On a road in Aurora, Colorado, lined with used-car dealers and pawnshops sits a tan, low-rise building called Mango House. Inside, among international-food stalls and ethnic-clothing shops, is a family-medicine clinic that serves a largely refugee and immigrant community. Improbably, the clinic makes enough money to sustain itself and pay staff well without relying on grants or donations. And it does so through Medicaid.

The prevailing wisdom is that Medicaid is a losing proposition for health facilities, an insurance program so stingy that many can’t afford to take it. Some of those that do essentially segregate Medicaid patients into separate clinics. Here, Medicaid is preferred.

Because the clinic relies so heavily on that program, I expected that the Trump administration’s upcoming Medicaid cuts might force Mango House to close or pare back. Instead, when I spoke recently with the clinic’s founder and owner, P. J. Parmar, they were far from his mind. Medicaid’s practices—and patients’ coverage—already fluctuate enough that he and his staff are used to weathering such unpredictable forces. Even if 15 percent of his patients fell off Medicaid because of the cuts, his practice would be fine, he said, showing me his calculations.

Parmar is a family physician who opened the practice—officially named Ardas Family Medicine, but now better known by its location inside Mango House—in 2012. He wanted to reengineer how a clinic could run, designing systems that maximized efficiency and ease of access.