County pushes back on federal mandate to limit services
Health Department contends RFJK Jr.'s mandate imperils local health care
SANDUSKY —
The Erie County Health Department is urging the Trump administration — specifically Health and Human Services Secretary Robert F. Kennedy Jr. — to maintain long-standing protections that allow nonprofit health centers to serve patients regardless of immigration status or ability to verify eligibility for certain federal benefits.
In a letter sent Tuesday, the health department’s CEO/CFO, Joseph Palmucci, called on HHS to preserve the exemption that keeps Community Health Centers outside the scope of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996’s “federal public benefit” verification requirements.
At issue is the Department’s recent interpretation of what counts as a “federal public benefit” — a definition that could have sweeping consequences for how safety-net providers operate. While the July 14, 2025, Federal Register notice maintained the current exemption for nonprofit charitable organizations, it left open the possibility of future changes.
“For decades, Community Health Centers have been a lifeline for millions who would otherwise have no access to comprehensive, affordable, quality healthcare,” Palmucci wrote. “Limiting access and creating new barriers would compromise the well-being of entire families and communities.”
Why it matters
Community Health Centers operate in nearly every part of the country, including 60 facilities across Ohio that serve more than one million residents each year. Many provide not only medical care, but also dental, behavioral health, pharmacy, vision, and detox services — often under one roof.
In 2024 alone, Ohio Community Health Centers cared for nearly 20,000 pregnant women, 14,000 veterans, more than 110,000 seniors, and almost 270,000 children. Nationwide, that figure climbs to 34 million patients, according to the county health department.
Under the Reconciliation Act, most federal public benefits require proof of lawful status, but Congress carved out an exemption for nonprofit charitable organizations to avoid cutting off essential health and human services to people in need. ECHD argues that removing that exemption would not only undermine public health, but also increase system-wide costs and widen health disparities.
What happens next
The comment period on HHS’s interpretation remains open, and health centers nationwide are expected to weigh in. For Erie County and other Ohio providers, the fight is about keeping their doors open to all — no matter who walks in.
“The Health Center Program should not be defined as a federal public benefit,” Palmucci concluded, “and must remain statutorily exempt to ensure it can continue to serve as a beacon of hope and health for millions.”
No means no