During federal shutdowns, essential health programs will still operate, but their efficiency is expected to drop significantly as many services halt and staff become stagnant, according to plans from the Department of Health and Human Services (HHS).
HHS predicts that approximately 32,460 employees will be sidelined during the shutdown, while still keeping about 79,717 employees active. It’s noted that around 15,000 of those retained are there due to legal requirements.
Ultimately, the department expects that around 41% of its workforce will be cut during this period.
Some agencies, such as the Administration for Strategic Preparation and Response, the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the Food and Drug Administration (FDA), are partly exempt from the shutdown, but many of their operations will be halted regardless.
Protected activities during the shutdown will be governed by laws that allow federal employees to voluntarily provide services in emergencies, focusing on “protection of human life safety or property.”
At the NIH, only 25% of staff will remain, leading to the suspension of nearly all management tasks, along with basic research and admissions of new patients at the NIH Clinical Center in Bethesda, Maryland.
The FDA will keep about 86% of its workforce but won’t be able to accept new product applications, meaning delays in approval are likely.
Work related to mandatory tasks like Medicare and Medicaid will still continue, including attention to constitutional duties such as the preparation of the Trump administration’s 2027 budget.
However, activities connected to contracts, grants, freedom of information requests, and data gathering will cease. HHS has indicated that CDC communications about public health have already been disrupted, and monitoring of Medicare and Medicaid contractors will not occur.
From the Centers for Medicare and Medicaid Services (CMS), 53% of staff will remain, but investigative actions regarding medical facilities will pause, except for serious complaints concerning patient harm.
CMS will also halt various policy developments and educational initiatives. There’s uncertainty about how long the shutdown could last; previous shutdowns, like the one in 2018-19, lasted around 35 days, and this may affect rebates for Medicare and Medicaid over an extended period.
The CMS anticipates substantial expenditures by the first quarter of fiscal year 2026.
Over 77 million people in the U.S. are enrolled in either Medicaid or the Children’s Health Insurance Program, while nearly 69 million are on Medicare.
This situation might impact customer service and services that beneficiaries typically rely on.
According to KFF, access to Medicare telehealth services will revert to pre-pandemic conditions, meaning beneficiaries may have to visit providers in person more often, especially since the expanded telehealth funding expired on September 30.
On the other hand, with 88% of Social Security Agency (SSA) staff retained, Social Security payments should continue uninterrupted during the shutdown.
However, adjustments to living costs could face delays, as reports indicate that certain economic data from the Bureau of Labor Statistics will be postponed due to the shutdown.
There’s an ongoing concern about possible layoffs for federal health workers. The CDC’s emergency response plan shows that 1,563 out of 8,742 staff are in “reduction in force” status.
The agency has recently experienced a challenging period, including a fatal incident at its Atlanta office and losing 600 employees in recent layoffs.
FDA Commissioner Marty McCurry recently stated in a video that his agency’s employees would be shielded from layoffs during the shutdown due to their critical role in public safety.
However, major agencies like NIH, CMS, and FDA haven’t indicated any immediate reduction plans during this shutdown.
The true effects of the layoffs may take time to unfold; it depends on how long Congress takes to reopen the government, considering many staff are being retained for necessary services.
As Quakenbush pointed out, extended shutdowns could lead to delays and disruptions in research activities and progress. “If it’s just a day or two, the impact is minimal. But if it drags on, the effects will intensify, particularly for federal workers who won’t be receiving their pay,” he noted.
