Jane Nee of Community Healthcare Association testifies on FQHC strain

Good afternoon, Chair and Council Members.

My name is Jane Nee, Director of Policy at the Community Healthcare Association of New York State, representing New York's federally qualified health centers.

Thank you so much for the opportunity to testify.

Community health centers operate nearly 480 sites across the city, including mobile sites and school-based health centers, providing essential primary and preventive care to more than 1.4 million New York City residents, no matter their insurance status or ability to pay.

We care for one in three uninsured New York City residents and one in four New York City Medicaid beneficiaries.

Yet, despite the critical role of health centers in the city's health care safety net, they are under tremendous financial strain.

In 2025 alone, New York City health centers provided more than 631,000 uninsured visits, delivering approximately $92 million in uncompensated care.

And we expect these numbers to grow as the impacts of HR1 continue to unfold.

Ichikani's analysis offers a sobering picture.

Nearly 150,000 existing New York City Health Center patients could lose their health coverage because of the new Medicaid work and community engagement requirements, with another 15,000 patients losing coverage due to essential plan changes.

New York City Health Centers already serve one in three uninsured.

As existing patients lose coverage and newly uninsured residents turn to health centers for care, we project that the number of uninsured patients served by New York City health centers could triple.

And this comes at a time when health centers are already struggling with inadequate Medicaid reimbursement, rising costs, and difficult decisions to reduce services and close sites.

With Medicaid as their largest revenue source, New York City health centers could stand to lose $224 million annually under HR1.

We ask that the New York City Council accelerate the implementation of INT 1668A that was passed back in October of 2021, expanding NYC care to include federally qualified health centers and to dedicate resources.

To expanding access to affordable coordinated care.

We must equip health centers with the resources needed to respond to the growing demand for uncompensated care and preserve access to essential health services.

Thank you.

Additional details are included in our written testimony, and I welcome questions.