The Paradoxical Politics of Community Health Centers from the Great Society to the COVID-19 Pandemic

Context: Although community health centers (CHCs) arose in the 1960s as part of a Democratic policy push committed to social justice, subsequent support has been shaped by paradoxical poli-tics wherein Republican and Democratic support for CHCs continually morphed in response to changes in the health policy landscape.Methods: Drawing on the CHC literature and empirical examples from firsthand accounts and reporting, this article explains CHCs' curious historical development from 1965 to the present.Findings: Both Republicans and Democrats have calibrated their support for CHCs in response to a broader set of political considerations, from antiwelfare policy commitments to aspirations of establishing a national health care plan.Conclusions: CHCs have proven to be a politically malleable policy tool within the broader context of American health care policy. The COVID-19 pandemic raised new questions about CHCs' sustainability and future, but CHCs will continue to play a critical role in providing health care access to underserved populations. They also will continue to be an attractive bipartisan pol-icy option within the larger framework of US health policy.