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Wisconsin has 17 community health centers across 243 sites serving 278,761 patients — the #32 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.
Wisconsin is the only state that never adopted ACA Medicaid expansion yet has no coverage gap: through a longstanding Section 1115 'BadgerCare Plus' waiver (renewed by CMS through December 31, 2029), it covers childless adults up to 100% FPL. The catch under H.R.1 (OBBBA): KFF confirms Wisconsin is one of just two partial-expansion-waiver states (alongside Georgia) whose childless-adult waiver population is treated like an expansion group, so 80-hour/month work requirements still apply to BadgerCare Plus adults ages 19–64 beginning January 1, 2027, with 6-month eligibility rechecks. Wisconsin's ~17 FQHC organizations serve nearly 300,000 patients at 200+ sites, and roughly 60% of patients at some centers rely on Medicaid.
Patient-weighted across the 17 centers with UDS 2024 data.
Wisconsin had been a reduced-practice/collaboration-requirement state after Gov. Evers vetoed APRN independence bills in 2022 and 2024, but in August 2025 he signed AB 257 (2025 Wisconsin Act 17), which lets APRNs practice independently only after completing 3,840 hours of physician-supervised practice, with added safeguards for pain management and title protections.
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.
5 primary-sourced findings on Wisconsin FQHC policy and financing.
Wisconsin DHS confirms that under H.R.1 (signed July 4, 2025), BadgerCare Plus members ages 19–64 must document 80 hours/month of work or qualifying activity (job, school, training, or volunteering) starting January 1, 2027 unless exempt; DHS will mail notices to affected childless adults in fall 2026. KFF's work-requirements tracker confirms Wisconsin is one of only two partial-expansion-waiver states (with Georgia) whose waiver enrollees are subject to the mandate despite never adopting full ACA expansion — making the requirement an unusually direct hit on FQHC patients who otherwise had stable BadgerCare coverage.
KFF (Medicaid Work Requirements Tracker)The Community Health Center Fund — which supplies roughly 70% of federal grant funding for Section 330 health centers — was extended to $4.6 billion for FY2026 but only through December 2026, after which the base grants that anchor Wisconsin's ~17 FQHC organizations face a funding cliff absent congressional reauthorization. NACHC warns the majority of CHCs already run negative margins and that as many as one in four nationally could close or cut services within two years without stable funding; in Wisconsin, where some centers draw ~60% of patients from Medicaid, the cliff compounds the January 2027 work-requirement coverage losses.
NACHCCMS approved a five-year extension of Wisconsin's Section 1115 BadgerCare demonstration, providing coverage from January 1, 2024 through December 31, 2029 for childless adults with incomes up to 100% of the federal poverty level. This is the mechanism that makes Wisconsin the unique 'non-expansion-but-no-gap' state: it covers the population an expansion state would cover at 138% FPL, but at the lower 100% threshold and without the enhanced federal expansion match — leaving FQHCs more exposed to state budget and federal Medicaid policy swings than peers in full-expansion states.
Wisconsin Department of Health ServicesThe Wisconsin Legislature's Joint Committee on Finance advanced an increase in the State Community Health Center Grant Program in the 2025-27 biennial budget (signed as 2025 Act 15), including for the first time a dedicated line item for FQHC Look-Alikes. WPHCA — representing Wisconsin's Community Health Centers serving nearly 300,000 patients at 200+ sites — publicly celebrated the new state dollars, which are intended to offset potential revenue losses to clinics as their uninsured and Medicaid caseloads rise; Gov. Evers' original budget had also proposed multimillion-dollar annual increases for FQHCs, Look-Alikes, and homeless-health centers.
Wisconsin Primary Health Care AssociationIn August 2025 Gov. Tony Evers signed AB 257 (2025 Wisconsin Act 17), reversing his 2022 and 2024 vetoes and finally allowing advanced practice registered nurses to practice independently — but only after completing 3,840 hours of physician-supervised practice, with additional supervision for CRNAs handling pain management and new title-protection rules. For Wisconsin's rural and workforce-strapped FQHCs, the law is a meaningful (if conditional) expansion of provider capacity in a long-standing collaboration-requirement state, after the Wisconsin Medical Society moved from opposition to neutral on the revised bill.
Wisconsin ExaminerBy patients (HRSA UDS 2024). Tap for the full profile.
| Organization | Patients | Sites | Uninsured | Revenue (990) | District |
|---|---|---|---|---|---|
| Sixteenth Street Community Health Center Milwaukee | 42,819 | 29 | 29.74% | $55M | WI-04 |
| Family Health Center of Marshfield, Inc. Marshfield | 39,446 | 18 | 10.79% | $52M | WI-07 |
| Access Community Health Centers, Inc. Madison | 33,015 | 10 | 13.38% | $44M | WI-02 |
| Lakes Community Health Center, Inc. the Iron River | 27,693 | 78 | 6.33% | $46M | WI-07 |
| Outreach Community Health Centers, Incorporated Glendale | 21,415 | 11 | 18.07% | $24M | WI-04 |
| Partnership Community Health Center Inc. Appleton | 17,515 | 5 | 16.03% | $18M | WI-08 |
| Progressive Community Health Centers, Inc. Milwaukee | 17,001 | 3 | 6.85% | $19M | WI-04 |
| La Clinica de los Campesinos, Inc. Wautoma | 15,816 | 11 | 16.91% | $31M | WI-06 |
| Kenosha Community Health Center, Inc. Kenosha | 15,765 | 5 | 22% | $16M | WI-01 |
| Milwaukee Health Services, Inc. Milwaukee | 12,316 | 2 | 3.59% | $25M | WI-04 |
| District | Representative | Sites |
|---|---|---|
| WI-07 | Thomas P. Tiffany | 91 |
| WI-04 | Gwen Moore | 44 |
| WI-08 | Tony Wied | 43 |
| WI-03 | Derrick Van Orden | 42 |
| WI-02 | Mark Pocan | 10 |
| WI-01 | Bryan Steil | 9 |
Wisconsin ranks #32 by FQHC patients and #33 by organization count among the 57 national-breadth states/territories (excludes California and Texas, which have dedicated dashboards). All 17 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. Intelligence items cite primary sources. Federal items apply to all states; state items are Wisconsin-only. Updated 2026-06-03.