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Waco Family Medicine warns funding cuts, Medicaid disenrollment have shrunk services and strained finances
Summary
Dr. Jackson Griggs told the Waco City Council that Waco Family Medicine served nearly 75,000 unique patients last year but faces major financial pressure: uninsured‑care costs to Waco residents total about $10.27 million annually while the city contributes roughly $1.25 million, and staffing and clinic consolidations followed recent policy shifts.
At a Dec. work session, Dr. Jackson Griggs, chief of Waco Family Medicine, told the Waco City Council that the federally qualified health center remains a central safety‑net provider but is operating under intense financial pressure.
"Of the 50 states, Texas ranks fiftieth for uninsurance, access and affordability," Griggs said, citing Commonwealth Fund data. He said the clinic cared for just shy of 75,000 unique individuals last year and conducted about 119,000 medical visits in McLennan County. About 55 percent of the patients treated in McLennan County live inside Waco city limits, he said.
Griggs gave a breakdown of uninsured‑care costs and support: "The 12‑month cost of uninsured care to Wacoans is a little over $10,000,000 — $10,270,000 a year," he said, and added that the city currently offsets roughly $1,250,000 of that total annually. He said clinical revenue comprises just over half of the Center’s total revenue mix, pharmacy sales about one‑third, and grants or other support around 12 percent. Griggs said the Center’s total operating scale is about $96 million.
The center’s pharmacy operates under the federal 340B‑type framework Griggs described as a critical margin to support care for uninsured patients. "The pharmacy really is key to our financial formula," he said, noting that pharmacy margins generated by purchasing at federally negotiated prices must be reinvested in care for uninsured or underinsured patients.
Griggs warned the council that recent policy changes and a statewide Medicaid disenrollment process materially reduced Medicaid revenues and forced service changes: the Center recorded a roughly 12 percent reduction in roles last year, temporary and permanent clinic closures (including Bells Hill and the MCC clinic), and other consolidations. He said the unwinding of pandemic‑era Medicaid rules and other federal and state changes have had direct operational consequences for safety‑net providers.
Griggs also highlighted program successes and areas for expansion, including HIV screening above HRSA benchmarks, improved blood‑pressure control, a school‑based behavioral health pilot, a teaching kitchen and partnerships for food prescriptions and medical‑legal services. He described the Center’s three‑year family medicine residency program — about 36 residents — as an important local workforce pipeline that helps sustain primary care capacity in Waco.
"We will stay focused on our mission of community wellness for all," Griggs said, calling for greater local awareness and collective problem‑solving to shore up the safety net.
Council members asked follow‑up questions about payer mix, Medicaid percentage and specifics of the 340B pharmacy program; Griggs said he would provide additional citation details and data slides outside the meeting. The presentation ended with council thanks and a move to the next agenda item.
