THE CLOCK IS TICKING — Congress is trickling back into town with an important item on its agenda: Pass a spending deal by Sept. 30 to avert a government shutdown. With just 24 days to go, the White House urged Congress last week to pass a continuing resolution — a short-term funding fix — that would keep the government open and punt larger spending decisions to later this year. The Biden administration wants the continuing resolution to include $3.7 billion for CMS to assist with eligibility verifications of Medicaid and marketplace programs and keep the marketplace up and running. It also asks for $1.9 billion in funding for HHS’ Office of Refugee Resettlement, noting that certain health programs, including community health centers and the Medicaid Disproportionate Share Hospital program, must also be extended. But, passing any funding deal at all looks to be an uphill battle, made more difficult by the House Freedom Caucus’ demands. The group of roughly three dozen Republicans said it won’t support a continuing resolution unless certain of its priorities are met. Those include passing a sweeping GOP border bill and opposing a “blank check” for Ukraine aid. Shutdown impact: During a government shutdown, essential services remain running, so Medicare and Social Security checks would still go out the door. The exchanges would also remain open. But, as the U.S. heads into respiratory infection season and the administration prepares for a fall vaccination campaign, a shutdown would hamper efforts to tamp down outbreaks. In 2018, for example, health experts and the public raised concerns that the CDC’s flu surveillance system would shut down until officials promised to preserve it. Emergency funds: According to HHS’ contingency plan, certain Covid-19 activities, like vaccine development and authorization and clinical trials, would continue using emergency funding appropriations from 2020 and 2021. Monitoring for disease outbreaks — though the plan doesn’t specifically mention flu or Covid — would continue. The CDC’s contingency plan also promises to keep the Vaccines for Children program going while continuing to monitor public health threats. HHS expects to furlough about 40 percent of its workforce if the government shuts down. Staff that work on Medicare, Medicaid and other mandatory health programs would be retained. Will the past predict the future? However, as past shutdowns have shown, the health programs that remain open can vary depending on how essential they’re deemed to be at the time. During the 2013 shutdown, the NIH briefly closed its portal to register new clinical trials and couldn’t enroll new patients, according to a GAO report. CMS also lost discretionary funding for waste, fraud and abuse, and states were forced to use their own money for formula grant programs like Temporary Assistance for Needy Families. And during the 1995–1996 shutdown, new Medicare enrollees were turned away daily in alarming numbers. Health policy experts said that’s unlikely to happen again. WELCOME TO WEDNESDAY PULSE. I will be insufferable about Duke football’s huge win against Clemson for the rest of the week, and possibly the rest of the year. Or longer. As we get ready for a busy fall, reach us with news tips, feedback and scoops at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo. TODAY ON OUR PULSE CHECK PODCAST, host Daniel Payne talks with POLITICO health care reporter Alice Miranda Ollstein, who explains why abortion disputes threaten the reauthorization of PEPFAR, a law governing the United States’ global HIV/AIDS relief work.
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