What a Government Shutdown Means for Your Health Care

Here’s why you’ve been hearing about a possible government shutdown next week: Keeping the U.S. government running requires Congress to authorize spending by September 30 of each year, since the federal government’s fiscal year begins on October 1. So far, though, Congress has not been able to agree on spending levels for federal agencies for fiscal year 2024. If no agreement occurs by September 30, the government will shut down all but essential services, ranging from air traffic controllers to staffers at the Centers for Disease Control and Prevention (CDC) who monitor for disease outbreaks.  

The longest U.S. government shutdown was in 2018–2019 and lasted 35 days, though Congress had already approved the budget of the Department of Health and Human Services (HHS), which runs agencies like the CDC and FDA.

That’s not the case this time, which means all HHS agencies will be subject to a contingency plan the department has drawn up. According to the plan, essential health work will continue, like responding to health emergencies including drug or device recalls, checking medical imports to the U.S., alleviating drug shortages, and dealing with outbreaks of foodborne illness. But several important health services—especially local ones—could fall by the wayside.

“Health departments may choose not to hire new and needed employees, at least for now, because their budgets have not been set and they don’t know if they will have the funding going forward,” Adriane Casalotti, chief of government and public affairs for the National Association of County and City Health Officials, which represents local health departments, told Verywell.

Here’s what a shutdown could mean for services like health care, health insurance, and vaccines.

What Does a Shutdown Means for Healthcare Services?

In the event of a shutdown, what’s locally available in terms of health services will vary by community, Bobby Kogan, senior director of Federal Budget Policy at the Center for American Progress, a think tank in Washington, DC, told Verywell.

That’s because a large part of the funding for community health centers, which offer things like free and reduced-fee checkups, comes from the federal government. Funds are allocated based on several factors, including how many people a center serves.

Kogan said some centers might have enough money on hand to keep the clinics open for a while while other clinics might have to pause some services. 

WIC program benefits (supplemental nutrition for women, infants, and children) are offered by local health departments and will cease in the event of a shutdown.

Veterans Health Administration hospitals will remain open and fully staffed.

What About Vaccines?

A portion of the COVID vaccines offered at community health centers are now paid for by a CDC program called Bridge Access—a program that will also fund vaccines for the underinsured or uninsured at pharmacies and doctors’ offices.

Money for COVID vaccines under Bridge Access has already been allocated, so the vaccines themselves will be available during a shutdown, Georges Benjamin, MD, executive director of the American Public Health Association, told Verywell. But some community health centers might not have the funding to keep enough people trained to administer the shots on staff during a shutdown. 

The shutdown won’t affect any free vaccines from the Bridge Access program available at doctors’ offices and pharmacies because they don’t rely on federal funding for staffing.

Casalotti thinks a shutdown could have an impact on people getting vaccines of all kinds, including flu and RSV shots.

“Local health department staff help drive vaccine uptake by reaching out to providers to make sure they have the information they need, by answering consumer questions when they call, and providing access to those hardest to reach,” she said.

What Does a Shutdown Mean for Medicare and Medicaid? 

The federal workers at the Centers for Medicare and Medicaid Services (CMS) tasked with making Medicaid and CHIP payments to states will continue to work, and dollars will continue to flow to states in the event of a shutdown. Existing programs will continue, but any applications for new programs or reviews of Medicaid programs by CMS staff would be on hold. 

According to the Bipartisan Policy Center, Medicare and Social Security have permanent funding, so recipients will still get their checks during a shutdown. But it’s quite possible that there won’t be staff during the shutdown to replace Medicare or Social Security cards that get lost, Benjamin said.

AARP has reported that people will be able to enroll in Medicare during a shutdown, that the Medicare hotline (800-633-4227) will continue to operate, and that the organization expects Medicare’s annual open enrollment to begin on October 15 as scheduled, even if there is a shutdown.

What Does a Shutdown Mean for Various Health Inspections?

Most inspections of drinking water facilities and hazardous waste sites by the Environmental Protection Agency (EPA) will be paused during a shutdown since the EPA’s staff will be furloughed.

At the same time, the FDA will stop routine inspections of low-risk foods, such as packaged cookies and crackers.

Workplace safety inspections made by the Occupational Safety and Hazard Administration (OSHA) will be limited.

There’s no telling how long a shutdown will last. According to the Bipartisan Policy Center, there have been 14 shutdowns since 1980, and 11 of those lasted less than a week. The other three were longer than two weeks, and the most recent shutdown, in 2018–2019, lasted over a month.