Hospitals, health groups demand end to shutdown: ‘The situation is worsening’

As the government shutdown approaches 40 days, hospitals and healthcare organizations are growing more restless and urging Congress to end the stalemate.

Trade groups representing hospitals and other providers have implored congressional leaders to end the shutdown, and they are pressing lawmakers to sign off on extending tax credits for the Affordable Care Act. The tax credits expire at the end of the year, and many Americans have already gone into open enrollment for health insurance. Without the tax credits, millions may be unable to afford health insurance, with premiums rising sharply this year.

The shutdown has disrupted telehealth and hospital-at-home programs, due to the expiration of Medicare waivers for those programs.

Sister Mary Haddad, president and CEO of the Catholic Health Association of the United States, sent a letter to House and Senate leaders this week asking them to resolve the dispute and preserve the Affordable Care Act tax credits.

“I urge you to work together to end the government shutdown and come together to fund programs that protect the vulnerable, strengthen the social safety net, and advance critical health priorities - such as maintaining access to telehealth, addressing the Medicaid disproportionate share hospital (DSH) cuts and extending vital health care tax credits that keep health insurance affordable for individuals and families,” Haddad wrote in the letter.

Democrats have insisted they won’t sign off on a spending bill to fund the government without an extension of the Affordable Care Act tax credits. Republicans and President Trump have told Democrats to approve a spending bill first, and then they can address the tax credits. After the GOP and Trump pushed a tax package that is projected to lead to steep cuts in Medicaid, Democrats say the Affordable Care Act tax credits must be part of any spending package.

The shutdown has prevented Medicare beneficiaries from accessing some telehealth programs. In addition, the Centers for Medicare and Medicaid Services has directed health systems running hospital-at-home programs to transfer those patients to brick-and-mortar facilities or discharge them. Nationwide, 147 health systems, and a total of 419 hospitals, are approved to provide acute care at home, according to federal data.

Kyle Zebley, senior vice president of public policy for the American Telemedicine Association, said the shutdown has caused real harm to patients and health systems offering virtual care and hospital-at-home programs.

“Despite broad bipartisan support for telehealth, patients and providers are being severely impacted by the lapse of Medicare telehealth flexibilities and the Acute Hospital Care at Home program — and the situation is worsening by the day,” Zebley said in a statement this week.

The Federation of American Hospitals, which represents for-profit hospitals, is calling attention to the number of Republican lawmakers that have indicated they would support extending tax credits for the Affordable Care Act.

“Millions of hardworking American families are waiting for Congress to act and extend the health care tax credits, but Congress remains at a stalemate,” the federation said in a statement. “It doesn't have to be this way: there is bipartisan agreement among key lawmakers - extending the health care tax credits is critical, and it must be done soon to avoid massive price hikes for their constituents.”

Healthcare groups say without an extension of the tax credits for the Affordable Care Act, millions will end up going without insurance. For 2026, if the enhanced tax credits lapse, KFF has estimated that those looking to enroll on the marketplace will see premiums rise by 114%, on average.

Those higher premiums would affect 22 million Americans, Haddad notes.

“Now is the time to set aside partisan and personal differences and come together to prioritize the American people by reopening the government and protecting the health and social safety net for those in need,” Haddad wrote in the CHA letter to legislative leaders.

Hospitals are pushing to preserve a Medicaid program that offers additional funding for hospitals with a high percentage of Medicaid patients. The Medicaid Disproportionate Share Hospital program provides funding to safety net hospitals, and a scheduled $8 billion cut to the program went into effect on Oct. 1. Congress has agreed to block those reductions before, and hospitals hope lawmakers will prevent the cut again.

The Catholic Health Association has also pushed Congress to end the shutdown and ensure funding for the Supplemental Nutrition Assistance Program, which helps 40 million Americans buy groceries.

Telehealth advocates are also worried about other flexibilities that are poised to expire at the end of the year, including the remote prescribing of some controlled substances. The Trump administration can extend those flexibilities, even with the shutdown, and the ATA hopes the administration will move soon.

While ending the shutdown would restore telehealth and hospital-at-home programs, advocates are looking for long-term relief. Zebley told Chief Healthcare Executive® in a recent interview that any telehealth extension is likely to last only as long as the short-term spending bill that funds the federal government.

Telehealth providers would like to see permanent reform at some point, or at least an extension that lasts in years rather than months.

“I'm hoping that we can build a case for why we need permanency, and again, if not permanency, at the very least a multi-year extension of these flexibilities,” Zebley said.