Government Shutdown 2019 Continues to Affect Healthcare in the United States

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This is the third piece in a series of posts that discusses the far-reaching impact of the government shutdown on various healthcare and medical-related issues, either directly or otherwise. First and foremost, as of the time of this posting, this partial shutdown has achieved the historic status of becoming the longest-lasting one in the history of the United States.

To be approximate, this particular shutdown, which began on December 22, 2018, has been in effect for more than 30 days without a foreseeable conclusion for the near future. In addition, masses of federal employees and the millions of Americans who depend on the impacted government programs are beginning to feel the fallout of this intricate situation.

The first post delved into the shutdown’s effects on federal entities such as the Environmental Protection Agency, the Indian Health Service and the Food and Drug Administration. Meanwhile, the second post explored the monetary blows to the Supplemental Nutrition Assistance Program (SNAP) and the Department of Housing and Urban Development (HUD), as well as the impact on the disabled persons and chronically ill senior citizens who rely on these programs.

Now it is time to shed some light onto the personal toll the government shutdown has had on federal employees and their families in regards to medical care. Members of the United States Coast Guard have sustained two tremendous blows since 1) they are not being paid and 2) some of their health insurance plans are directly affected.

Health Coverage for the United States Coast Guard

Because of the government shutdown, members of the U.S. Coast Guard are reporting to work without pay at the present time. Due to the fact that Coast Guard members have not been receiving any pay, no funds can possibly be deducted from their paychecks to cover the premiums for the varied health insurance plans that provide coverage to them and their families.

Tricare has declared it will continue to provide medical coverage to all members of the Coast Guard. However, representatives of BENEFEDS, the company responsible for administering dental and vision plans for Coast Guard members and their dependents, have stated that policyholders may end up being directly billed for any insurance premiums. Also, premiums will need to be paid to ensure continuation of coverage.

Health Coverage for Dependents of Other Types of Governmental Employees

The following excerpt was taken from an article on the Benefits Pro website:

Joseph Daskalakis’ son was born New Year’s Eve, a little over a week into the current government shutdown, and about 10 weeks before he was expected. Little Oliver ended up in a specialized neonatal intensive care unit, the only one that could care for him near their home in Lakeville, Minn.

But air traffic controller Daskalakis, 33, has an additional worry: The hospital where the newborn is being treated is not part of his current insurer’s network and the partial government shutdown prevents him from filing the paperwork necessary to switch insurers, as he would otherwise be allowed to do.

He could be on the hook for a hefty bill — while not receiving pay. Daskalakis is just one example of federal employees for whom being unable to make changes to their health plans really matters.

The following tale describes yet another situation of how the current shutdown has impacted the medical care of an individual:

Other families are also worried about paperwork delays, and the financial and medical effects a prolonged shutdown could cause. Dania Palanker, a health policy researcher at Georgetown’s Center on Health Insurance Reforms, studies what happens when families face insurance difficulties. Now she’s also living it.

After arranging to reduce her work hours because of health problems, Palanker knew her family would not qualify for coverage through her university job. No problem, she thought, as she began the process in December to enroll her family into coverage offered by her husband’s job with the federal government.

“We could not get the paperwork in time to apply for special enrollment through the government and get it processed before the shutdown,” Palanker said. Georgetown allowed her to boost her work hours this month to keep the family insured through January, but Georgetown’s share of her coverage will end in February.

Her treatments are expensive, so she is likely to hit or exceed her annual $2,000 deductible in January — then start over with another annual deductible once the family secures new coverage. “I’m postponing treatment in hopes that it is just a month and I’m back on the federal plan in February, but I can’t postpone indefinitely, as my condition will get worse,” said Palanker, who has an autoimmune disease that causes nerve damage.

Government Shutdown 2019: Other Indirect Impacts on Healthcare

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As many people might already know, several divisions within the United States federal government have been completely shut down since December 22, 2018. Moreover, as of the time of this writing, this stoppage has attained the noteworthy status of being the longest-lasting shutdown in the history of the nation. In actuality, this particular shutdown has been taking place for 30+ days without an end in sight.

Although the current partial government shutdown had not been directly caused by any healthcare policies or programs, it does have a noticeable effect on multiple aspects of the health system in the United States. The previous posting discussed the impact of the shutdown on government-run departments such as the Indian Health Service, the Food and Drug Administration and the Environmental Protection Agency.

The predominant aim of this nonpartisan, nonpolitical piece is to mention a number of ways the 2019 government shutdown is affecting the healthcare system, either directly or indirectly. Federal entities such as the United States Department of Housing and Urban Development and the United States Department of Agriculture have sustained profound blows to their operations due to the shutdown, although in differing ways.

The United States Department of Housing and Urban Development

The US Department of Housing and Urban Development, referred to as HUD for short, is a division within the executive branch of the federal government. HUD administers many of the major affordable housing and homelessness programs, including the Housing Choice Voucher Program, more commonly known as Section 8 Project-Based Rental Assistance.

In addition, HUD is in charge of the Section 202 housing program for approximately 400,000 lower income senior citizens, as well as Section 811 housing for thousands of low income disabled individuals. Many chronically ill persons in the US health system, such as the aforementioned senior citizens and the disabled, are heavily dependent on these various HUD programs to cover the costs of their monthly housing expenses.

Because of the recent shutdown, hundreds of affordable housing contracts have now expired. This event places the housing situation of vulnerable elderly and disabled persons in a perilous limbo. It also places their health at risk since numerous low-rental housing complexes arrange for mobile medical units to visit chronically ill residents on a routine basis for the purpose of providing some of their healthcare needs.

The United States Department of Agriculture

The US Department of Agriculture, abbreviated USDA, provides food to millions of indigent Americans through the Supplemental Nutrition Assistance Program (better known as SNAP). Through SNAP, more than 43 million people utilize food stamps via electronic benefits transfer cards to obtain food at participating supermarkets, grocers and corner stores across the country.

In addition to the poor, millions of disabled persons with chronic illnesses and lower income elderly people with health issues depend on food stamps in order to eat. Some participating grocers are not able to accept food stamps during this shutdown because they cannot renew the licensure that is required to process EBT funds.

These stores’ licenses, which are supposed to be renewed once every five years, cannot be renewed during this current shutdown because the government employees who usually process them are not available to work on the necessary paperwork as a result of furloughs. An estimated 2,500+ stores in the US can no longer accept food stamps because their licensure expired on January 1.

Furthermore, as the shutdown drags on, the ability of food stamp recipients to obtain food remains uncertain. Many states have disbursed the February 2019 SNAP benefits to recipients several weeks ahead of schedule. However, unless this shutdown ends soon, food stamp benefits might not be distributed in March, thereby limiting the ability of many different populations to acquire food in the near future.

Government Shutdown 2019: How Does It Impact Healthcare?

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Multiple segments of the United States federal government have been shut down since December 22, 2018 and, as of the time of this writing, it is now officially regarded as the lengthiest shutdown in the nation’s history. In fact, this particular government shutdown has been going on for 30+ days with no foreseeable end in sight due to partisanship and sharp divisions with regards to political viewpoints.

Meanwhile, the masses of furloughed government workers must anxiously contend with the uncertainty of what the near future will bring. In addition, while many government workers have not been furloughed, they are reporting to their workplaces without pay. Since a large number of these men and women exist from paycheck to paycheck, many of their families will soon experience financial hardships and a lack of money to pay household bills.

Even though the current partial government shutdown was not directly related to or a direct result of healthcare policies or programs, it does have a notable impact on several aspects of the health system in the United States. The primary goal of this nonpartisan, nonpolitical piece is to bring up a handful of the federal entities that are presently being affected by the 2019 government shutdown.

Federal entities such as the Indian Health Service, the Food and Drug Administration and the Environmental Protection Agency all possess ties to the US healthcare industry, albeit in very different ways.

The Indian Health Service

The Indian Health Service, abbreviated IHS, is a governmental entity that operates within the US Department of Health and Human Services while obtaining its funding entirely via the Department of the Interior. The IHS delivers hands-on healthcare and implements public health service initiatives for descendants of federally recognized Native American tribal people, as well as Native Alaskan people.

Clinics operated by the IHS are still open and treating patients. However, the healthcare workers who staff these clinics currently report to work without pay. The unpaid federal employees who are working without pay include physicians, nurses, midlevel healthcare providers (physician assistants, nurse practitioners, midwives, clinical nurse specialists), medical office assistants, and other staffers who have been deemed ‘essential personnel.’

Furthermore, the IHS has temporarily halted all activities that have been regarded as nonessential. For instance, the IHS preventative health clinics operated by the Office of Urban Indian Health Programs are upheld by grants that have been suspended until the government shutdown comes to an end. In addition, monetary grants that sustain various tribal health programs have also been placed on hold until further notice.

The Food and Drug Administration

The Food and Drug Administration, referred to as the FDA for short, is another federal agency with close ties to the US healthcare industry. Even though the FDA falls under the large sphere of of the US Department of Health and Human Services, this very important agency receives the entirety of its operational funding through the US Department of Agriculture.

Here’s the problem…the US Department of Agriculture has not yet been funded as a result of the government shutdown. Consequently, many operational divisions within the FDA are now not funded. Thus, nearly half of the individuals who work for the FDA have been furloughed. The FDA is responsible for carrying out multiple tasks that involve health and safety such as routine food inspections, pharmaceutical drug approvals, and regulation of tobacco products and cosmetics.

The Environmental Protection Agency

The Environmental Protection Agency, known as the EPA, is an independent agency of the federal government entrusted with a number of important responsibilities and programs that directly tie into public health and safety. Some of these responsibilities include ensuring the drinking water that citizens consume is safe, regulating insecticides, and managing the disposal of hazardous waste products.

The EPA is presently unfunded due to the government shutdown. As a result, an incredibly tiny skeleton crew of about 700 EPA employees have been reporting to work without pay. Meanwhile, more than 13,000 EPA workers have been furloughed due to the lack of funding. Because of the vast number of furloughed EPA employees, the health and safety activities usually carried out by them are not being completed at full capacity.