At the time of this writing, the government shutdown is in its fourth week. This affects military service members, TSA agents, air traffic control, sensitive enforcement operations and those dependent on food assistance—among many other services. And let’s not forget what this shutdown is doing to the healthcare system.
The Centers for Medicare and Medicaid Services (CMS) is directly affected by the current Congressional impasse. Despite this, there has been conflicting messages coming out of this agency, with the latest advisory indicating that the shutdown will not affect claims management and payment. We’ll see how long they can keep this up before the money dries up completely. And then there are other operations, such as national disease surveillance efforts that are facing cessation—just in time for the flu and virus season.
According to a recent article in Becker’s Hospital Review, there are three things to know about how the Congressional budgetary shutdown is affecting those in the healthcare space:
- Funding delays are now directly affecting large swaths of the healthcare workforce and related support systems. More than one million civilian federal employees and military personnel—including those at the Department of Health and Human Services (HHS) and the Department of Veterans Affairs—are now working without paychecks. The first round of these holds on wages was October 24, with more to follow by Oct. 30. This is according to a report by the Bipartisan Policy Center. If the shutdown stretches into December, an estimated 4.5 million paychecks totaling $21 billion in lost wages will be withheld.
- In a notable reversal, CMS recalled all furloughed employees on October 27 to support Medicare and ACA Marketplace open enrollment efforts. Nearly half of the agency’s 7,700-person workforce had been furloughed since October 1. To fund the move, the agency is drawing on user fees collected from researchers accessing CMS data, with plans to reimburse the account once appropriations resume. According to Beckers, the decision comes amid mounting pressure to stabilize key healthcare functions as disruptions and delays in telehealth reimbursement and hospital-at-home programs continue to ripple across the system.
- In the 2024-25 respiratory virus season, the CDC confirmed 70 human cases of bird flu and one death during an outbreak spanning millions of poultry animals, dairy cows and wild birds. This virus season (2025-26) has not recorded a human case so far, but the U.S. Department of Agriculture has confirmed increasing avian flu illnesses among commercial and backyard flocks, as well as wild birds, since the summer.
And let’s not forget other consequences of the shutdown. You’ll recall that the Medicare telehealth flexibilities ended with the shutdown, meaning that telehealth services are now limited to rural areas (as they were before the COVID public health emergency) and that patients can no longer receive telehealth services in their homes. In addition, the ability to provide audio-only services to Medicare patients lapsed, as did the Acute Hospital Care at Home program. There are some exceptions when it comes to mental health or substance use disorders, as well as certain Medicare Shared Savings Program accountable care organizations (ACOs).
We will have to keep our fingers crossed and trust that some faction in Congress comes to their senses soon and undertakes moves for a restoration of the smooth and orderly operation of the federal government. The welfare of many hospitals, physicians and patients hangs in the balance.