduate Medical Education funding along with other provisions not related to health centers. Resolving the differences between these approaches will be the difficult task of Congress between now and January 19.

California’s health centers have participated in several advocacy events in 2023 to encourage Congress to extend the Health Center Fund. These events include NACHC’s Policy & Issues Forum in Washington, DC in March, Health Center Week in August, and a number of alerts seeking emails and phone calls to Members of Congress in support of health center funding. Before the funding expiration on January 19, health centers should expect additional advocacy asks from CPCA and NACHC. Make sure Congress hears your voices!