Will the Government Shutdown Affect Our Healthcare?

I’ve ranted before and I’m going to rant again about the incompetence of our lawmakers to perform the most basic and probably the most important duty we elected them to do, fund the government so it can perform the services that we finance with our hard-earned taxes. I know how politically divided we are, I know there are two very different viewpoints on how we should proceed with both the enhanced Affordable Care Act subsidies and Medicaid cuts, the major issues that prevented passing a continuing resolution. But that doesn’t mean the lawmakers should hold the people they are sworn to serve hostage while they try to one up each other on who’s to blame or create political talking points they can use when they run for office in the upcoming midterm elections. It seems that no matter which party is in power they use this yearly funding obligation for political gain, and I think it’s deplorable. Ok, that’s enough bellyaching, let’s talk about how this government shutdown will impact you and me and our healthcare.

The guiding principle of a government shutdown is that it will only cause the furlough of non-essential personal. The formal definition of essential is anyone who’s job it is to protect life or property, is employed as directed by statute or presidential duty, like the military, or to keep essential systems operational, like information systems. Those defined as essential must go to work even though they might not get paid until the shutdown ends. There is a lot of leeway in some of these definitions so there is always confusion for workers to know if they should report to work or not. Unfortunately, the confusion will be less this time because there have been 22 shutdowns since 1976 with two in the last 12 years so we’ve had some practice on how to do this unsavory job. But there will be confusion, and it might very well have some impact on parts of our healthcare.

The good news is that the Social Security checks (or automatic deposits as most of us use) will still arrive on time and almost all of the normal healthcare services under Medicare will continue. I know that you’ve been getting the click bait notices that give you reasons to wonder about both Social Security and Medicare, but most of us won’t experience any difference unless the closure exceeds the record of 35 days. There will be some services, however, that will be affected depending on your current needs. Even if you are impacted by some of the services detailed below your provider may choose to take the chance of not getting reimbursed or at least be delayed in their payment and still provide the service.

One of the things that won’t continue is the expanded use of telehealth. The COVID pandemic sped up the effective use of telehealth and we have continued this cost-effective and time saving method of providing care. The rules expanding the use of telehealth were close to being extended but were interrupted by the government shutdown. Since the rules expired on September 30th, the use of telehealth has been greatly diminished. Audio only physical therapy, speech therapy and psychological care will no longer be reimbursed or at least delayed if it’s finally passed and the reimbursement is grandfathered back to October 1st. It just seems crazy that a manner of care that has been proven over the last few years to be effective, saves money and time and has garnered bipartisan approval could be stopped by the political posturing that caused the government shutdown.

Another treatment option that has been stopped is the Acute Hospital Care at Home initiative. This was another example of an effective money saving treatment that let Medicare patients leave the hospital quicker because they could receive high-level hospital care at home. With the advancement in electronics and wearable monitoring devices we are finding more and more ways to reduce the need for the very expensive in-hospital care. It’s a shame that this stoppage has even temporarily put a stop to this initiative. Since many senior programs like Meals on Wheels, senior transportation, and aging-in-place grants often rely on discretionary funding, which is frozen, they could be affected too. Unfortunately, many of these service reductions will be in rural and underserved communities.

Another part of Medicare will see reductions in services. While Medicare itself continues, regional offices and support hotlines are closed, which may delay:

·       New claims processing

·       Appeals and reconsiderations

·       Help with billing errors or coverage questions

You will probably see the wait time drastically increase on any help or informational calls you make to Medicare service lines.

I’m always interested in how things affect the care of military veterans. Their normal care will continue but there will be big reduction in the staffing at regional offices with some offices closing. New applications for disability benefits or the processing of an appeal to a disability denial will definitely be delayed.

Since I live out west, I have heard a lot about how the shutdown will affect National Parks. They have already been impacted by the government’s reductions in force and the shutdown has further reduced the ability to service National Parks. There have already been reports of damage and the lack of proper monitoring of property. While this is not directly related to healthcare, seniors are big users of National Parks and will be disappointed if long term damages are the result of the shutdown.

While a relatively short shutdown may not affect most of us directly, several essential services are already feeling the strain—and the longer it lasts, the more widespread the impact will become. We all need to tell our lawmakers that nobody wins when they choose to ignore the most basic of duties and play political brinkmanship. It accomplishes nothing and threatens the services that we need and deserve.

Best, Thair