How the government shutdown affects your Medicare, Medicaid

As Democrats and Republicans clash over future health care funding, many beneficiaries want to know if their health insurance coverage will be affected.

If you have Medicare or Medicaid, you should be able to see your doctor without disruption. But if the government shutdown drags on for several weeks, problems could surface, experts said.

The Centers for Medicare & Medicaid Services will continue operations during the shutdown. The agency said it has funding for Medicaid through the end of this year.

Government shutdown starts: Millions of seniors could lose access to telehealth and in-home care

Doctors could delay appointments if Medicare, Medicaid payments slow

Doctors, hospitals and other health providers could see delays in Medicare and Medicaid payments during a longer-term shutdown, said Jonathan Burks, executive vice president of health and economic policy at the Bipartisan Policy Center.

Doctors might be reluctant to schedule appointments for new or existing patients if their payments are delayed, Burks said. The Department of Health and Human Services, which includes CMS, will furlough 41% of staff during the shutdown.

“The funding is generally there, it’s just a question if the administrative back end is adequate to keep up,” Burks said.

Community heath centers, funded largely by federal grants and Medicaid, provide non-emergency health care for about 34 million Americans each year. These centers are often used by the uninsured, rural and low-income Americans.

These centers should get enough funding to maintain operations and staffing despite the shutdown, according to the National Association of Community Health Centers.

But the shutdown adds uncertainty, the organization said, noting community health centers have relied on six short-term federal funding extensions over the past two years.

Affordable Care Act premiums will spike for millions without deal

Millions of Americans who get Affordable Care Act health insurance also will see their costs significantly increase next year when COVID-19 pandemic era subsidies expire. Democrats are pushing to extend these subsidies that made ACA plans more affordable for working-class Americans and free for families that earned $22,000 or less.

On Sept. 26, Senate Majority Leader John Thune said any deal to extend the more generous ACA subsidies must come with some reforms.

Without the subsidies, ACA customers will see their average total premium payments more than double to $1,904 in 2026, up from $888 in 2025, according to an analysis by KFF, a health policy nonprofit.

Democrats are also demanding Congress restore Medicaid funds cut by President Donald Trump’s tax cut and spending bill. Over the next decade, 7.5 million people are projected to lose Medicaid coverage because of changes under the law, the Congressional Budget Office said. Nondisabled adults on Medicaid will be required to get a job, volunteer or enroll in school to maintain their Medicaid coverage, and states must double Medicaid eligibility checks to twice a year.