Looking Ahead: Advocacy and Health Center Priorities for 2025

The start of a new year, like 2025, presents an excellent opportunity for reflection, growth, and goal setting. For community health centers (CHCs), this time can be pivotal for reassessing advocacy strategies, strengthening commitments, and setting actionable objectives to better serve their communities. NEVHC remains committed to ensuring that CHCs, their patients, and staff are prioritized at the federal, state, and local levels. Below is a look ahead at health center priorities for the new year, along with ways you can actively participate in the advocacy process.?

Health Center Viability & Medicaid Protection?

CHCs are an essential healthcare safety net for underserved populations but face persistent financial and operational challenges. Delays in federal funding and inflation are straining their ability to meet growing demands. Congress recently passed a Continuing Resolution (CR) also known as H.R. 10545 – The American Relief Act of 2025 to extend two federal funding buckets that CHC’s rely on to provide essential healthcare access.??

• Mandatory Funding: NEVHC relies on the Community Health Center Fund for 70% of its federal funding. This fund, extended by the CR until March 31, 2025, ensures affordable, quality care for underserved populations.?The CR also extended funding for the National Health Service Corps and Teaching Health Centers programs. However, a proposed 15% funding increase was excluded, underscoring the need for continued advocacy.
• Discretionary Funding:?The remaining 30% of CHC federal funding was also extended in the CR that is expected to expire on March 14, 2025. Both the House and Senate bill maintain discretionary Fiscal Year 2025 funding levels for CHCs at FY 2024 levels (i.e., $1.85 billion).?
• Advocacy Needed:?With a substantial amount of funding set to expire this March, the National Association of Community Health Centers (NACHC) emphasizes the urgent need for increased funding. Many CHCs are already operating at net losses, jeopardizing their ability to provide critical services.?

Besides CHC funding negotiations, potential reductions in Medicaid funding are being discussed amongst Congress and the incoming administration.?

• Federal Share of Medicaid Costs: In California, Medicaid is paid for through the state and 50% share from the federal government (Source); however, federal share could be reduced to 40% or more.?

• Block Grants: A second item is potentially cutting Medicaid by providing block grants that set a fixed amount of funding for the program. A fixed set amount would not adequately reflect the needed funding for each state's true health costs. This would place a larger strain on the state budgets to cover the costs of Medicaid or cut programs.??

• Advocacy Needed: Advocacy will be needed at both the state and federal levels to ensure funding for Medicaid/Medi-Cal is strong to support the populations we serve. Whether that be Medi-Cal programs that provide Health Navigators Enrollment funding at the state or Medicaid funding at the federal level.?

Health Access for Vulnerable Populations?

Health advocates are concerned about potential harm to vulnerable populations served by CHCs, particularly immigrants and children. Policy proposals from the incoming administration suggest adding restrictions to public benefits for immigrants and mixed-status families, potentially reinstating changes to the public charge policy.?

• Reinstating Public Charge Rule: Under previous federal immigration policy, individuals could be denied entry to the U.S. or green card status if they were deemed a "public charge" — that is, if they were likely to require public benefits like Medicaid (Medi-Cal). Studies conducted after the policy was introduced found that between 2 and 4.7 million people eligible for Medicaid or Children’s Health Insurance Program (CHIP) did not seek medical care due to fear of being classified as a public charge (Source). Though the policy was rescinded in 2020, concerns remain that it could be reinstated in 2025.??

• Vaccines and Immunization for Children:? Proposed changes in leadership at the U.S. Department of Health and Human Services (HHS) are also underway that can impact immunization and overall public health. HHS leadership oversees various health agencies including the Centers for Disease Control (CDC) and its Advisory Committee on Immunization Practices (ACIP). The ACIP outlines recommendations to the states and health insurance companies on what vaccines are allowable. Specifically, vaccines that are recommended by ACIP for children under 18 years of age are covered under the Vaccines for Children (VCP) program. VCA is a critical program under a provision of the Affordable Care Act that provides vaccines for children for families who are unable to afford them. State legislators across the country are also planning to introduce legislation that will weaken or eliminate school vaccine requirements. Even more concerning, as vaccination rates in children have declined since the 2020 pandemic, the U.S. can expect to see serious illnesses begin to spread such as measles, whooping cough, or meningitis.??

• Advocacy Needed: NEVHC is committed to ensuring access to life-saving vaccinations continue as we serve over 34,000 pediatric patients in the San Fernando and Santa Clarita Valleys.?

Our mission has always been to deliver comprehensive care that is sensitive to the economic, social, cultural, and linguistic needs of our community. Without coverage or access to healthcare, individuals are more likely to seek costlier forms of care that burden the hospital system. It is vital that we continue to serve as a trusted safety net for our patients in the San Fernando and Santa Clarita valleys.?

Prop 35: A New Opportunity for Medi-Cal Funding?

Although there will be robust advocacy at the federal level, California’s Proposition 35, which voters overwhelmingly passed in November, is a key development for CHCs. Over one-third of California’s population—approximately 15 million people—rely on the state’s Medi-Cal (Medicaid) program for health coverage. Nearly half of California's children also depend on Medi-Cal for healthcare. However, demands for healthcare services are growing, while access to services remains limited. Over 5.9 million Californians live in areas that lack primary care doctors, or they face long wait times to see specialty physicians.?

Currently, the Managed Care Tax (MCO) generates $7–8 billion annually. With Prop 35, Medi-Cal funding is expected to increase by an additional $2–5 billion annually. The benefits of Prop 35 will be rolled out in phases, beginning this year and continuing through 2027. CHCs and other health partners will see Medi-Cal funding allocated to increase access to primary care services, strengthen the Medi-Cal workforce, expand specialty care, improve dental services, and enhance family planning programs. Prop 35 aims to ensure that Medi-Cal funding remains robust to meet the growing demands on California's healthcare system.?

?How can you get involved???

Sign up for NEVHC’s Advocacy Network where you’ll get updates from both NEVHC and the National Association of Community Health Centers on pertinent action alerts.?

Sign up here!?

Written by Julie Leyba, Government & Community Relations Manager, NEVHC?