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In a former church in Louisville, Kentucky, a men's day shelter welcomed weary men, some of whom had endured the harsh realities of homelessness for years. Johnny Henderson, a 71-year-old with a compromised health status, was grateful for the temporary respite. He shared the space with a great-grandfather in a wheelchair battling prostate cancer, a 54-year-old with multiple psychiatric disorders, and a 66-year-old with a walker and a heightened risk of falling.

These individuals were among the many potential candidates for permanent, government-subsidized apartments under the "Housing First" approach, which advocates for providing stable housing before addressing other issues. However, this approach is under threat under the Trump administration.

Providers and advocates argue that the impending changes will have dire consequences for some of the nation's most vulnerable populations. The prospect of losing access to permanent housing raises concerns about the fragility of their well-being. Ra’Shann Martin, executive director of St. John, emphasizes that "Housing is healthcare." As people experience extended periods of homelessness, their health deteriorates, making it increasingly challenging to regain stability.

Across the United States, homelessness has been on the rise, with nearly 750,000 individuals experiencing homelessness in 2023, according to the U.S. Department of Housing and Urban Development. While this figure is slightly lower than in 2024, it remains a staggering 31% higher than in 2019. The number of chronically homeless individuals, defined as those with a disability and experiencing long-term or repeated episodes of homelessness, has also increased since 2019, now comprising about a quarter of the total homeless population.

The "Housing First" model has proven effective in keeping people stable in housing, with research indicating that it outperforms alternative approaches such as "Treatment First," which prioritizes mandatory services for addiction and serious mental illness. However, opponents argue that the administration's shift towards "Treatment First" and short-term transitional housing may push individuals with severe health risks back onto the streets or maintain them in suboptimal living conditions.

As a result, housing projects have been canceled in communities like Corbin, Kentucky, and housing options have become scarcer in places like Santa Cruz County, California, and Louisville, where nonprofits are considering converting permanent housing to temporary arrangements.