Ending federal support for housing first programs could increase U.S. homelessness by 5% in one year, new JAMA study finds

(Press-News.org) AURORA, Colo. (Dec. 18, 2025) – Eliminating federal funding for Housing First programs, initiatives that provide people experiencing homelessness (PEH) with stable housing without requiring sobriety or treatment, could lead to a sharp rise in homelessness nationwide, according to a new study published today in JAMA Health Forum.

Researchers at the University of Colorado Anschutz estimate that ending support for federally funded permanent supportive housing (PSH) and rapid rehousing (RRH) programs would result in 44,590 additional people experiencing homelessness within a single year, a roughly 5% increase from 2024 levels.

Housing First programs have been a cornerstone of national homelessness policy since federal pilots began in 2003, demonstrating improved housing stability and reduced dependence on healthcare systems. A July 2025 Executive Order sought to eliminate discretionary federal spending on these programs, prompting researchers to quantify the immediate impact of that decision.

“Our analysis shows that the loss of federal support for Housing First programs would have swift and significant consequences for communities across the country,” said Josh Barocas, MD, associate professor at CU Anschutz and study corresponding author. “These programs are often the final safety net for people with complex medical and social needs. Removing that support would push tens of thousands in both rural and urban communities back into homelessness almost overnight.”

Using the best available data, investigators modeled one-year changes in homelessness under several policy scenarios, including full elimination of federal support, funding removal for PSH only, and removal for RRH only.

Key findings include:

Complete elimination of Housing First funding = 44,590 additional PEH End of PSH funding but continued RRH support = 13,210 additional PEH End of RRH funding but continued PSH support = 38,890 additional PEH The model incorporated program exits, relapse to homelessness, loss of replacement housing units, increases in entries into homelessness due to diminished support and annual mortality rates among PEH.

“These short-term projections highlight only a fraction of the broader harms communities could face and so are likely an underestimate,” notes Kirk Fetters, MD, the study’s first author and infectious disease clinical fellow at CU Anschutz School of Medicine. “Without effective housing interventions, local systems—from hospitals to shelters—will experience mounting pressure.”

The study did not estimate long-term effects but underscores the immediate implications policymakers should consider when evaluating changes to Housing First funding.

 

About the University of Colorado Anschutz
The University of Colorado Anschutz is a world-class academic medical campus leading transformative advances in science, medicine, education and patient care. The campus includes the University of Colorado’s health professional schools, more than 60 centers and institutes, and two nationally ranked independent hospitals - UCHealth University of Colorado Hospital and Children's Hospital Colorado - which see nearly three million adult and pediatric patient visits each year. Innovative, interconnected and highly collaborative, CU Anschutz delivers life-changing treatments, exceptional patient care and top-tier professional training. The campus conducts world-renowned research supported by $890 million in funding, including $762 million in sponsored awards and $128 million in philanthropic gifts for research.

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