Will Your Health Be Affected By A Government Shutdown?

While most federal agencies appear to be prepared, the longer a shutdown lasts, the greater the uncertainty for the public’s health.

With funding for the federal government expiring on Saturday, it appears we’re headed for a shutdown. Congressional leaders are battling the clock but don’t seem to be close to an agreement on moving forward. You might be wondering how this will affect public health. While most federal agencies appear to be prepared, those most vulnerable—the 7 million women and children who rely on WIC, the Special Supplemental Nutrition Program for Women, Infants and Children—could lose access to meals within a week of the shutdown. And the longer it lasts, the more uncertainty there will be. Let’s review what we know with regard to the short term.

• WIC is at risk because it relies on a very small federal contingency fund and limited state funding. The 40 million people who rely on food stamps or SNAP—the Supplemental Nutrition Assistance Program—probably have a month of cushion, but there will be uncertainty past that point.
• Medicare, for the more 60 million Americans who rely on it, will keep running, though it may take a bit longer to speak to a representative during a shutdown. Similarly, Medicaid will continue at least through the end of the year. States will receive money to administer the Children’s Health Insurance Program, and the Centers for Medicare and Medicaid Services will continue to support the federal exchanges created through the Affordable Care Act. In sum, people will retain their health insurance from the government.
• The Centers for Disease Control and Prevention will keep tracking diseases, responding to outbreaks and, along with the Food and Drug Administration, investigating foodborne outbreaks. Regular food inspections of meat and poultry will continue, but other food facility inspections may be delayed. Both CDC and FDA will keep monitoring and responding to flu and Covid-19.
• Medical research funded through the National Institutes of Health will continue, and the NIH Clinical Center will remain open, but new clinical trials for medical treatments may be paused. FDA will keep evaluating the safety and efficacy of drugs and devices while responding to instances of counterfeit products and addressing drug shortages.
• The Department of Veterans Affairs, Department of Defense health care facilities and Indian Health Services sites will keep providing health care services. Unfortunately, federally qualified health centers, where 30 million Americans receive their care, will see the bulk of their funding expire. While these centers may be able to stay afloat for a limited time, a lack of new funding will put staffing and services at risk.
• Other programs that will continue through carryover funding include the Ryan White program serving individuals with HIV/AIDS and critical behavioral health programs such as the 988 Suicide and Crisis Lifeline, which connects people in crisis with life-saving resources.

If a shutdown happens, it’s anyone’s guess as to how long it would last. The 2018 shutdown lasted 34 days, whereas the 2013 shutdown lasted 16. Hopefully, reasonable minds will prevail and government funding will resume in a short enough timeframe that the health of Americans will not suffer.

At the very least, the list above is a reminder about what government does to protect Americans’ health on a daily basis. Given some of the bluster we hear these days about abolishing entire federal agencies, this is an important counternarrative: Government does really serve the people, especially those most vulnerable.