Hospitals urge Congress to end government shutdown

Hospital and healthcare leaders are urging Congress to end the government shutdown.

Health systems and telehealth advocates are urging Congress to end the government shutdown and fund key health programs.

The shutdown began early Wednesday, as the spending legislation financing government programs expired Sept. 30. Lawmakers haven’t been able to come together on a compromise, and one of the key issues involves extending tax credits for the Affordable Care Act.

With the government shutdown, telehealth and hospital-at-home programs have been disrupted. With the spending bill stalled, Congress has also still yet to act on other funding streams that have been important priorities to hospitals.

Sister Mary Haddad, president and CEO of the Catholic Health Association of the United States, issued a statement Wednesday imploring hospitals to end the shutdown.

“We urge Congress to come together to fund the government for Fiscal Year 2026 and extend vital health and safety net programs that millions rely on,” Haddad said in the statement. “A government shutdown jeopardizes the health and stability of millions of families—especially those living paycheck to paycheck and communities that depend on essential services.”

With the shutdown, waivers authorizing telehealth and hospital-at-home programs have lapsed for the first time since the early days of the COVID-19 pandemic in 2020.

The Centers for Medicare & Medicaid Services have directed health systems to transfer patients getting acute care at home to their hospitals or to discharge those patients. Many seniors are affected, as they’re no longer getting Medicare coverage for telehealth programs.

Kyle Zebley, executive director of ATA Action, the advocacy arm of the American Telemedicine Association, said Congress needs to restore the waivers and ensure providers can get reimbursed.

“Most providers and hospital systems are taking calculated risks to continue care during this time, but long-term continuity depends on action by our telehealth champions in Washington to restore these flexibilities and ensure retroactive reimbursement,” Zebley said in a statement Wednesday.

“Medicare patients woke up this morning without telehealth coverage for the first time since the pandemic, five years ago,” he added. “Our healthcare services are regressing, falling woefully short for millions of patients in need.”

Nationwide, 147 health systems, and a total of 419 hospitals, are approved to provide acute care at home. Hospital-at-home programs are operating in 39 states, according to federal data.

Health systems and providers with telehealth services have been frustrated for months about the recurring stress over lawmakers extending telehealth programs. Since a two-year extension expired at the end of December, the telehealth waivers have been tied to short-term spending measures to fund the government. Providers have been seeking permanent reforms, or at least multi-year extensions to have some more predictability.

The lack of longer-term certainty has caused some hospitals to hold off on developing or expanding hospital-at-home programs, hospital leaders say.

Lawmakers remain supportive of telehealth programs, and President Trump first authorized telehealth waivers in the beginning of the COVID-19 pandemic. Zebley is calling on Trump and Congress to end the shutdown and allow programs to resume.

“We are grateful to Congress and the Administration for their continued bipartisan leadership and historic support for telehealth,” Zebley said in a statement. “Their efforts have been instrumental in expanding access to care, and we look forward to working collaboratively to immediately reinstate these vital services to ensure millions of patients can continue to receive care where and when they need it.”

Hospitals have been pressing Congress to preserve a Medicaid program that offers additional funding for hospitals with a high percentage of Medicaid patients. The Medicaid Disproportionate Share Hospital program delivers vital 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 have been urging lawmakers to block those cuts.

Health systems have also pressed Congress to retain two Medicare programs supporting rural hospitals: the Medicare-dependent Hospitals and Low-volume Adjustment programs. Those programs expired on Sept. 30. Congress has also kept those programs afloat in the past, and hospitals are hoping a new spending deal makes provisions for those programs.

Democrats have been holding firm on rejecting any spending package that doesn’t extend tax credits that help Americans pay for the Affordable Care Act. Health systems say millions of Americans may lose coverage without those tax credits. The tax credits are slated to expire at the end of the year.

Lawmakers and healthcare advocates say the tax credits are vital, especially with health insurance plans projecting substantial increases next year.

Republicans and President Trump have told Democrats to sign off on a spending bill, and said they could address the tax credits in separate legislation. Democrats have said the tax credits need to be part of a deal to end the shutdown. Healthcare groups have said the tax credits need to be preserved as soon as possible, since many Americans enroll in health insurance plans in the fall.

Haddad says lawmakers need to get together.

“We encourage lawmakers to swiftly work together to end the shutdown and preserve critical health programs,” Haddad said. “This includes extending essential telehealth flexibilities, preventing harmful Medicaid cuts to safety net hospitals, addressing the disproportionate burden of payments carried by hospitals serving underserved communities, and extending enhanced premium tax credits that are vital for millions of working Americans.”

Ryan Oglesby, president of the Emergency Nurses Association, said the fallout from the shutdown could reach hospital emergency departments.

“Without funding, ENA-supported initiatives and programs which focus on, among other things, emergency care for children, nursing workforce development, critical nursing research, the opioid crisis and the health and well-being of health care workers are in danger of being disrupted,” Oglesby said in a statement.

Brian Frazee, president & CEO of the Delaware Healthcare Association, said in a statement that he’s anxious to see an extension of the Affordable Care Act tax credits. But Frazee also hoped to see an end to the stalemate in Washington.

“Nobody benefits from a government shutdown, and this shutdown will have real implications on critical healthcare programs,” Frazee said. “The current political gridlock creates uncertainty making these times only more challenging.”