Government Shutdown Extends into Second Week: 4 Things to know
The U.S. government shutdown is entering its second week with no immediate resolution in sight. Lawmakers are scheduled to return on october 6th, but a rapid end to the impasse appears unlikely. Here’s a breakdown of key impacts:
1. ACA Subsidies and Funding Deadlock: The future of ACA premium tax subsidies is caught in the broader funding debate. Democrats are advocating for an extension of these credits before open enrollment begins on november 1st. However, Republicans are seeking to address spending issues through the standard appropriations process, resisting the addition of healthcare provisions to short-term funding bills. The House will not reconvene until at least October 14th, further delaying action.
2. Telehealth and Hospital-at-Home Programs Disrupted: The shutdown has already caused disruptions to telehealth and hospital-at-home programs. The CMS hospital-at-home waiver expired on October 1st, forcing providers to quickly transition patients back to customary hospital settings. Medicare coverage for telehealth visits, previously extended multiple times, has also lapsed. As a result, Medicare will largely no longer reimburse for telehealth services delivered outside of rural areas or in patients’ homes, with a limited exception for behavioral health and clinicians participating in Medicare Shared Savings Program ACOs. CMS is temporarily holding Medicare claims for up to 10 business days, delaying payments but not preventing submissions.
3. HHS Workforce Furloughs: The Department of Health and Human Services (HHS) is furloughing approximately 41% of its 79,717 employees. While essential functions like Medicare and Medicaid payments, disease outbreak monitoring, and FDA food safety oversight will continue, other activities are paused. These include oversight of research grants and contracts, some CMS contractor monitoring, and most patient admissions at the National Institutes of Health (NIH).The CDC has also warned of potential limitations in public communication.
4. Potential for Permanent Federal Job Losses: Unlike previous shutdowns, the current governance is reportedly viewing the funding lapse as an prospect to permanently reduce the size of federal agencies. The Office of Management and Budget has directed agencies to develop layoff plans targeting programs that do not align with the administration’s priorities. This move is being legally challenged by unions who argue it represents an “unlawful abuse of power” and could lead to meaningful legal battles with ramifications for the healthcare system.
sources: Politico, NBC news, The Hill, Becker’s Hospital Review.
