WHAT HAPPENS NEXT? The federal government is barreling toward a potential shutdown after the House voted down — 174-235 — a second plan offered by Republicans on Thursday night. If the government partially shuts down tonight, Medicare and Medicaid claims could take longer to process, health officials’ response to emergencies could slow and drug research efforts could be interrupted. Where we are: Congress has until midnight to pass a spending bill to avert a partial government shutdown, but the new plan House Republicans drew up Thursday night — which stripped away many health provisions the first deal included — failed in the House. In the event of a shutdown, HHS will furlough 55 percent of its staff, according to its 2025 contingency plans. However, staff who work on mandatory programs, including Medicare and Medicaid, will be retained, and emergency surveillance operations will continue. Here’s how HHS agencies will fare: — CDC: The agency would continue a few of its most vital operations, including “immediate response to urgent disease outbreaks” and “critical investigation needs” into food, health care, insect-borne diseases or “high-consequence pathogen threats.” Additionally, the CDC would stop providing technical assistance to state and local health departments, responding to inquiries about public health matters and analyzing surveillance data for reportable diseases.
The CDC is dealing with several high-profile responses, chief among which is the avian flu outbreak tied to dairy cattle. On Wednesday, the agency announced the first severe case of bird flu in a human. — CMS: CMS would maintain staff needed to run Medicare and Medicaid, but claim payout could slow. According to the contingency plan, CMS has enough funding for Medicaid through the first quarter of 2025 and funding for only certain Medicaid grants in subsequent quarters. Survey and oversight of health facilities, such as nursing homes, would be hampered, and only complaints of serious incidents of patient harm would be investigated. CMS would also slow down or pause rulemaking and wouldn’t provide oversight of its major contractors, including the Medicare Call Center. Beneficiary casework services would also be suspended.
— National Institutes of Health: The National Institutes of Health would furlough three-quarters of its staff. Although clinical trials would continue, according to the agency's contingency plan, basic research conducted by NIH scientists, some translational research conducted by NIH scientists, some veterinary services and scientific equipment services would cease. Remaining staff would continue to support priority research projects, research oversight and contracts that would be hurt by a funding interruption. — FDA: The FDA’s shutdown plan says that a shutdown would significantly impact its ability to protect public health and safety, hurt research efforts, delay policy development and delay hiring efforts. But a large portion of the agency would continue to work during a funding lapse because of the FDA’s reliance on user fees. Out of the agency’s workforce, 77 percent would remain, including staff who respond to emergencies, manage product recalls, monitor adverse events and handle medical product shortages, foodborne outbreaks and infectious disease threats.
The agency did not comment further on its shutdown planning beyond pointing to the contingency staffing document. WELCOME TO FRIDAY PULSE. What a week leading into the holidays, huh? I plan to decompress tonight with a cheesy Christmas movie. Send your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.
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