As the partial government shutdown enters its twenty-sixth day, many Americans are becoming increasingly worried about how this situation will personally affect them and their families. Despite assurances from the Trump administration that key health care agencies and services remain insulated by previously approved appropriations bills, uncertainty reigns as the political impasse appears to have no end in sight.
The system is built to weather the storm in the short term; however, as the shutdown persists and begins to enter record-breaking territory, a serious public health disaster becomes a real threat. For the time being, the Department of Health and Human Services remains adequately funded to maintain payments for Medicare services, the Affordable Care Act (ACA) and other mandatory programs. Similarly, operations carried out by the Centers for Medicare and Medicaid Services (CMS) will continue to operate as normal since the agency’s funding is assured until at least September 30, 2019.
On the other hand, unfunded agencies that perform health-related functions, most notably the Internal Revenue Service (IRS) and Treasury Department, could eventually have devastating results for millions of Americans if the shutdown drags on unchecked. Crucial accounting functions performed by the IRS to regulate ACA marketplaces, such as processing enrollee applications for federal income-based assistance, could be seriously hampered by a long-drawn-out government shutdown.
Several Democratic leaders in both the House and Senate have joined forces to caution the administration about this potential consequence. In a letter dated January 14, they expressed deep concerns that the federal government’s failure to pay the cost of Advance Premium Tax Credits could result in higher insurance premiums and coverage loss for taxpayers who receive plans through the government-run marketplaces.