Spending bill showdown: Health programs on the line if Congress doesn’t get votes to avert a government shutdown

The Department of Health and Human Services does have a contingency plan established in 2017 in the event of a government shutdown. (Sarah Stierch/CC BY 4.0)

House Republicans are up against the clock and trying to lock in votes today on a short-term spending bill to avoid a government shutdown that would force most federal agencies to stop operations.

UPDATE: House passes short-term spending bill that funds CHIP, but Senate divided as government shutdown looms

Congress must agree to a bill and send it to President Trump to approve the funding by midnight on Friday. But House Democrats are opposed to a short-term spending bill to extend funding to mid-February unless it includes a fix to the Deferred Action for Childhood Arrivals, which allows young people—known as “dreamers”—who were brought to the U.S. by their parents without proper documentation, to stay and work here.

RELATED: Stopgap funding bill could delay ACA taxes, fund CHIP

Another sticking point is the inclusion in the bill of funding the Children’s Health Insurance Program for six years. Federal funding for CHIP expired at the end of September. Congress has approved two short-term measures that extended the funding, but many states will soon run out of money unless there is a long-term fix.

RELATED: Without quick funding from Congress, community health centers in danger of closures, layoffs

Senate Democrats also want to include funding for community health centers in the short-term measure. Ron Wyden, D-Oregon, the ranking member on the Senate Finance Committee, told reporters Wednesday that he also advocates for an extension of programs for home visits from nurses and for rural healthcare, according to The Hill.

Wyden said in an announcement that he would vote against a funding bill without those protections. “I am also disappointed that Republicans turned away from a historic opportunity to make CHIP permanent and address other healthcare priorities like funding for Community Health Centers, which provide crucial front-line health are to Oregonians. It’s a sad state of affairs when Americans’ healthcare, especially for kids, continues to take a back seat.

“This bill fails to do the hard work of trying to improve our country’s economy and creating jobs, and instead it kicks the can while leaving Dreamers, vulnerable kids and so many other Americans behind,” he said.

Meanwhile, several hospital organizations, including the American Hospital Association, have urged (PDF) Congress to include a two-year delay in proposed Medicaid disproportionate share hospital cuts, as well as straight five-year extensions of the Medicare-dependent hospital and enhanced low-volume adjustment programs. The DSH program provides funding to hospitals that provide a significant amount of uncompensated medical care. The MDH and LVA programs serve a large number of Medicare beneficiaries who live in rural areas. The MDH program adjusts payment to hospitals that have a high percentage of hospitalized Medicare patients. The LVA program provides an add-on payment for low-volume provider to sustain access to care in rural areas.

Healthcare programs are also threatened in the event of a government shutdown. The last shutdown occurred in 2013. Those 16 days ended up costing the .U. S. economy $24 billion and hampered the Centers for Disease Control and Prevention’s ability to respond to new and emergency health threats, a serious concern in light of the current flu epidemic.

The Department of Health and Human Services does have a contingency plan (PDF) established in 2017 in the event of a government shutdown. The agency, which includes the Food and Drug Administration and the Centers for Medicare & Medicaid Services, would retain about half of its 82,000 staff and put the remaining 41,000 on furlough. In 2013, the shutdown forced CMS to stop its healthcare fraud and abuse operations, the CDC was unable to monitor the spread of the flu and the National Institutes of Health stopped admitting new patients.