Tuesday, October 1, 2013
The federal government shutdown will shutter all non-essential services. Sadly, this means a hiatus for many programs designed to protect public health, such as CDC's seasonal influenza or outbreak protection programs. It means suspension of many programs serving vulnerable populations: HeadStart, senior nutrition, elder abuse prevention, and refugee programs. It means that programs designed to improve health IT or quality measurement will be on hold, as will efforts to monitor grants under programs such as SAMHSA or to measure performance of Medicare or Medicaid providers. Some of these programs may be able re-start roughly where they stopped when the government re-opens, of course with the costs of suspension and delay. But others may result in irretrievable harm, from individuals victimized by abuse to spread of an undetected infectious outbreak.
Some programs will continue, primarily those devoted to patient care. The Indian Health Service will continue to operate, Medicare will continue to pay physicians, and NIH will not discharge current patients into the streets. Medicaid will continue to operate and to pay providers. HHS will provide support for the ACA rollout, including interfaces with state Medicaid.
Over half of HHS employees will be without work or pay--surely demoralizing in light of sequestration furloughs and the prospect that Congress may not in the end make it up to them for lost days at work.
HHS's full description of what can only be described as a health disaster of garguantuan proportions can be found here.