This would mark the first time since 2013 the Department of Health and Human Services (HHS) would be impacted by a government shutdown. That shutdown lasted just more than two weeks.

The most recent shutdown, in 2018, only affected part of the government, and most HHS appropriations bills had already been passed by that point. 

The context:

• Compared to other sectors, HHS and federal health programs aren’t going to be hit the hardest by a shutdown.
  
  
• Medicare and Social Security are mandatory entitlement programs funded by taxes and premiums, so they aren’t dependent on Congress. That means benefits will continue as normal.
  
  
• However, administrative actions like benefit verifications and issuing replacement Medicare cards will be paused for the duration of the shutdown. 

In a contingency planning document updated last week, HHS said its COVID-19 response will continue, as will clinical research. The Food and Drug Administration will also continue drug and medical device reviews, because those are funded by industry-paid user fees. 

HHS said it will “continue to protect human life and property,” such as monitoring for disease outbreaks, managing high-risk recalls and drug shortages. The agency is also responsible for caring for patients in the hospital onsite at the National Institutes of Health, though it will only be able to admit “medically necessary” patients.

The Centers for Disease Control and Prevention will continue working on outbreak response, laboratory functions, the President’s Emergency Plan for AIDS Relief and emergency operations. However, PEPFAR faces a separate threat, as some of the law’s authorization is set to expire on Saturday, and a disagreement over abortion is putting that in jeopardy.

A shutdown would hit federal workers the hardest. HHS said 42 percent of the agency’s employees — more than 37,000 people— would be furloughed without pay beginning on the second day of a funding lapse. 

The remaining 58 percent of staff are considered “excepted” and will have to work unpaid for the duration of the shutdown.

Doctors and hospitals could continue to submit bills to Medicare and get paid, but the staff shortage could result in reimbursement delays. 

Without a stopgap bill to essentially keep the lights on, government funding is set to lapse on Sept. 30 at 11:59 p.m.