AAFP: Federal shutdown hurts patient access to care, training programs for new physicians

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A federal government shutdown is hurting access to health care for Americans and training programs for new doctors, according to the American Academy of Family Physicians (AAFP).

The federal government shut down operations Oct. 1, prompting AAFP to request money for the Teaching Health Center Graduation Medical Education program and the Community Health Center Fund. AAFP asserted federal leaders should continue allowing flexibilities for telehealth services that maintain patient access to care.

“Our ask is clear: Congress must safeguard the programs that keep care within reach,” AAFP said in a statement titled “Family Physicians Stand With Our Patients and Communities.”

“A shutdown only stifles access to care, impacts training opportunities for preparing the next generation of physicians and leaves our patients scrambling for alternative care — or worse yet, going without care,” the AAFP statement said. “On behalf of family physicians across the U.S., we urge our elected leaders to recognize the human faces behind every policy decision and reach a swift bipartisan resolution that preserves access to care.”

Losing access to health care

AAFP said its members feel uncertain as patient needs increase, but available health care resources decrease.

“As family physicians, our commitment goes beyond the exam room,” the AAFP statement said. “We are neighbors, listeners and advocates for the families who trust us with their health. With a government shutdown now in effect, we see firsthand the anxiety and uncertainty this brings to patients who depend on government-supported programs for their care and well-being, and we feel that uncertainty ourselves as we experience the conflict of helping patients achieve healthier lives in the face of limited resources.

“We know what’s at stake for parents trying to keep their children healthy, for individuals managing chronic conditions and for older adults who rely on timely access to their doctors,” AAFP’s statement said. “The possibility of lost access to vital services, whether it’s a residency program, a local community health center or the convenience of telehealth, is one more blow to the fragile web of services and programs that are critical to so many of our patients.”

What are the programs?

There are 82 Teaching Health Centers (THCs) with almost 1,200 medical and dental residents in nearly 30 states, according to the American Association of Teaching Health Centers (AATHC). The association was founded in 2013 to be a nationwide hub for THC programs across the country. THC residencies focus on family medicine, internal medicine, dentistry, psychiatry, obstetrics and gynecology, geriatrics, and pediatrics

“By moving primary care training into the community, THCs are on the leading edge of innovative educational programming dedicated to ensuring a relevant and sufficient supply of health workforce professionals,” the association’s website said.

The program is highly competitive, with many centers receiving more than 100 applications for each residency. Compared with traditional graduate medical education, more THC graduates remain in primary care practice (82% vs. 23%), practice in underserved communities (55% vs. 26%) and practice in rural areas (20% vs. 8%).

The program has an average cost of $209,623 per resident per year; as of July 2022, the per resident allocation was $160,000. THCs generally have had strong bipartisan support, and a March 2024 proposal included a five-year, $1.3 billion spending plan for teaching health centers. That proposal was not included in the appropriations bill, and since then THC advocates have been asking for more money, according to an AATHC policy update from September 2024.

Community health centers

Community health centers have been part of the nation’s health care system for at least 60 years, according to an official description from the Health Resources & Services Administration (HRSA). There are approximately 1,400 health canters running at least 16,200 sites across the country serving more than 32.4 million people a year, with 90% of patients having incomes less than 200% of the federal poverty level.

Community health centers were in the spotlight earlier this year due to budgetary problems, spending freezes and layoffs at the U.S. Department of Health and Human Services, according to news reports. Once President Donald J. Trump took office, there were “significant delays in accessing funding,” according to a letter from Sen. Mark Warner and Sen. Tim Kaine, both Democrats from Virginia.

As of June, at least one analysis forecasted drastic spending cuts for community health centers due to Medicaid reforms and cuts in the One Big Beautiful Bill Act, the national spending plan approved by Congress and supported by the Trump administration. Particularly, new work requirements for Medicaid enrollees could result in a loss of $32 billion over five years for community health centers. That would effectively return community health centers to service levels of 2013, before health insurance reforms of the Affordable Care Act, said a data note published by the Geiger Gibson Program in Community Health at George Washington University.