by Kaiser Health News | Updated on 1.3.19
There seems to be no end in sight for the current partial government shutdown, the third since the beginning of the Trump administration.
For the vast majority of the federal government’s public health efforts, though, it’s business as usual.
That’s because Congress has already passed five of its major appropriations bills, funding about three-fourths of the federal government, including the Department of Health and Human Services and the Department of Veterans Affairs.
But seven bills are outstanding — including those that fund the Interior, Agriculture and Justice departments — and that puts the squeeze on some important health-related initiatives.
The shutdown itself is not about health policies. It’s the result of differences of opinion between the administration and congressional Democrats regarding Trump’s so-called border wall. But it’s far-reaching, nonetheless. Here’s where things stand:
Funding for “big-ticket” health programs is already in place, alleviating much of the shutdown’s immediate potential impact.
Since HHS funding is set through September, the flagship government health care programs — think Obamacare, Medicare and Medicaid — are insulated.
That’s also true of public health surveillance, like tracking the flu virus, a responsibility of the Centers for Disease Control and Prevention. The National Institutes of Health, which oversees major biomedical research, is also fine. It’s a stark contrast to last January’s shutdown, which sent home about half of HHS’s staff.
But some other public health operations are vulnerable because of complicated funding streams.
Although the Food and Drug Administration falls under the HHS umbrella, it receives significant funding for its food safety operations through the Department of Agriculture, which is entirely caught up in the shutdown.
The USDA provided an estimated $2.9 billion last year to the FDA for these oversight efforts, which involve everything from food recalls to routine facility inspections and cosmetics regulation. Not having those dollars now means, according to the FDA contingency plan, that about 40 percent of the agency — thousands of government workers — is furloughed.
The FDA’s responsibilities for drug approval and oversight are funded by user fees and are not affected. Regulation of tobacco products is also continuing.
Health services for Native Americans are also on hold.
Because Congress has yet to approve funding for the Indian Health Service, which is run by HHS but gets its money through the Department of the Interior, IHS feels the full weight of the shutdown. The only services that can continue are those that meet “immediate needs of the patients, medical staff, and medical facilities,” according to the shutdown contingency plan.
That includes IHS-run clinics, which provide direct health care to tribes around the country. These facilities are open, and many staffers are reporting to work because they are deemed “excepted,” said Jennifer Buschik, an agency spokeswoman. But they will not be paid until Congress and the administration reach a deal.
Other IHS programs are taking a more direct hit. For example, the agency has suspended grants that support tribal health programs, as well as preventive health clinics run by the Office of Urban Indian Health Programs.
Public health efforts by Homeland Security and the EPA face serious constraints.
The Department of Homeland Security’s Office of Health Affairs assesses threats posed by infectious diseases, pandemics and biological and chemical attacks. It is supposed to be scaling back, according to the department’s shutdown contingency plan. This office is just one component of the 204-person Countering Weapons of Mass Destruction Office, which is retaining about 65 employees during the funding gap.
Other DHS health workers are likely to work without pay — for instance, health inspectors at the border, said Peter Boogaard, who was an agency spokesman under the Obama administration. According to DHS’s plan, the vast majority of border patrol employees will continue working through the shutdown.
The Environmental Protection Agency has also run out of funding. According to its contingency plan, it’s keeping on more than 700 employees without pay, including those who work on Superfund sites or other activities where the “threat to life or property is imminent.” (More than 13,000 EPA workers have been furloughed.)
That limits the agency’s capacity for activities including inspecting water that people drink and regulating pesticides.
But it’s not just regulation. The public health stakes are visceral — and sometimes, frankly, pretty gross.
Just look at the National Park Service, which has halted restroom maintenance and trash service for lack of funding. On Sunday, Yosemite National Park in California closed its campgrounds. On Wednesday, Joshua Tree National Park, also in California, did the same.
Why? Per a park service press release: “The park is being forced to take this action for health and safety concerns as vault toilets reach capacity.”
Written by Kaiser Health News
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Just because it hasn’t affected me doesn’t mean it’s fine by me. I read today that low-income parents who qualify for WIC could be impacted if this shutdown continues. And WIC recipients include young families in our armed forces.
Zero effect. Now fund the wall.
My ten year old grandson is diabetic. Under the Affordable Care Act, his parents were allowed some help with grossly overpriced costs of having a child with this disease. Please support this act and tell the POTUS that real American families are struggling with extreme medical costs. The wall he wants money for would be better spent helping these families. NO WALL. Money to help with outrageous medical fees would be something that would be of true value to the American people.
👿 Schumer / Democratic Governmental Shutdown 👿 My HeathCare programs have not been impacted by the Schumer / Democratic Governmental Shutdown....... SneakyPete......... 🙀👍🏻👍🏻👍🏻🙀. 1*3*19.........
Trump is holding American government hostage unless taxpayers fund his monstrously useless monument.
NOT ONE RED CENT FOR TRUMPS RIDICULOUS WALL!!!
No, I don’t have a health program, obama took that away from me years ago.
I'm taking bets on how many of you are lying. I've felt no effect at all. #BuildTheWall #SchumerShutdown
It will hurt the students I teach and members of my community. Healthcare in this country is broke. I have adequate healthcare coverage but it has gotten progressively worse for the past 19 years. This is NOT a democratic or republican issue but a humanitarian issue. Insurance companies have no oversight, that’s the problem.
Absolutely not, why would it!
It would be good if these shutdowns affected every single family so everyone would know what it feels like to be neglected and overlooked. I'm still trying to figure out what making america great again means. My guess is that it depends on whether you feel you don't have what you think you deserve or not. I can say this for sure. Nobody wants what they deserve!
Obamacare raised my premodern $350 for wife and Into $980 a month and LESS COVERAGE.
Spin off the healthcare programs as nonprofits so they can continue operating.
My family smartly opted out of Obamacare and instead moved to other means of healthcare insurance. Why would we pay $2000 a month for a family of 5 on Obamacare meant to subsidize the lazy and those who do not want to work?!?’
Now watch as the FDA shuts down and no one dies. The food industry already self-regulates to higher standards.
Once this becomes a problem for the healthcare system and the economy what will we do next to overcome the Presidents Veto?
Government should have nothing to do with healthcare whatsoever. Every government intervention has only made healthcare less efficient and less affordable.
Would affect even less if the government isn’t involved in the first place.
Kill the poor! What a bunch of schmucks. They can all go straight to Hell!
Leave it shut down we need the wall I live in Texas and I wish to hell I lived in Alaska as far away as he’s from these illegals is like a possibly get. But our tax dollars to give them free food free housing free insurance. And I drive brand new vehicles because there men work cash paying jobs and pay no taxes but somehow or another they collect taxes because they get fake Social Security numbers.