Blog
Federal Changes & Virginia's Safety Net
Trends to know when it comes to federal changes and the healthcare safety net.
Virginia's healthcare safety net is beginning to see impacts from federal changes and we are anticipating more changes in the future. In total, an estimated 360,000 Virginians are expected to lose health coverage from the loss of the Affordable Care Act (ACA) Marketplace enhanced premium tax credits and upcoming changes to Medicaid from H.R. 1. KFF estimates that 260,000 Virginians would become uninsured due to changes in Medicaid that go into effect in 2027 while VA officials anticipate 100,000 Virginians who previously utilized subsidies could be affected by higher premiums, with many expected to go without insurance as the 90-day grace period for premium payments ends.
This looming surge of uninsured patients comes at a time when nonprofit free health clinics have already seen sustained increase in demand: Between 2022 and 2024, free clinics saw a staggering 51% increase in patients while clinic operating costs continue to rise.
Free and charitable clinics will be an important lifeline for the uninsured to access healthcare. Hospitals need free clinics to limit overcrowding of ERs by preventing unnecessary & costly ER visits while FQHCs can't afford to take on more uninsured patients given large loss of Medicaid & ACA insurance revenue they will absorb.
Free clinics are already strained financially. The cost to operate free clinics continues to rise with current drivers including inflation, loss of volunteers forcing clinics to hire more paid providers, more complex patient care needs, rising need for costly language services, and having to play an increasingly larger role in public health. Cost of care at a free clinic has risen 178% from FY16-FY25 (going from $353 to $982 per patient a year)
“Clinics are trusted by patients and stand ready to support Virginians who become uninsured in the months ahead, but additional state funds to support current and upcoming patient demand are required,” said VAFCC CEO Rufus Phillips. “As state lawmakers examine strategies to support Virginia's safety net amidst significant federal policy changes, investing in free and charitable clinics is not only an urgently needed action, but also one of the smartest and most cost-effective solutions to care for the incoming surge of uninsured.”
We are grateful to our legislators, partners, and members whose efforts resulted in the inclusion of a $5 million annual increase in state funding for VAFCC full member clinics in the amended versions of the FY27-FY28 state biennial budget. While we celebrate this inclusion, our work continues. We remain vigilant and hopeful that this vital funding remains in the final consensus budget delivered to the Governor in the coming weeks.
This looming surge of uninsured patients comes at a time when nonprofit free health clinics have already seen sustained increase in demand: Between 2022 and 2024, free clinics saw a staggering 51% increase in patients while clinic operating costs continue to rise.
Free and charitable clinics will be an important lifeline for the uninsured to access healthcare. Hospitals need free clinics to limit overcrowding of ERs by preventing unnecessary & costly ER visits while FQHCs can't afford to take on more uninsured patients given large loss of Medicaid & ACA insurance revenue they will absorb.
Free clinics are already strained financially. The cost to operate free clinics continues to rise with current drivers including inflation, loss of volunteers forcing clinics to hire more paid providers, more complex patient care needs, rising need for costly language services, and having to play an increasingly larger role in public health. Cost of care at a free clinic has risen 178% from FY16-FY25 (going from $353 to $982 per patient a year)
“Clinics are trusted by patients and stand ready to support Virginians who become uninsured in the months ahead, but additional state funds to support current and upcoming patient demand are required,” said VAFCC CEO Rufus Phillips. “As state lawmakers examine strategies to support Virginia's safety net amidst significant federal policy changes, investing in free and charitable clinics is not only an urgently needed action, but also one of the smartest and most cost-effective solutions to care for the incoming surge of uninsured.”
We are grateful to our legislators, partners, and members whose efforts resulted in the inclusion of a $5 million annual increase in state funding for VAFCC full member clinics in the amended versions of the FY27-FY28 state biennial budget. While we celebrate this inclusion, our work continues. We remain vigilant and hopeful that this vital funding remains in the final consensus budget delivered to the Governor in the coming weeks.
