Government Shuts Down, Impacts Healthcare Initiatives
On Tuesday, October 1, the new fiscal year began—but without a federal budget agreed upon by both the US Senate and House of Representatives, the government shutdown at 12:01 a.m. Many Americans, including healthcare professionals, were left asking “How did we get here?” and “What does this mean for me?”
Impact of the Shutdown
The Department of Health and Human Services (HHS) has created a document outlining what services will and will not be affected during the government shutdown. Though services closely related to health information management and healthcare like Medicare payments and Veterans Affairs medical centers will not be impacted, the shutdown does impact Americans as a whole in various ways and also impacts ongoing healthcare-related initiatives.
For example, the Office of the National Coordinator for Health IT will be unable to continue the Standards and Interoperability Framework activities as well as related standards and testing activities. Policy activities such as privacy, security, and clinical quality measure development, and the administration of the Certified Health IT Product List, would also stop.
The Food and Drug Administration (FDA) will be unable to support the majority of its food safety, nutrition, and cosmetics activities, according to HHS. The FDA will also have to cease safety activities such as routine establishment inspections, some compliance and enforcement activities, monitoring of imports, and notification programs.
The Centers for Medicare and Medicaid Services (CMS) would be unable to continue discretionary funding for healthcare fraud and abuse strike force teams resulting in the cessation of their operations. Fewer recertification and initial surveys for Medicare and Medicaid providers would be completed, putting beneficiaries at risk of quality of care deficiencies.
An estimated 800,000 federal employees have been furloughed as a result of the break down in budget negotiations that lead to the shutdown. Some employees are exempt from the current shutdown and limited services are still being provided. Services that will continue during the shutdown include, but are not limited to:
- Provider payments for Medicare and Medicaid claims
- Social Security payments to beneficiaries
- Healthcare exchanges
- Law enforcement and 911 services
- US Postal Services
- Most services provided by the Department of Veterans Affairs
- Military service members will continue to be paid; Department of Defense civilian employees will be furloughed
- Passport services
What Led to the Shutdown
Historically, the US Senate and House of Representatives (House) consider 12 annual appropriations bills to fund the federal government by the start of the fiscal year. Both chambers of congress must agree on the same legislative language in the bills before they are sent to the President to be signed into law.
If congress does not pass the bills individually, an Omnibus appropriations bill can also be used to fund the federal government for the upcoming fiscal year. If congress does not pass appropriations bills individually or through an Omnibus, then a Continuing Resolution (CR) can be used to continue funding the federal government temporarily.
The 113th Congress is currently debating the terms of a CR to fund the federal government for fiscal year 2014. Without an agreed upon appropriations measure, the government effectively shut down on October 1.
Members of congress are debating over the implementation of the Affordable Care Act (ACA). The House version of the CR delays the individual mandate of the ACA for one year. In addition, it would also roll back the Medical Device Tax which is used to fund the ACA implementation. The US Senate has rejected these changes to the CR. This debate resulted in a standoff which ultimately caused the first government shutdown in 17 years.
The House is currently considering three bills that would re-open parts of the federal government. These bills would impact the National Park Service, Department of Veterans Affairs, and the District of Columbia.
Speak Your Mind
To contact your US Senator and US Representative to discuss the government shutdown, visit AHIMA’s Advocacy Assistant at http://www.ahima.org/about/advocacy.
The AHIMA Advocacy and Policy Team (firstname.lastname@example.org) is based in Washington, DC.