When Washington Shuts Down: What It Means for Home Care Providers

For the first time in nearly seven years, the federal government is on the brink of a shutdown. Unless Congress acts by midnight on September 30, agencies will begin closing their doors and furloughing staff. The standoff is the product of a long and bitter fight over federal spending, policy priorities, and partisan divisions.

​Every year, Congress is supposed to pass certain appropriations bills to fund the government by the start of the fiscal year on October 1. In practice, lawmakers often rely on short-term “continuing resolutions” to buy time for negotiations. This year, deep disagreements over health care policy, proposed Medicaid cuts, and other riders have derailed progress. While the Senate has worked on a bipartisan stopgap, the House has struggled to unify around a plan. That impasse has left agencies scrambling to activate contingency plans and raised the prospect of the first funding lapse since 2018–2019.
 
The consequences of a shutdown ripple far beyond Washington. Essential programs such as Medicare and Social Security continue, but much of the machinery that keeps federal health care programs running slows or stalls. The Department of Health and Human Services has already announced that about half of its workforce would be furloughed. At the Centers for Medicare & Medicaid Services (CMS), just over half of employees will remain on duty, tasked mainly with processing Medicare claims and keeping essential services alive. (Click here for more on this from CMS.)
 
Medicare payments will not stop. Claims will continue to be processed, though providers may face slower turnaround times and reduced support for appeals, enrollment, and oversight. Medicaid is more complex: thanks to advance appropriations, states have enough federal funds to keep programs running through the first quarter of fiscal year 2026. Still, with fewer federal staff available to answer questions or issue guidance, states may adjust their administrative timelines, which could affect providers.
 
Beyond core funding, the shutdown will hit several areas that touch home care indirectly. E-Verify, the Department of Homeland Security system for verifying work eligibility, is expected to go offline, complicating hiring for agencies. The Department of Labor’s Wage and Hour Division will function with only a skeleton staff, reducing enforcement and employer support, but leaving key compliance obligations intact. And SBA loan processing will halt, potentially delaying financing for smaller agencies. Even the nation’s air traffic system could be strained, leading to travel delays that may affect staff and client mobility.
 
The lesson for home care agencies is clear: while the lifelines of Medicare and Medicaid remain intact for now, the administrative gears that support these programs are slowing down. Claims and payments may take longer, oversight will be scaled back, and hiring or financing processes may be disrupted.
 
Practical steps for home care agencies to take in the event of a shutdown:
 

1. Cash-flow check
   Even with Medicare continuing and states funded for Medicaid Q1, build in extra time for claim status, appeals, and MAC support. Keep days-cash-on-hand targets tight.
2. Staffing and hiring
   If you use E-Verify, document onboarding dates and follow DHS guidance once systems return. Continue timely Form I-9 completion.
3. Compliance
   Do not assume enforcement is “off.” Safety-related enforcement can continue. Keep wage-and-hour and recordkeeping practices tight.
4. State Medicaid coordination
   Confirm any state-specific billing or portal notices. Federal funding is available for Q1, but state administrative timelines may still shift.
5. Travel and scheduling
   Build cushion into airport arrivals and critical trips during the lapse.

 
HCAOA is closely monitoring developments in Congress and across federal agencies. We will continue to update members as guidance changes and will advocate for policies that protect the stability of home care during this period of uncertainty.