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Montana has 13 community health centers across 155 sites serving 109,975 patients — the #46 FQHC state by patients outside California and Texas. As an expansion state, Medicaid anchors the safety net, and H.R. 1 work requirements plus the December 2026 funding cliff are the key risks.
Patient-weighted across the 12 centers with UDS 2024 data.
Medicaid community-engagement (work) requirements under CMS-2454-IFC (80 hrs/month, full implementation Jan 1, 2027) plus expiry of the enhanced ACA premium tax credits (end of 2025) threaten Montana's expansion population and FQHC Medicaid revenue.
By patients (HRSA UDS 2024). Tap for the full profile.
| Organization | Patients | Sites | Uninsured | Revenue (990) | District |
|---|---|---|---|---|---|
| Bighorn Valley Health Center, Inc. Hardin | 25,040 | 42 | 22.61% | $34M | MT-02 |
| Yellowstone City County Health Department Billings | 14,404 | 10 | 13.47% | — | MT-02 |
| Butte-silver Bow Primary Health Care Clinic, Inc. Butte | 12,693 | 10 | 15.78% | $24M | MT-01 |
| Community Health Care Center, Incorporated Great Falls | 11,263 | 25 | 6.88% | $25M | MT-02 |
| Flathead Community Health Center, Inc. Kalispell | 9,896 | 13 | 17.54% | $24M | MT-01 |
| Pureview Health Center Helena | 9,458 | 9 | 6.97% | $15M | MT-02 |
| Lincoln County Community Health Center, Incorporated Libby | 7,735 | 4 | 8.62% | $15M | MT-01 |
| Marias Healthcare Services Inc. Shelby | 6,884 | 6 | 18.16% | $10M | MT-02 |
| Bullhook Community Health Center, Inc. Havre | 3,984 | 2 | 12.3% | $8M | MT-02 |
| Glacier Community Health Center Inc. Cut Bank | 3,091 | 4 | 13.91% | $6M | MT-01 |
1 hospital/university/county-operated: 1 county.
| District | Representative | Sites |
|---|---|---|
| MT-02 | Troy Downing | 82 |
| MT-01 | Ryan K. Zinke | 65 |
Montana ranks #46 by FQHC patients and #38 by organization count among the 57 national-breadth states/territories (excludes California and Texas, which have dedicated dashboards). All 13 centers depend on the federal Community Health Center Fund, authorized only through December 31, 2026.
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 Montana-only. Updated 2026-06-03.