Virginia’s community health centers feel the shutdown first

When the government shuts down, most people expect the pain to appear slowly: closed parks, delayed services, long waits for federal paperwork. But for Virginia’s community health centers (CHCs), the impact is immediate. CHCs are the first to feel the shutdown and the first to see its consequences. 

CHCs are not faceless institutions. They are places where hope, resilience and trust are built every day. Each year, more than 400,000 Virginians rely on CHCs for primary care, behavioral health, dental visits, substance use treatment and chronic disease management. Many live in rural areas, small towns or underserved city neighborhoods, where CHCs are the only accessible source of affordable care. Without them, Virginians simply have nowhere else to turn for lifesaving care. 

Now, with the government shutdown, these clinics and the hospitals that support them are facing a funding cliff. Core federal funding for CHCs has been paused, Medicaid Disproportionate Share Hospital (DSH) payments have been slashed, and Medicare reimbursement add-ons for rural hospitals have expired. Ambulance services and medical education support have also vanished. 

Another critical blow from the shutdown affects patients covered by Medicare: the end of telehealth coverage. Congress never extended the pandemic-era rule that allowed care to be delivered virtually. For seniors and others on Medicare, this change has a real and immediate impact. Many of these patients face transportation challenges, mobility limitations or ongoing recovery from hospital stays. Telehealth visits previously provided a lifeline, ensuring continuity of care, early intervention for health issues and peace of mind. Now, health outcomes are at risk. Seniors may miss timely check-ins, medications may go unmanaged and preventable complications may escalate into emergencies. Restoring these telehealth flexibilities is critical to ensuring that Medicare patients can continue receiving the care they need. 

These aren’t abstract numbers. They are lives. The funding cuts could mean reduced hours, delayed appointments or fewer staff on hand. For small rural CHCs, it may mean facing the impossible choice between closing doors or reducing services. 

Meanwhile, the Department of Health and Human Services is operating on a skeleton crew. Critical approvals and decisions are frozen, leaving Virginia’s CHCs in limbo and making it nearly impossible to plan, hire or innovate. 

Community health centers save millions for the health care system each year by keeping patients out of costly emergency rooms. They provide care that prevents bigger crises down the road. The shutdown threatens the very funding that makes this possible. The result is uncertainty — for patients, for providers and for entire communities. 

Thousands of dedicated doctors, nurses, counselors and staff work where the need is greatest. But when funding is paused, they face questions about job security and the ability to care for their patients. And the people who feel it first are often those already struggling the most: children who need vaccines, seniors managing chronic illnesses, families seeking safe and affordable care. Make no mistake: community health centers don’t wait for the effects of a shutdown to “trickle down.” They feel it on day one. And so do their patients. 

That’s why we are urging Congress to move beyond stopgap solutions and deliver long-term, stable funding for CHCs. Health care should not rise and fall with the tides of politics. Families should never have to wonder if their CHC will be open next week. 

For more than 60 years, CHCs have been there for Virginia — through recessions, disasters and public health emergencies. They’re the first line of care for hundreds of thousands of people. But when Washington shuts down, they are also the first hit. 

It’s time for our leaders to stop making patients and providers pay the price of gridlock. Virginia’s health and the health of our nation depend on it. 

Tracy Douglas serves as the Chief Executive Officer for Virginia Community Healthcare Association (VCHA), the primary care association representing Virginia’s Federally Qualified Health Centers. VCHA works with community health centers, community leaders and partners to enhance access to affordable, high-quality health care and to find solutions for expanding access to care in areas that need it most.