With the United States federal government shutdown approaching the three-week mark, Democrats and Republicans have reached a stalemate. Negotiations to unlock about one quarter of the government have been frozen for over two weeks. The growing impact on healthcare and health programs is beginning to pile up.
When Did it Start?
This partial shutdown ignited on December 22nd, 2018 and impacts about nine federal departments. As it stretches on, it is becoming one of the longest shutdowns in history.
What About Healthcare?
According to Fierce Healthcare, “Congress has already passed five of its major appropriations bills, funding about three-fourths of the federal government, including the Department of Health and Human Services and the Department of Veterans Affairs.” Unfortunately, seven bills remain unpassed, affecting pivotal health-related initiatives. Although the shutdown itself isn’t fully related to health care, the differences of opinion within the administration puts a strain on all departments.
Will Medicaid and Medicare Continue to be Funded?
Medicaid and Medicare funding are mandatory. Alex Hecht, Steven Weiner, and Andy Shin of Mintz Levin shared last week: “If the federal government is forced to shut down as a result of a budget impasse in Congress, discretionary programs and federal employees would be the most affected, while payments for Medicare services, the Affordable Care Act (ACA), and other mandatory programs would continue, albeit at a slower rate if the government were to undergo a long term shut down.” Health and Human Services (HHS) funding to government health programs are set through September meaning, Medicaid and Medicare are completely covered and insulated.
Are any Public Health Operations Impacted?
Congress hasn’t approved any federal funding for the Indian Health Service run by HHS but receives money from the Department of Interior (IHS). The IHS is feeling the impact of the shutdown, only services that are essential to the needs of patients and medical personnel are allowed to operate. IHS-run clinics that provide healthcare around the country are open but, are not being paid. Once these funds run out, access to life-saving medicine and healthcare operations will take a turn to life or death. Modern Healthcare adds “Tribes are among the worst impacted by this shutdown because it affects the day-to-day operation of their health clinics and hospitals.” These tribes are hoping for the government to reopen as soon as possible to ensure regular order.
The Supplemental Nutrition Assistance Program (SNAP) provides food stamps to approximately forty million Americans. Popular Science reports “The program is expected to run out of money in February, and it’s unclear what cutbacks to the program might look like.” If the SNAP program is not brought back to life by February, people will start to go hungry, food insecurity will be on the rise.
According to the Department of Homeland Security’s Office of Health Affairs has been ruled to scale back during the shutdown. This poses a threat to infectious diseases, pandemics and biological and chemical attacks.
The Centers of Medicare & Medicaid will continue all Affordable Care Act (ACA) activities not limited to Medicaid and the Marketplace. During this shutdown, the U.S will be lacking discretionary funding for healthcare fraud. “Fewer recertification and initial surveys for Medicare and Medicaid providers would be completed, putting beneficiaries at risk of quality of care deficiencies.” says HHS. Depending on when the shutdown ends, CMS will continue with varied support.
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