Housing First Visionary Sam Tsemberis Confronts US Government Censorship and Policy Reversal
After four decades of pioneering research and more than ten years of federal endorsement, Sam Tsemberis, the architect behind the globally influential Housing First methodology for addressing homelessness, finds himself in an unprecedented position. The psychologist and advocate, whose work has transformed homelessness policies across continents, is experiencing direct censorship from the United States government.
The Censorship Incident: A Federal Red Pen Targets Evidence-Based Solutions
In October, while preparing a routine presentation about homelessness and health for medical and legal professionals, Tsemberis encountered what he describes as an "eye-opening experience." Federal officials from the Health Resources and Services Administration demanded to review his slides before the event. When returned, the materials contained extensive redactions, with federal officials deleting references to racial discrimination as a cause of homelessness, removing terms like "harm reduction" and "trauma-informed," and systematically eliminating mentions of "Housing First" and Tsemberis's foundational role in developing the approach.
"It's a big country," Tsemberis reflected from his Santa Monica apartment. "The fact they had someone who had the time to go through my slides like that was terrifying. It was a real wake-up call." The event organizer ultimately decided to forgo federal funding rather than implement the censored changes.
Housing First: A Simple Premise with Transformative Results
Tsemberis began developing Housing First in the 1990s based on a straightforward principle: people experiencing homelessness want and deserve immediate access to safe, permanent housing without preconditions. When combined with accessible mental health services, addiction support, and consistent case management, research consistently shows that at least 85% of participants remain housed after 12 to 24 months. These retention rates significantly outperform alternative approaches.
The methodology's success has been demonstrated through numerous implementations, including a partnership between the Department of Housing and Urban Development and the Veterans Administration that reduced veteran homelessness from 73,000 in 2009 to 36,000 in 2020. In Milwaukee, Wisconsin, Housing First contributed to a 42% reduction in homelessness between 2015 and 2024.
Trump Administration's Systematic Opposition
The censorship incident represents just one facet of the Trump administration's comprehensive campaign against Housing First. In summer 2024, President Donald Trump signed an executive order titled "Ending Crime and Disorder on America's Streets" that explicitly condemned Housing First for "deprioritizing accountability" and prohibited federal funding for the approach.
This policy reversal marks a dramatic shift from more than a decade of federal support. The administration now promotes "Treatment First" models that require homeless individuals to resolve addiction, mental health issues, and other challenges before obtaining housing. Historically, these approaches have demonstrated less than half the housing retention rates of Housing First.
European Embrace Contrasts with American Backlash
While facing opposition in his home country, Tsemberis recently experienced a markedly different reception in Berlin, where he helped organize the first European Housing First conference. The event attracted hundreds of social workers, government officials, and formerly homeless individuals from over twenty countries.
"You know, it's funny," Tsemberis observed. "Thirty-five years ago, when I started this, I was an outlaw, an outlier in the US. Then I built all this data, persisted, and Housing First became mainstream. Now, it's full circle. I'm a hero in Europe – and back to being an outlaw in the US."
European programs in France, England, and elsewhere report similar success rates to American implementations, with 80% or more participants remaining housed between 12 and 36 months after program initiation. Stefan Ripka of the European Union's executive branch affirmed the Commission's commitment to Housing First, stating that "access to affordable housing should not be seen as a privilege, but a fundamental right."
Conservative Critiques and Ideological Opposition
The Trump administration's opposition aligns with conservative think tanks and commentators who have long criticized Housing First. Project 2025, a conservative policy blueprint, calls for ending Housing First policies, describing them as "a far-left idea premised on the belief that homelessness is primarily circumstantial rather than behavioral."
Critics frequently mischaracterize Housing First as simply providing "keys to a subsidized apartment" without expectations or support services. Devon Kurtz of the Cicero Institute celebrated the policy reversal in a November column, declaring "Finally, the failed era of Housing First is over."
Nicholas Pleace, author of the European Housing First manual, describes such critiques as "deeply illogical," comparing them to asking "Why should we have doctors if people still get sick?" He warns that abandoning evidence-based approaches represents regression to ineffective historical models.
Chilling Effects on Non-Profits and Service Providers
The policy shift has created palpable anxiety among organizations serving homeless populations. One director of a non-profit with a multimillion-dollar budget, whose Housing First program achieves over 90% housing retention after 24 months, declined to be identified while criticizing the administration, citing concerns about unpredictable retaliation against federal funding.
"It's sad we're in this place," the director said. "It's all ideology on their part and they're not thinking things through." Tsemberis confirms that organizations nationwide are "trying to figure out how to stay off the radar" to protect their funding.
Legal Challenges and Uncertain Future
The administration's actions face legal opposition, including a lawsuit from twenty states plus Washington D.C. that describes HUD's policy change as "blatantly arbitrary and capricious" and notes the agency has "made no effort whatsoever to explain their utter abandonment of Housing First policies."
Ann Oliva, CEO of the National Alliance to End Homelessness and a former HUD official, acknowledges implementation challenges with Housing First but warns that the current administration's approach represents regression to ineffective 1980s and 1990s models. "We're regressing to models that didn't work, and didn't produce permanent housing," she said.
As Tsemberis prepares for the upcoming "Housing First in Challenging Times" conference focused on maintaining the model despite government opposition, experts warn that structural factors including affordable housing shortages, social service cuts, economic inequality, and the fentanyl epidemic will continue driving homelessness regardless of policy changes.
The fundamental question, as Pleace frames it, extends beyond policy specifics to "deep questions about what kind of society you want to be."
