Upcoming Membership Structure Changes: Continuing Our Mission of Access and Fairness

Next month marks three years since we launched our Health Equity Fund and tiered membership model — an experiment in bringing a mutual-aid approach to Direct Primary Care.

At the time, we made our best guesses about how to structure things in a way that would keep care accessible to those who need it most while sustaining our team and clinic. Some of those guesses were right; others, we’ve learned, need adjusting.

What’s Changing and Why

From day one, demand for Accessible memberships has far exceeded our resources.

Today, more than 70 people remain on the waitlist, and some have been waiting nearly a year. And the policy landscape is about to get rougher: the enhanced Affordable Care Act subsidies are set to expire at the end of 2025, and national health insurance premiums are projected to rise 18% on average in 2026 (KFF).

At the same time, the cost of running a fair-wage, full-service health clinic continues to rise.

To meet these growing needs and better live out our mission, we’re making adjustments that will allow us to triple the number of Accessible memberships we can offer — from 10% to 30% of our total panel — by rebalancing our rates and making our pricing model needs-based instead of age-based.

Tier	Monthly Rate	Description
Accessible	$60	For members who need financial flexibility — self-assessed, no paperwork required.
Sustainable	$90	Our standard rate reflects the true cost of care.
Equity	$100-$120	For members able to contribute more to offset the cost of Accessible memberships.

🩺 All ages will now use the same rate structure.

Support for Current Youth Members

We know this transition will feel like a big jump for some of our younger patients, so we’re taking steps to make it as smooth as possible:

• Current youth (ages 3–24) on Sustainable memberships can switch to an age-limited Accessible membership ($60/month) if requested. This rate will last until they turn 25, at which point they can request a regular Accessible membership through the usual process.

  
  

• Current youth (ages 3–24) on Accessible memberships can keep their current rate if requested. This legacy rate will last until they turn 25, after which it converts to the standard Accessible rate.

✴️ To request a change, click here.

How You Can Help Sustain This Work

If your circumstances have changed, please consider whether your current tier still fits:

• Sustainable members: If your economic outlook has improved, consider upgrading to an Equity membership to help others access care. If things have gotten tighter, please reach out to join our Accessible waitlist.

  
  

• Accessible members: If your situation has improved, switching to Sustainable opens a slot for someone else who needs it more right now.

  
  

• Equity members: You can adjust your contribution up or down anytime — just let us know.

  
  

✴️ To request a change, click here.

Our Commitment

We know change is hard, and we never take a price adjustment lightly. These updates help us care for more people, more equitably, while staying true to our promise:

transparent costs, fair wages, and inclusive, stigma-free care.

Thank you for being part of this community.

Together, we’re proving that healthcare can work differently — and better.