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WACH Statement on HHS Interpretation of PRWORA
July 11, 2025
On July 10, the Department of Health and Human Services announced the rescinding of a 1998 interpretation of the Personal Responsibility and Work Opportunity Act (PRWORA). This new interpretation will limit access to federal public benefits - which includes the Health Center Program – for immigrant populations.
The announcement creates confusion and imposes new administrative hurdles to cost-effective patient care at a time when health centers are already facing financial and operational instability. Our health centers provide the most high-quality, preventative primary health care available.
When more people receive care at health centers, chronic disease is better managed and reliance on emergency rooms for non-emergency care decreases. In addition to supporting
whole-person health, this leads to more cost-effective care that lowers federal spending. This policy will drive more people away from preventative care, make communities sicker, weaken the community health center network, and further strain emergency rooms and hospitals.
Health centers are required by federal statute and by mission to serve everyone who walks through their doors, including immigrants and seasonal workers. This policy change lies directly in contrast with that critical mission.
Let us be clear: this change will impact everyone who receives care at a health center, regardless of their citizenship status. The Washington Association for Community Health has grave concerns about this change and remains resolute in our efforts to ensure health centers can continue to deliver high-quality primary care to everyone.
40 Years of Supporting the CHC Mission
By Dave Pearson, WACH CEO
July 9, 2025
You could describe the last six months in multiple ways: exciting, chaotic, innovative... The response to the things taking place in the world and in our country today resonates differently with different people and in different places. If you find that this level of near constant change is disruptive and difficult to navigate, you are far from alone. One thing is true though. As leaders in healthcare today, we have a duty and a desire to calm the storm, so that we can provide care and attention to the people who seek our support and services. WACH has been on that journey with you for 40 years and we will continue to be here in the years ahead.
Our compass in times like these is our collective mission, which I am rapidly assimilating. I have learned that the overriding mission of all community health centers (CHCs) is to deliver high quality, compassionate primary care to populations with a lower ability to pay, while preserving and strengthening access to culturally appropriate, whole-person care for everyone. I don’t believe there is anything controversial in that. CHCs have a record of distinguished service to your communities and thousands of patient stories where lives are forever changed for the better. That body of work can and must continue! But what do you do when you have dug as deep as you can and you can’t dig any further? Do you hand the shovel off to someone who is fresher or do you teach someone else how to dig? That is where WACH, your association partner, can help carry the load. We’re not afraid to help address difficult challenges on your behalf and in concert with you. We’re busy surveying and mapping this new landscape, so we can show you where all the pitfalls and opportunities may lie. We look forward to your active engagement with us and I'm eager to hear more from you. So let us commiserate but not forget to celebrate and also contemplate what surviving this new terrain looks like while delivering on our mission to care for the people of Washington over the next decade.
WACH Statement on Passage of Federal Budget Bill
July 3, 2025
H.R. 1 - known as the “One Big, Beautiful Bill” - which passed out of Congress will put great
strain on Washington State’s Community Health Centers (CHCs) and the people they serve.
The bill will increase the number of uninsured people in our state by as much as 25% and
erase decades of progress toward improving access to health coverage for Washingtonians.
The cuts to Medicaid will hit Washington State and our CHCs harder than others. According
to Gov. Ferguson’s statement, at least 250,000 will lose their Medicaid coverage, and up to
620,000 are at risk of losing other existing health coverage.
Medicaid makes up 61% of care delivered by CHCs in Washington. Due to their mission and
values, health centers already serve anyone regardless of their insurance status. A significant increase in the number of uninsured in our community, coinciding with a significant decrease in Medicaid revenue, however, will hinder their ability to provide lifesaving, coordinated, and comprehensive care to all. CHCs will be left with some tough choices including cutting core services, reducing essential staff, or closing sites.
The bill also eliminates the funding authorization for Area Health Education Centers (AHEC). If not included in the upcoming appropriations process, our health system will see reduced access to care in underserved and rural areas and a shrinking community health workforce. We ask that Congress include funding for AHEC in the upcoming appropriations process.
We appreciate the efforts of the Senate to mitigate the impact through the Rural Health Transformation Program. However, this will not be enough to sustain our health system and our CHCs. We will continue to work with Congress through the appropriations process to ensure we can continue to operate effectively and provide the highest quality care for the most vulnerable among us.
