After
Congress
failed
to
pass
a
funding
bill,
the
government
shut
down
early
Wednesday
morning,
which
has
significant
implications
for
healthcare,
including
the
future
of
telehealth
flexibilities
and
Affordable
Care
Act
(ACA)
coverage.
The
shutdown
has
sparked
strong
backlash
from
the
healthcare
community.
Patient
advocacy
group
Families
USA,
for
example,
criticized
Congressional
leaders
for
not
extending
the
ACA’s
enhanced
premium
tax
credits.
These
enhanced
subsidies
(which
are
set
to
expire
at
the
end
of
the
year)
were
introduced
in
2021
and
lowered
monthly
premiums
for
those
who
buy
coverage
on
the
marketplaces.
The
subsidies
are
a
key
sticking
point
between
Democrats
and
Republicans,
with
Democrats
calling
for
an
extension,
while
Republicans
say
negotiations
should
happen
after
the
funding
is
approved.
“We
shouldn’t
need
a
shutdown
to
prevent
a
massive
spike
in
health
insurance
premiums.
After
an
election
on
affordability,
Republican
leaders
are
betraying
their
own
voters
with
their
willingness
to
shut
down
the
government
to
avoid
extending
tax
credits
that
help
more
than
20
million
working-class
Americans
afford
health
care,”
said
Anthony
Wright,
executive
director
of
Families
USA.
“When
Republicans
in
Congress
passed
huge,
permanent
tax
credits
for
billionaires
and
big
corporations
this
summer,
they
blocked
multiple
attempts
and
amendments
to
similarly
extend
the
tax
credits
that
help
working
families
pay
their
health
insurance
premiums.”
According
to
KFF,
if
the
enhanced
subsidies
expire,
out-of-pocket
premium
payments
would
increase
by
114%,
from
$888
on
average
in
2025
to
$1,904
in
2026.
Another
key
issue
with
the
shutdown
is
the
expiration
of
the
Medicare
telehealth
flexibilities,
which
expired
on
Tuesday
and
will
remain
expired
unless
Congress
includes
them
in
the
next
funding
bill.
The
flexibilities
introduced
during
the
Covid-19
pandemic
broadened
Medicare
eligibility
for
virtual
care,
which
had
previously
been
limited
to
patients
in
rural
areas
and
required
them
to
be
at
an
approved
originating
site,
such
as
a
hospital
or
physician’s
office.
Now
that
the
flexibilities
have
expired,
Medicare
telehealth
coverage
will
return
to
its
pre-pandemic
requirements.
The
American
Telemedicine
Association
is
calling
for
Trump
and
Congress
to
restore
these
flexibilities
and
retroactively
reimburse
providers
still
offering
telehealth
services
during
the
shutdown.
“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,”
said
Kyle
Zebley,
executive
director
of
ATA
Action
and
senior
vice
president
of
public
policy
at
the
ATA,
in
a
statement.
“Medicare
patients
woke
up
this
morning
without
telehealth
coverage
for
the
first
time
since
the
pandemic,
five
years
ago.
Our
healthcare
services
are
regressing,
falling
woefully
short
for
millions
of
patients
in
need.”
An
executive
for
a
brain
health
company
also
expressed
concern
over
the
uncertainty
of
Medicare
telehealth
flexibilities.
“Most
likely
telehealth
benefits
will
be
extended,
but
we
are
getting
a
lot
of
questions
both
from
our
employees
and
patients
on
where
they
stand,”
said
Dr.
Julius
Bruch,
co-founder
and
CEO
of
Isaac
Health.
“In
an
area
like
dementia
care,
where
there
are
already
so
few
neurologists,
and
not
nearly
enough
to
care
for
the
aging
population,
telehealth
works
wonders
to
increase
access,
and
the
potential
of
this
going
away
could
be
detrimental
for
not
only
patients
with
dementia,
but
for
their
caregivers,
and
other
loved
ones.”
Another
industry
follower
is
worried
about
how
the
shutdown
will
affect
those
who
depend
on
government-funded
programs,
such
as
the
Supplemental
Nutrition
Assistance
Program
(SNAP).
“If
this
shutdown
lasts
more
than
a
month,
which
is
a
possibility
given
the
last
shutdown
was
34
days,
those
experiencing
food
insecurity
across
the
country
may
see
a
lapse
in
SNAP
benefits,
as
government
funding
for
the
program
will
only
last
about
a
month.
We
risk
creating
more
non-medical
barriers
to
health,
like
lack
of
access
to
food
or
transportation
to
doctor
appointments,
which
can
account
for
up
to
80%
of
a
person’s
health,”
said
Cindy
Jordan,
CEO
and
co-founder
of
Pyx
Health,
an
engagement
company.
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