{"id":51127,"date":"2025-10-02T11:35:09","date_gmt":"2025-10-02T11:35:09","guid":{"rendered":"https:\/\/www.newsbeep.com\/il\/51127\/"},"modified":"2025-10-02T11:35:09","modified_gmt":"2025-10-02T11:35:09","slug":"what-the-shutdown-means-for-medicare-medicaid-and-other-health-programs","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/il\/51127\/","title":{"rendered":"What the shutdown means for Medicare, Medicaid and other health programs"},"content":{"rendered":"

Your Medicare, Medicaid or Affordable Care Act coverage<\/a> won\u2019t vanish during the government shutdown<\/a>, but changes to some benefits and fewer government workers to help could still disrupt care for millions.<\/p>\n

At the heart of the shutdown fight is whether Republican leaders accept a demand from Democrats to extend Obamacare subsidies<\/a> before they expire at the end of the year and premiums start skyrocketing. Democrats also sought to undo President Donald Trump\u2019s Medicaid cuts, but the GOP has shown no interest.<\/p>\n

Fortunately for everyday people, core programs like Medicare and Medicaid will keep running because their funding is built into law. But a popular Medicare benefit \u2014 telehealth \u2014 has already ended for many, and so-called discretionary programs, such as Community Health Centers (CHCs), may be at risk unless Congress acts soon.<\/p>\n

More than 167 million people \u2014 roughly half the U.S. population, according to data from the Centers for Medicare & Medicaid Services \u2014 are covered by the programs.<\/p>\n

Here\u2019s what the shutdown means for health care coverage:<\/p>\n

Medicare and telehealth <\/p>\n

One of the first casualties of the shutdown are telehealth services offered to people on Medicare. A pandemic-era rule that let Medicare patients see doctors from home \u2014 not just rural clinics \u2014 and expanded which providers were covered expired Tuesday, cutting off access to many homebound seniors. The service will remain expired unless Congress includes funding in a coming spending bill. <\/p>\n

That means telehealth coverage will revert to pre-pandemic rules, under which it was largely limited to people living in rural areas, said Alex Cottrill, a senior policy analyst at KFF, a nonpartisan health policy research group. The policy had a few exceptions, which allowed coverage for people on home dialysis or those who experienced strokes.<\/p>\n

More than 6.7 million older adults got care through telehealth services last year.<\/p>\n

Joseph Furtado, the president of the Arizona Association for Home Care, which advocates for telehealth, said he will continue to see patients for now, with the risk of not getting reimbursed if Congress decides not to extend funding. Other providers may not take that risk and turn patients away, he said.<\/p>\n

\u201cTelehealth is not a convenience thing,\u201d he said. \u201cThis is Grandma can\u2019t get out of the house. This is Grandma just came home from the hospital and she can\u2019t get out to see her doctor. You don\u2019t want to go to the doctor when you come home, and it\u2019s dangerous sometimes to do that.\u201d <\/p>\n

In the near term, Medicare coverage more broadly will continue during the shutdown, meaning patients will be able to see their doctors and other health care providers \u2014 albeit most likely in person, Cottrill said. <\/p>\n

\u201cBecause Medicare is categorized as a mandatory program, its funding doesn\u2019t require annual approval from Congress, and Medicare-covered services will still be available during the shutdown,\u201d he said.<\/p>\n

Patients may have longer wait times when they call Medicare, Cottrill said, and providers might experience some delays in payments due to some agency workers\u2019 being furloughed.<\/p>\n

Medicaid<\/p>\n

Coverage for people enrolled in Medicaid \u2014 which is jointly funded by states and the federal government \u2014 will also continue throughout the rest of this year and some of next year, according to CMS.<\/p>\n

In a statement on its website<\/a>, CMS said it \u201cwill have sufficient funding for Medicaid to fund the first quarter of FY [fiscal year] 2026.\u201d<\/p>\n

Art Caplan, the head of the Division of Medical Ethics at NYU Langone Medical Center in New York City, said it\u2019s very likely that the agency will get additional funding by then.<\/p>\n

It\u2019s slim chances the shutdown \u201cwould last that long,\u201d he said. <\/p>\n

Coverage for the Children\u2019s Health Insurance Program \u2014 which provides health care coverage to children and pregnant women in families that earn too much money to qualify for Medicaid \u2014 will also remain. <\/p>\n

\u201cCMS will maintain the staff necessary to make payments to eligible states for the Children\u2019s Health Insurance Program (CHIP),\u201d the agency said. <\/p>\n

Obamacare subsidies<\/p>\n

People will still be able to get coverage through their ACA plans, too. <\/p>\n

But there could be consequences, Caplan said, if Congress decides not to extend the ACA enhanced subsidies in the coming bill, the sticking point for Democrats who want to see the subsidies continue.<\/p>\n

The enhanced subsidies<\/a> were enacted in the 2021 American Rescue Plan, which made ACA plans affordable for many middle-class families. The Inflation Reduction Act of 2022<\/a> extended the subsidies through 2025. Without the subsidies, out-of-pocket premiums could grow by as much as 114% next year, according to a KFF analysis<\/a>.<\/p>\n

When ACA open enrollment begins Nov. 1, families could face sticker shock<\/a>, Caplan said. And even if Congress restores the subsidies later in the year, some people may decide not to sign up, believing costs will stay high. <\/p>\n

\u201cIf they don\u2019t do something in 30 days, people are going to see big jumps in their health insurance,\u201d Caplan said.<\/p>\n

There could be a major political risk to Republicans and Trump if they don\u2019t extend them, he added.<\/p>\n

\u201cThese are not people desperately poor. These are often people who are in the working class, who use the subsidy to get access to health care when it doesn\u2019t come through their job,\u201d he said. \u201cI think they\u2019ve been somewhat supportive of Trump and MAGA, and they will not be happy to see that jump.\u201d<\/p>\n

Local health clinics <\/p>\n

The effects on public health will be \u201csubstantial\u201d if the shutdown lasts several weeks, said Lawrence Gostin, director of the O\u2019Neill Institute for National and Global Health Law at Georgetown University.<\/p>\n

\u201cMany functions of CDC will be affected, such as disease surveillance and funding for states and local health departments,\u201d Gostin said. The Centers for Disease Control and Prevention provides support for tracking respiratory diseases, like Covid and the flu, and provides grants to states, including for chronic disease prevention and vaccine programs. <\/p>\n

Funding for federal qualified health centers has already expired with the shutdown. But the clinics are unlikely to be affected, at least for the time being, according to the National Association of Community Health Centers.<\/p>\n

Those centers \u201cshould not experience an immediate disruption in funding,\u201d Amy Simmons, an NACHC spokeswoman, wrote in an email. Simmons said the group has been in contact with the Health Resources and Services Administration, where officials said there is enough money set aside \u201cto maintain CHC operations and staffing while government services are paused.\u201d <\/p>\n

The number of people seeking care at community health centers has reached its highest in decades, Simmons said, at up to 52 million.<\/p>\n

Emergency services such as those provided by the Federal Emergency Management Agency may be reduced or delayed, Gostin said, as well as funds for ongoing and new biomedical research.<\/p>\n

\u201cThe longer the shutdown goes on, the greater the risks to public health,\u201d he said. \u201cThe shutdown has lifesaving impacts on America\u2019s most vulnerable citizens.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Your Medicare, Medicaid or Affordable Care Act coverage won\u2019t vanish during the government shutdown, but changes to some…\n","protected":false},"author":2,"featured_media":51128,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[163,521,85,46],"class_list":["post-51127","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-health","tag-healthcare","tag-il","tag-israel"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/51127","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=51127"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/51127\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/51128"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=51127"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=51127"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=51127"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}