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Federal government to re-open temporarily with funding for FDA, IHS


Updated at 7:25 p.m. ET

The House and Senate approved a bill late Friday to end the partial government shutdown. It is now headed to the other end of Pennsylvania Ave. where President Donald Trump is expected to sign it into law shortly.

The temporary truce to the 35-day work stoppage will fund shuttered departments through Feb. 15. It did not include the border wall funding that triggered the dispute between President Donald Trump and congressional Democrats. The stand-off launched the federal government shutdown on Dec. 21.

“I was glad to see today the president’s announcement that he and Democrats have reached an agreement that will immediately re-open the government, while providing the room to negotiate a funding bill for the Department of Homeland Security,” Senate Majority Leader Mitch McConnell (R-Ky.) said on the Senate floor moments after Trump’s speech discussing the three-week continuing resolution that will prioritize backpay for furloughed government workers.

This was the longest government shutdown in U.S. history. Although Congress funded HHS for the year, the healthcare landscape keenly felt the impact of the closures.

Hundreds of major healthcare groups last week sent letters to Trump and Congress with a dire prediction that a further prolonged shutdown could have severe implications for public health.

The U.S. Food and Drug Administration was forced to halt food safety inspections and about half the agency was furloughed. FDA Commissioner Dr. Scott Gottlieb had warned that if the shutdown continued much longer the FDA would run out of funds to approve generic drugs. It recently called back to work 400 employees after public concern over the inspection lapses.

The Indian Health Service (IHS) also had its funding shut off even though its administration falls under HHS. Financing flows from the Department of Interior, which was closed down. The service that provides federal funding to native tribes and forced them to scramble to make up the difference in funding for health services.

Friday morning ahead of Trump’s announcement, Sen. Tom Udall (D-N.M.) convened a call with tribal leaders to announce his introduction of a Senate bill to authorize advance appropriations for IHS and the Bureau of Indian Affairs.

One of these leaders, W. Ron Allen who serves as Tribal Council Chairman for the Jamestown S’Klallam Tribe of Washington State, said the financial hit on health centers and hospitals caused by the funding lapse varied extremely. Some tribes had reserves to rely on, or could borrow money, while others were facing stark financial straits.

Some Northwestern sister tribes to the S’Klallam had to furlough doctors and nurses at their health centers, and were no longer paying administrative staff, Allen told Modern Healthcare on Friday. He warned that the funding lapse could threaten the already-stretched healthcare workforce in Indian Country.

In an effort separate from Udall’s, Rep. Markwayne Mullin (R-Okla.) earlier this month led a bill to fund IHS for a full fiscal year, although the Senate didn’t introduce a companion measure.

The Department of Agriculture’s temporary closure also impacted some rural hospitals and clinics when the officials in charge of administering low-interest rural health loans went on furlough. This impacted a small health center in Pecos, N.M. and threatened a costly delay to a 9,000 expansion construction project.

Other health programs managed by the USDA were at serious risk of being cut or frozen, including breastfeeding support and food assistance programs such as the Supplemental Nutrition Assistance Program.

If the shutdown ends it will also mean that several major healthcare lawsuits could resume their journey through the federal court system. These include litigation over the Trump administration’s rules to expand the duration of short-term plans and a lawsuit led by 20 states to strike down the Affordable Care Act.

While Washington is on course to end the shutdown on Friday, the impact of the 34-day closure could linger for many areas of the healthcare industry. For instance, the shutdown delayed the release of the 2020 Notice of Benefit and Payment Parameters, which outlines the required design of insurance plans sold on the Affordable Care Act’s exchanges.

The rule is usually released in the fall but it was released just last week, giving insurers little time to study the regulations before applying for new plans in a couple of weeks.

Lawmakers of all stripes welcomed news of the agreement, although it is far from clear they can resolve the dispute over border wall funding within the next three weeks.

The appropriations for the Department of Homeland Security—the bureau responsible for border defense—will head for a House and Senate conference. —Robert King contributed to this article.