Background: Community health centers (CHCs) serve over six million women of reproductive age. However, the changing landscape of health policy over the last several years has made CHCs’ capacity to respond to reproductive health needs unclear. This study aims to explore the challenges, opportunities, and successful models of family planning service delivery in CHC settings in the context of rapidly shifting state and federal policies. Methods: Using a comparative case study approach, we conducted site visits at four CHCs from distinct geographic regions and state policy climates. We conducted semi-structured interviews with clinical, administrative, and executive staff members (n=22). Two investigators conducted thematic content analysis of transcripts until consensus was reached. Results: Salient themes include perceptions of and responses to reproductive health needs; models of family planning care; and the impact of federal and state policies on CHC operations. Although all CHCs provided some level of family planning care, some staff considered family planning a portal of entry into primary care, while others perceived primary care as an entry point for family planning. Staff discussed the instability of state and federal policies and the need for flexibility in response to continuing policy changes. Finally, organizational leadership was perceived to facilitate CHCs' ability to navigate changing policy climates. Implications: This study explores a range of approaches to family planning in a time of policy uncertainty. As federal and state policies continue to shift, the findings from this study offer emerging best practices that can be implemented in CHCs around the country.