Medicaid non-expansion state

Alabama FQHC Intelligence

Alabama has 19 community health centers across 216 sites serving 344,203 patients — the #28 FQHC state by patients outside California and Texas. As a non-expansion state, the uninsured are the biggest exposure, and the ACA premium-credit expiry is the dominant federal risk.

Organizations

216

Service sites

0.3M

Patients (UDS)

25%

Uninsured

#28

National rank (patients)

Payer mix

Patient-weighted across the 19 centers with UDS 2024 data.

32.5%

25%

13.3%

Medicaid/CHIP 32.5%Uninsured 25%Medicare 13.3%Remainder: private/other

Alabama FQHCs run 1.5 points lower on uninsured patients than the non-expansion-state average (26.5%).

Alabama policy context

Medicaid

Non-expansion

Alabama Medicaid

Primary Care Assoc.

ALPHCA

Alabama Primary Health Care Association

NP scope

reduced

Alabama is a reduced-practice state: NPs must maintain a career-long collaborative agreement with a physician for at least one element of practice (AANP 2026).

Legislature

annual

Alabama Dept. of Commerce / AlabamaWorks Rapid Response

Headline federal risk

Expiry of the enhanced ACA premium tax credits (end of 2025) is the dominant federal risk in this non-expansion state — it widens the coverage gap and raises uninsured/self-pay volume at FQHCs; Medicaid community-engagement (work) requirements (CMS-2454-IFC, full implementation Jan 1, 2027) compound the redetermination burden.

Largest Alabama FQHC systems

By patients (HRSA UDS 2024). Tap for the full profile.

Organization	Patients	Sites	Uninsured	Revenue (990)	District
Cahaba Medical Care Foundation Centreville	46,775	32	22.63%	$62M	AL-06
Health Services Inc. Montgomery	36,072	15	19.91%	$31M	AL-02
Franklin Primary Health Center, Inc. Mobile	35,505	21	37.3%	$43M	AL-02
Southeast Alabama Rural Health Associate Troy	32,077	14	8.92%	$29M	AL-02
Mobile County Board of Health Mobile	27,863	11	29.66%	—	AL-02
Altapointe Health Systems Inc. Mobile	21,000	9	7.49%	—	AL-02
Quality of Life Health Services, Inc. Gadsden	20,272	25	35.54%	$37M	AL-03
Christ Health Center, Inc. Birmingham	19,319	6	26.38%	$18M	AL-07
Whatley Health Services Inc. Tuscaloosa	17,614	13	31.79%	$27M	AL-07
Central North Alabama Health Services Inc. Huntsville	13,527	6	51.3%	$14M	AL-05

See all 19 Alabama FQHCs in the directory

Federal footprint

Section 330 awardees

FQHC Look-Alikes

Independent nonprofits

$369M

Total revenue (990, 17 orgs)

Congressional exposure

District	Representative	Sites
AL-07	Terri A. Sewell	63
AL-02	Shomari Figures	51
AL-05	Dale W. Strong	32
AL-06	Gary J. Palmer	21
AL-01	Barry Moore	19
AL-04	Robert B. Aderholt	19

National district map

National context

Alabama ranks #28 by FQHC patients and #29 by organization count among the 57 national-breadth states/territories (excludes California and Texas, which have dedicated dashboards). All 19 centers depend on the federal Community Health Center Fund, authorized only through December 31, 2026.

HHS Region 4 — neighboring states

Florida Georgia Kentucky Mississippi North Carolina South Carolina Tennessee

Alabama directory

All 19 centers with HRSA data

National overview

The expansion divide, measured

Explore all 50 states

FQHC data from the HRSA bulk-sites file + UDS 2024 + IRS 990. State policy profile via NACHC/KFF/AANP. Federal items apply to all states; state items are Alabama-only. Updated 2026-06-03.

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