How a government shutdown would affect Medicare and Medicaid benefits

A government shutdown could wreak havoc on many federally funded programs if lawmakers cannot negotiate a spending deal by the Saturday deadline, including potential disruptions to some services provided by the Centers for Medicare & Medicaid Services.

Medicare benefits will not be affected, and Medicaid has full funding for the next three months. While the agency is partially shielded from the impending tumult, it will retain fewer than half of its employees — many unpaid — until a shutdown ends, according to the updated Health and Human Services contingency plan released Thursday.

The truncated staffing could hamper CMS’s ability to provide adequate oversight on many health benefit programs. Administrative tasks such as issuing replacement Medicare cards and benefit verification services would be temporarily halted. Hospitals and medical providers might experience delays in receiving payment from Medicare.

When asked for comment on other issues that could arise from the shutdown, CMS referred The Washington Post to the Office of Management and Budget. OMB did not immediately respond to an email seeking comment.

[Congress in crisis mode as House GOP remains divided with days to go before shutdown]

Millions of Americans depend on Medicare benefits, making any potential disruptions to the agency concerning. The last time Medicare was severely disrupted was during the 1995-1996 shutdown, when more than 10,000 Medicare applicants were temporarily turned away every day of the shutdown, according to the Committee for a Responsible Federal Budget, a nonprofit public policy organization based in Washington.

The current shutdown is looming because House Republicans and Democrats are fighting over ideological divisions about how to reduce the national debt. Ultraconservatives say the risk of a shutdown is worth it to achieve more aggressive spending cuts, even though the programs under discussion account for only a small portion of the overall budget.

Some Democrats have labeled the potential halt a “Republican shutdown” and expressed concerns that the impacts could trickle over to Social Security or Medicare benefits.

“Republicans want to totally shutdown the government and possibly risk your social security, medicare, and vets benefits while focusing their time on a lying smear campaign against Pres Biden,” Rep. Bill Pascrell Jr. (D-N.J.) wrote on X, formerly known as Twitter, Sunday.

However, since much of the operational work is done by administrative contractors, consumers are unlikely to see any hiccups, according to Jack Hoadley, a research professor at the Health Policy Institute of Georgetown University’s McCourt School of Public Policy.

“(People) should not worry about getting services from a doctor,” Hoadley said. “If they have scheduled a medical appointment, (have) an emergency or need to go to the hospital, none of that should be affected.”

The potential shutdown also would not impede Medicare drug pricing negotiations, a highly anticipated effort to assist seniors and disabled Americans in affording costly medications. Since $3 billion in funding for the negotiations was already included in the Inflation Reduction Act that President Biden signed in 2022, the money should be there to keep the negotiations afloat even if a shutdown happens.

“These are prices that aren’t going to go into effect for a couple of years, so if there were a delay for a month, I don’t think it’s going to affect it ultimately,” Hoadley said. “Somebody (will have) to work a little bit harder when things get started again.”

Republicans and Democrats have only a few more days before settling on an agreement that would avert a shutdown. Unless a deal can be reached, the government will shut down at 12:01 a.m. on Oct. 1.