Statement from Tracy Douglas, VCHA Chief Executive Officer
Richmond, VA (December 11, 2025): Virginia Community Healthcare Association (VCHA) acknowledges the recent ProPublica article highlighting medical debt collection practices among some community health centers nationwide. We appreciate the attention to this important issue and want to reaffirm our commitment to ensuring access to care for all patients, regardless of ability to pay.
Federally Qualified Health Centers (FQHCs) were founded to serve as a safety net for individuals and families who face barriers to healthcare. That mission remains unchanged. Every day, health centers across Virginia provide high-quality, affordable care to more than 420,000 patients, many of whom live in areas challenged with accessing healthcare services, underinsured or uninsured.
When the FQHC program was created, federal leaders understood that grant funding alone would never be enough to sustain these clinics. To ensure long-term viability, health centers were required to bill for services like private practices and hospitals, while also offering sliding fee discount programs tied to federal poverty guidelines. This dual approach guarantees access for patients regardless of ability to pay while supporting financial sustainability.
FQHCs undergo rigorous Operational Site Visits to demonstrate compliance with these federal guidelines, including billing and collection policies. Non-compliance can jeopardize a center’s designation, federal funding, and malpractice coverage. Simply put, the federal government does not want to invest in a health center serving a community with limited access to care only to see that center fail. Following these guidelines is essential to keep doors open and maintain care for those who need it most.
VCHA’s Position:
- No patient is denied care because of inability to pay.
- Health centers offer sliding fee discounts and payment plans to reduce financial burden.
- Collection practices are designed to be fair, compassionate, and compliant with federal and state law.
- We support federal and state policies that strengthen funding and reduce reliance on collections, so health centers can focus on care, not debt.
“We believe patients should never have to choose between healthcare and financial hardship,” said Tracy Douglas, VCHA Chief Executive Officer. “Our goal is to balance patient dignity with the financial sustainability needed to keep clinics open for everyone.”
About Virginia Community Healthcare Association
Founded in 1980, VCHA is a non-profit membership organization serving as the primary care association for Virginia’s community health centers and look-alike health centers. Its mission is to advocate, educate, and elevate member health centers, enhancing their ability to provide affordable, accessible, quality healthcare to all communities, regardless of ability to pay. For more information, visit www.vcha.org.
