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I read the new CMS data on FQHCs. The numbers surprised me. 🔍
Everyone told me the One Big Beautiful Bill would hollow out the safety net. The National Association of Community Health Centers warned that many community health centers were already making tough decisions about cutting back services, reducing essential staff, and closing sites.
House Minority Leader Hakeem Jeffries said hospitals and community-based health centers were closing all throughout America.
The data says something different.
According to the Paragon Health Institute, drawing from comprehensive CMS enrollment data, here is what actually happened between July 1, 2025 and July 17, 2026:
🔹 The number of FQHCs increased by 338, a 3.1 percent gain
🔹 The number of Rural Health Clinics rose by 148, a 2.7 percent gain
🔹 Combined, that is a net gain of nearly 500 facilities serving rural and lower-income communities
Zoom out even further. Compared to the fourth quarter of 2023, the number of FQHCs has increased by nearly 1,400.
Nearly 1,400 more community health centers operating than just two years ago.
🧩 Now here is the part that matters most for anyone in this space.
The data does not tell us the full story. Paragon is clear about this. The OBBB’s biggest reforms, community engagement requirements and limits on state-directed payments, have not yet taken effect. The real test comes later, not now.
Some providers have closed. Individual closures are real. But an accurate accounting has to look at both sides: the openings and the closures.
The dominant narrative collapsed when you put actual numbers next to it.
⚠️ Here is what I think is actually happening.
FQHCs have proven to be more resilient than anyone predicted in the short run. The Rural Health Transformation Program, which began distributing $10 billion in annual federal funds to states in early 2026, is likely contributing to some of this growth.
But resilience now does not mean safety later. The pressures building inside these centers, staffing strain, Medicaid uncertainty, administrative burden, are not going away. They are compounding quietly.
The centers that open this year will face a harder operating environment next year.
More doors open does not automatically mean more capacity inside those doors.
What we build right now, the workflows, the tools, the infrastructure, will determine whether these centers can absorb what is coming. That is the work I wake up thinking about every morning.
👉 Follow Jonathan Govette, CEO of Oatmeal Health, for daily healthcare insights on LinkedIn. Deeper dives in The Oatmeal Bite on Substack: https://news.oatmealhealth.com
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Author:
CEO/Co-Founder @ Oatmeal Health | AI Lung Cancer Screening | Almost Became a Doctor | Engineer | Follow to Share What I’ve Learned Along the Way
I help patients get the care they need earlier, preventing late-stage cancer.
That’s been the throughline across three companies and almost 20 years in healthcare. At ReferralMD, we fixed broken referral networks so patients didn’t fall through the cracks. At Oatmeal Health, it’s lung cancer: building the diagnostic and screening infrastructure so the 85% of cases caught too late get caught early instead.
Today as CEO of Oatmeal Health, I lead a team embedding AI into radiology workflows to turn routine lung CT scans into reimbursable cancer risk assessments. We partner with FQHCs to reach underserved communities, and with health systems and payers to make early detection economically sustainable. Think HeartFlow or Cleerly, but for lungs.
Between companies, I advised at Techstars and Plug and Play, mentoring founders building in digital health. That experience shaped how I think about what separates companies that ship from companies that stall: distribution, reimbursement, and clinical trust, not just technology.
I’m a CancerX alumnus, a 3x healthcare founder, and someone who believes the biggest problems in cancer aren’t scientific. They’re operational.
We’re hiring mission-driven builders at Oatmeal Health. If you want to work on something that matters, reach out.
When I’m not working, I’m traveling, mentoring, and keeping up with one very energetic husky. 🐾
Substack – The Oatmeal Bite:
Millions of patients get less care because of who they are, where they live, or how they look. I’m fighting to change that. CEO @OatmealHealth, a startup built for the underserved. The Oatmeal Bite: intel for clinicians, investors, and advocates.
Jonathan Govette
CEO of Oatmeal Health
Substack:
https://oatmealhealthjonathangovette.substack.com/
