NAFC Written Testimony to Subcommittee on Health Energy and Commerce

Written Testimony

Submitted to Subcommittee on Health Energy and Commerce

On behalf of the National Association of Free and Charitable Clinics

Nicole Lamoureux, CEO and President

January 31, 2024

On behalf of the NAFC Board of Directors, our patients, and the 1,400 Free and Charitable Clinics and Pharmacies in the United States, thank you for the opportunity to submit this written testimony about the “Health Care Spending in the United States: Unsustainable for Patients, Employers, and Taxpayers” hearing to the Subcommittee on Health.

The Unsustainable Nature of Health Care Spending:

The current trajectory of healthcare spending in our country is economically unsustainable and ethically unacceptable. As we discuss the financial burdens placed on patients, employers, and taxpayers, it is imperative to shed light on the plight of the millions of uninsured and underinsured individuals who bear the heaviest brunt of these escalating costs. With 27 million uninsured Americans, the cost of health care remains a tremendous burden, disproportionately affecting those without access to affordable insurance options.

The Role of Free and Charitable Clinics and Pharmacies:

Amidst this crisis, the invaluable contribution of Free and Charitable Clinics and Pharmacies cannot be overstated. These organizations serve as beacons of hope for the most vulnerable members of our society, providing access to essential healthcare services without federal government financial support. With over 1,400 such clinics and pharmacies nationwide, a volunteer and staff workforce of over 200,000 provides affordable access to health care to 1.7 million people annually. These organizations not only represent a lifeline for millions of uninsured and underinsured individuals, but they also provide vital medical care that would otherwise be out of reach. For every dollar that is donated to Free or Charitable Clinics or Pharmacies, seven dollars in services are provided.

Data and Insights:

The data from these grassroots healthcare nonprofit organizations is astounding:

  • In 2022 alone, these organizations provided care to 1.7 million patients through 5.8 million patient visits.
  • Shockingly, 85% of these patients were uninsured, underscoring the dire need for accessible and affordable healthcare options.
  • Of the patients served, 59% were members of racial/ethnic minorities, highlighting the critical role these clinics play in addressing health disparities.
  • Additionally, 52% of patients were employed, emphasizing the widespread impact of healthcare costs on the workforce.
  • Notably, 41% of patients served were Caucasian, while 33% were Hispanic and 14% were Black, reflecting the diversity of the population benefiting from these services.
  • 69% of clinics/pharmacies have an operating budget of $500,000 or less.
  • 35% of locations are in rural areas, 49% in urban areas and 33% are in suburban areas

Addressing the Challenges of Health Care Spending:

We urge this esteemed committee to recognize the indispensable role of Free and Charitable Clinics and Pharmacies in mitigating the adverse effects of unsustainable healthcare spending. Furthermore, we call upon Congress to take concrete steps to support and bolster these vital healthcare providers. Specifically, we recommend granting these clinics automatic HPSA (Health Professional Shortage Area) and MUA (Medically Underserved Area) designations, akin to Federally Qualified Health Centers, to facilitate loan repayment for healthcare providers and address workforce shortages in underserved communities. Additionally, we urge the Committee to include Free and Charitable Clinics and Pharmacies in testimony opportunities and meetings for further information and education on how this country can scale cost-saving measures that are utilized at these organizations.


In conclusion, the unsustainable nature of health care spending in the United States demands urgent attention and decisive action. By recognizing and supporting the invaluable contributions of Free and Charitable Clinics and Pharmacies, we can take meaningful strides towards achieving equitable access to healthcare for all Americans. Cost-saving measures in this country will be achieved when Congress recognizes that America’s safety net extends beyond government-recognized agencies. It’s crucial to understand that the 27 million uninsured patients in this country often resort to emergency rooms for basic healthcare needs, driving up costs for everyone. By working with nonprofits and grassroots organizations on the ground, not only can we foster innovation in healthcare, but we can also address the root causes of rising healthcare costs. Providing care to the uninsured and those who serve them is essential for tackling the underlying issues of healthcare affordability and accessibility. It is time for Congress to think outside the box of the current healthcare paradigm and take bold steps to enact the change needed for equitable, affordable, accessible healthcare.