Donna LeValley
Yet again the clock is ticking for lawmakers to lay down their swords and come to an agreement on funding the federal government to avert a shutdown. If they fail, a government shutdown could affect you as many agencies, departments and services would be interrupted until the government reopens, Medicare is one of the many areas that would be affected by a government shutdown.
Some agencies — including the Centers for Medicare and Medicaid (CMS) — would continue to provide essential services, albeit with a reduced staff. That means that in the event of a funding lapse, Medicare, as well as Medicaid programs and services would continue, according to the latest CMS contingency plan.
Medicare and Medicaid — essential services
The government categorizes Medicare and Medicaid, along with Social Security as mandatory programs that are funded by existing laws, so they do not require an annual vote by Congress to keep running. This is separate from the many other agencies and departments that are currently at risk of being shut down if Congress fails to pass the bills that would keep them funded.
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The upshot is that, under CMS, you would continue to receive Medicare even if a shutdown occurs. Social Security checks, too, would not be affected by a government shutdown.
According to the Health and Human Services (HHS) contingency plan, Medicaid has sufficient funding for the first quarter of FY 2025.
Other CMS programs that would continue include the Health Care Fraud and Abuse Control and the Center for Medicare & Medicaid Innovation services. CMS would also maintain the necessary staff to continue making payments to states that administer Children's Health Insurance Program (CHIP) coverage.
Other activities that would continue include the National Institutes of Health Clinical Center’s patient care and admittance of new patients, if medically necessary, as well as the Food and Drug Administration’s (FDA) maintenance of core emergency functions such as monitoring for, and responding to, foodborne illness and flu outbreaks, HHS said.
Medicare and Medicaid — what would be impacted
About 49% of CMS staff would be furloughed and certain services would be paused during a shutdown. This could lead to longer wait times to speak with a CMS representative during a shutdown.
You would also need to wait till the government reopened to replace your Medicare card. The Social Security Administration, which administers Medicare cards, said it would continue certain activities — including those related to timely payments of benefits — but that it would pause the replacement of Medicare cards among other services.
At HHS overall, about 45% of staff would be furloughed, but those working on specific operations that have substantial direct-service components would be retained. This would include a limited number of employees to support funded activities, such as Medicare, Medicaid and other mandatory health program payments, HHS said.
Agencies are required to provide contingency plans in the event of a federal shutdown. You may find links to agency contingency plans at the Office of Management and Budget.
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