A government shutdown will have far-reaching effects for public health, including the nation's response to the current, difficult flu season. It will also disrupt some federally supported health services, experts said Friday.
In all, the Department of Health insurance and Human Services will send home – or furlough – about half of its employees, or nearly 41,000 people, according to an HHS shutdown contingency plan released Friday.
Here are some federal services and programs consumers may be curious about:
CENTERS FOR DISEASE CONTROL AND PREVENTION
According to the HHS plan, the CDC will suspend its flu-tracking program. That's bad timing, because of the country is at the height of the particularly bad flu season, said Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of drugs in Houston. With no CDC's updates, doctors could have a harder time diagnosing and treating patients quickly, he explained.
Although states will still track flu cases, “they can't call CDC to verify samples or seek their expertise,” said Dr. Thomas Frieden, who had been the director from the agency throughout the 2021 government shutdown.
A government shutdown will even modify the CDC's involvement in key decisions about next year's flu vaccine, which are scheduled to be made in coming weeks, said Dr. Arnold Monto, a professor of global public health at the University of Michigan.
Beyond influenza, the CDC will give you only “minimal support” to programs that investigate infectious-disease outbreaks. The Atlanta-based agency's ability to test suspicious pathogens and keep its 24-hour emergency operations center will be “significantly reduced,” according to the plan.
That could prevent the CDC from identifying clusters of symptoms and disease “that are the earliest indicators of outbreaks,” Frieden said.
NATIONAL INSTITUTES OF HEALTH
Although the NIH will continue to deal with patients at its clinical center in Bethesda, Md., the company won't enroll new patients in numerous studies – which many people with life-threatening illnesses see his or her last hope.
Beneficiaries is going to be largely unaffected by a shutdown, particularly if it is short. Patients will continue to get their insurance policy, and Medicare continues to process reimbursement payments to medical providers. But those checks could be delayed if the shutdown is prolonged.
States curently have their funding for Medicaid with the second quarter, so no shortfall in coverage for enrollees or payments to providers is anticipated. Enrolling new Medicaid applicants is really a state function, to ensure that process shouldn't be affected.
States also handle a lot of the kids Medical health insurance Program (CHIP), which provides coverage for lower-income children whose families earn an excessive amount of to be eligible for a Medicaid. But federal funding for CHIP is running dry – its regular authorization expired on Oct. 1, and Congress has not agreed on a long-term funding solution. Federal officials announced Friday the staff necessary to make payments to states running low on funds will continue to work throughout a shutdown.
COMMUNITY HEALTH CENTERS
According to the HHS plan, the Health Resources and Services Administration will continue to function the country's 1,400 community health centers – clinics that provide about 27 million low-income people, providing preventive care, dentistry along with other services. It will likewise continue the Maternal, Infant and Early Childhood Home Visiting Program, which targets low-income and at-risk families with house calls and lessons for healthy parenting. That program served about 160,000 families in fiscal year 2021.
But even those programs may not be at full speed. Funding for community health centers and the home visiting program was not renewed last fall – a casualty of Congress' fight over the CHIP reauthorization – so, they're operating on left-over funds.
ACA PREMIUM SUBSIDIES
The shutdown won't affect probably the most politically charged healthcare programs, including ones developed by the Affordable Care Act. Subsidies for people who get their medical health insurance through healthcare.gov or state marketplaces will not be affected, based on HHS.
Staffing for that Department of Veterans Affairs will remain largely intact. “Even in the event that there is a shutdown, 95.5 percent of VA employees will come to operate, and most facets of VA's operations wouldn't be impacted,” said department press secretary Curtis Cashour in an email.
More than 99 % of employees from the Veterans Health Administration, which runs the care system, continues working, according to the department's contingency plan.
However, the Veterans Benefits Administration, responsible for overseeing benefits such as life insurance and disability checks, will face larger cutbacks. On the third of its employees face furlough under a government shutdown.
FOOD AND DRUG ADMINISTRATION
In the short term, the important activities that protect consumers will get done, said Jill Hartzler Warner, who had been the associate commissioner for special medical programs at the FDA throughout the 2021 shutdown.
Programs that are crucial for the general public safety will continue, as will positions paid for by user fees, including work under the Center for Cigarettes and tobacco products, according to the HHS plan.
The hundreds of staff members who conduct sample analysis and review entry of products into the U.S. will continue to work. However, routine inspections and laboratory research will cease.
Warner, who left the agency in March 2021 and today works being an industry consultant, said grants for rare-disease drug development were determined in 2021 not to be necessary and were postponed.
NUTRITION SERVICES FOR SENIORS
The Administration for Community Living won't be able to finance federal senior nutrition programs during any shutdown, based on HHS officials. However it was not immediately clear how quickly clients could be affected.
A shutdown could delay federal reimbursements to independent Meals on Wheels programs, which serve more than 2.4 million seniors nationwide, based on Colleen Psomas, a spokeswoman for Meals on Wheels America. That could force programs to grow waiting lists for meals, reduce meals or delivery days, or suspend service, she said.
The magnitude from the effect could vary through the entire shutdown and any final allocation. Some programs, however, could weather a shutdown, staffers said. In Portland, Ore., Meals on Wheel People spokeswoman Julie Piper Finley said meal delivery there'll not be suspended. That agency receives about 35 percent of its funding through the Older Americans Act, but enhances the remaining money, ensuring that services aren't disrupted.
Meanwhile, services linked to food and nutrition services for other needy populations are likely to keep operating with state partners who've funding through February and, in some instances, March, according to a Department of Agriculture spokesperson. Those programs include the Supplemental Nutrition Assistance Program, the Child Nutrition Programs and also the Special Supplemental Nutrition Program for ladies, Infants and Children.
The FDA's food safety programs will cease, based on the HHS plan, but inspections conducted by Agriculture's Food Safety and Inspection Service (FSIS) will continue.
Meat and poultry inspections are “such a vital, essential task, and also the poultry and meat inspection acts require that inspectors show up continuously,” otherwise processing plants would have to close, said Brian Ronholm, former head of FSIS who now works best for the law firm Arent Fox.