A deal was struck Jan. 29 between Senate Democrats and Republicans to move five spending bills forward after a six-bill government funding package earlier that day failed to reach the 60-vote threshold for passage, The New York Times reported.
The revised package includes funding through Sept. 30 for five agencies — including HHS — and a two-week stopgap for the Department of Homeland Security. The Senate is expected to vote on the new deal Jan. 30, but any final agreement would still need House approval. To avoid a partial government shutdown, the House would need to pass the package as is, or return an amended version for another Senate vote before the Jan. 30 midnight deadline. However, with the House not scheduled to return until Feb. 2, a brief shutdown beginning early Jan. 31 appears likely.
A lapse in funding would take effect Jan. 31 at 12:01 a.m. Eastern time, disrupting operations at HHS and other federal agencies.
The original six-bill package failed in a 55-45 vote, with eight Republicans joining Democrats in voting no. The impasse was related to a bill that included Department of Homeland Security funding. Senate Democrats refused to move DHS funding forward without reforms to immigration enforcement operations, NBC News reported Jan. 29. Ahead of the vote, Senate Minority Leader Chuck Schumer of New York called for the DHS funding bill to be separated from the broader package and voted on separately, saying Democrats are ready to pass the other five bills immediately.
The vote follows a 43-day government shutdown, the longest in U.S. history, that ran from Oct. 1 to Nov. 12 after lawmakers could not reach a spending deal.
“I am working hard with Congress to ensure that we are able to fully fund the Government, without delay,” President Trump wrote in a post on Truth Social after the new deal was announced. “Republicans and Democrats in Congress have come together to get the vast majority of the Government funded until September, while at the same time providing an extension to the Department of Homeland Security (including the very important Coast Guard, which we are expanding and rebuilding like never before), Hopefully, both Republicans and Democrats will give a very much needed Bipartisan ‘YES’ Vote.”
Here are three things to know:
1. Homeland Security funding remains a key sticking point. The House initially passed the six-bill package Jan. 22. At the time, the bills were largely expected to pass in the Senate. However, after Alex Pretti, a 37-year-old registered nurse, was shot and killed by federal immigration agents in Minneapolis on Jan. 24, Democrats said they would not support DHS funding without broad reforms to Immigration and Customs Enforcement operations.
On Jan. 26, an open letter from CEOs at more than 60 Minnesota-based companies, including health systems such as Rochester-based Mayo Clinic, Minneapolis-based Allina Health and Bloomington-based HealthPartners, called for immediate deescalation following Mr. Pretti’s death.
2. A shutdown would pause some HHS activities. HHS’ fiscal 2026 contingency plan indicates that 32,460 employees, or 41% of staff, would be furloughed in the event of a total government shutdown.
Becker’s has reached out to HHS regarding its plan for a partial shutdown and what a one- to two-day closure would entail, and will update this story should more information become available
Mandatory programs such as Medicare and Medicaid, healthcare fraud investigations and constitutional duties like budget preparation would remain active during a shutdown. HHS would also maintain key activities, including disease outbreak monitoring through the CDC, pandemic and emergency response through the Administration for Strategic Preparedness and Response, research and clinical activities through the National Institutes of Health, and drug and medical device reviews through the Food and Drug Administration.
However, many HHS functions would stop during a shutdown, including oversight of research grants and contracts, data collection efforts and public records requests. The CDC would have limited ability to communicate health information to the public, the NIH would stop admitting new patients to its Clinical Center unless medically necessary and CMS would not be able to oversee major contractors, the plan said.
3. Shutdown risk complicates hospital at home. Hospitals are navigating disruptions to hospital-at-home programs for the second time in a few months as Congress faces another funding deadline.
Even if Congress reaches an agreement early next week, disruptions to the program are unavoidable at this point, as hospitals have already begun winding down operations to comply with federal rules.
Worcester, Mass.-based UMass Memorial Medical Center stopped accepting new hospital-at-home patients Jan. 28, Constantinos “Taki” Michaelidis, MD, medical director of UMass Memorial Health’s Hospital at Home program, told Becker’s. The move comes two months after the program reopened in November following the government shutdown that began Oct. 1.
Any patients still receiving care through UMass Memorial Health’s Hospital at Home program by Jan. 30 will be transferred back to the brick-and-mortar hospital for ongoing acute care.
“This is the exact opposite of what we need to be doing. We need to be growing the program, helping offload boarding and supporting patients and families in the community,” Dr. Michaelidis said. “Instead, we’ll be shutting the program down and making the boarding problem worse in our busiest emergency department.”
He said the uncertainty has made it harder to secure funding to expand the program, even with strong executive support. Recent pauses have raised concerns about committing to a major investment, particularly for a safety-net system for which spending is closely scrutinized.
“It takes weeks to plan for a shutdown and weeks to turn the program back on,” Dr. Michaelidis said. “With Hospital at Home, when we lose the waiver, if we still have patients with us, it becomes a compliance issue. We would be in violation of Medicare Conditions of Participation if a patient is still on service at 12:01 a.m. Saturday morning [Jan. 31].”
The Boston Globe reported that in the event of a funding lapse, Boston-based Mass General Brigham would also plan to shift its hospital-at-home infrastructure to provide advanced home care for patients after they have been discharged from the hospital.
The waiver previously lapsed when the most recent government shutdown began Oct. 1. Congress later revived the program as part of a stopgap spending bill passed Nov. 12, which extended the program through Jan. 30 and allowed retroactive payments. The legislation now under discussion includes an extension of the waiver through 2030.
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