Federal Reserve Banks across the country collect anecdotes from contacts and hone in on concerns for Federal Reserve Beige Book summaries, published eight times each year. Historically, insights about conditions affecting low- and moderate-income communities have come from the perspective of businesses. Several Reserve Banks began including “Community Conditions” and “Community Perspectives” sections in the fall of 2022. These sections provide insight into local changes through direct accounts of nonprofit and community leaders and workforce professionals serving lower-income people. Here are some takeaways from the August 2025 Beige Book, which was prepared at the Federal Reserve Bank of Philadelphia and based on information collected on or before August 25, 2025.

Please note that the Beige Book summarizes comments received from contacts outside the Federal Reserve and is not a commentary on the views of Federal Reserve officials.

“Many rural areas are underserved by healthcare professionals, including nurses, doctors, and support staff, and funding constraints are likely to exacerbate existing shortages. Community leaders anticipated that upcoming changes to Medicaid may cause reductions in health care services more broadly, including hospital closures, as well as a greater number of uncompensated services. Additionally, community leaders expected the new work requirements for Medicaid recipients to exacerbate existing childcare shortages.”
– New York Fed, Federal Reserve 2^nd District, Community Perspectives

“In a recent survey of Ohio’s Federally Qualified Health Centers, which provide services to underserved populations and areas, most respondents indicated that potential Medicaid cuts would significantly impact their budgets. Several reported that cuts would negatively affect their staffing levels, patient access to care, and recruitment and retention of providers. Some mentioned developing strategies to mitigate these effects, including increasing revenue from non-Medicaid sources. One respondent planned to shift more to value-based care, a model through which providers are paid for quality of care over quantity of patients. Another mentioned that credentialing with commercial plans allowed them to receive reimbursement from health insurance companies. Others suggested scaling back or cutting services and staff hours.”
– Cleveland Fed, Federal Reserve 4^th District, Community Conditions

“Several workforce intermediaries reported continued signs of a weakening labor market, including fewer job requisitions from employers, and smaller employers increasingly opting for contract labor. Against a backdrop of constrained organizational resources, direct service providers noted increased demand for food assistance. Community development financial institutions and small business support providers observed a rise in business owners utilizing personal and other high-interest debt to cover elevated operating costs as well as the purchase of inventory in anticipation of higher costs due to tariffs. Federal funding volatility, including delayed disbursements, cuts, and clawbacks, has resulted in restricted cash flow for organizations providing employment, food, housing, and small business supports.”
– Atlanta Fed, Federal Reserve 6^th District, Community Perspectives

“Community, nonprofit, and other nonbusiness contacts saw little change in activity over the reporting period and many expressed uncertainty about the state of the economy as major changes in federal policy continue to take effect. One state government contact saw a decline in overall tax revenues, but an increase in sales tax revenues. Small business contacts reported that in response to higher tariffs, owners were pivoting to find new suppliers and identifying other ways to contain costs. Leaders of nonprofit and social service organizations continued to experience uncertainty regarding program funding pending federal appropriations decisions. In the meantime, they were hopeful for sustained local support heading into the back-to-school season, which carries additional costs for low-income families.”
– Chicago Fed, Federal Reserve 7^th District, Community Conditions

“The housing market for lower-income homebuyers remains tight overall, but contacts reported slight softening in recent months. Home prices in the relatively lower range increased only slightly, but contacts said that interest rates, insurance costs, and property taxes remained barriers to new purchasing activity. Some reports of more low-income homeowners selling their houses emerged as escrow payments rose, but the more common trend was for lower-income buyers to avoid moving to keep their low-rate mortgage if they had one. As a result, inventories of lower priced homes have not risen as much as they have at higher price ranges. Contacts in most local markets reported continued competition with investor purchasers for lower-priced homes. However, rising availability of rental units and softening rent growth reportedly offset some of the price pressures associated with the additional institutional buyers active in local markets.”
– Kansas City Fed, Federal Reserve 10^th District, Community Conditions

“Nonprofits continue to see elevated demand for a broad range of social services, including food, childcare, housing, transportation, and disaster assistance. Food assistance has emerged as one of the fastest growing needs among clients but rising costs and loss of federal funding are making it harder for nonprofits to meet that need. Subsidized childcare remains a critical barrier to employment for some families, with one organization noting that there are more than 11,000 children on the waitlist for their service area. One contact said that with the cut in FEMA funds they are having a hard time referring individuals to places for weather and disaster-related help. The current environment remains challenging for nonprofits as they contend with the impact of federal spending cuts amid high demand. Hence, even the most agile organizations are facing shifts in strategic priorities and staff reductions.”
– Dallas Fed, Federal Reserve 11^th District, Community Perspectives

“Community and support organizations continued to report elevated demand for services and limited funding, similar to the previous reporting period. As a result, organizations found it more challenging to fulfil needs for housing, food assistance, and health care. The start of the school year raised demand across the District for assistance in obtaining school supplies. Cuts in federal grants and corporate funding were reportedly more pronounced in nonprofits working with underrepresented populations or environmental groups. One contact noted that nonprofit organizations offering legal support had an easier time attracting and hiring law students who previously gravitated towards more conventional legal sector jobs.”
– San Francisco Fed, Federal Reserve 12^th District, Community Conditions

Visit the August 2025 Beige Book report for a full national summary and more information about economic conditions from each Reserve Bank, including labor markets, financial services, real estate, and more.