Digital Debut

Government Shutdown Could Affect ASCs

Areas where surgery centers might feel the impact

BY ALEX TAIRA AND DAVID OPONG-WADEE | OCTOBER 6, 2025

On October 1, the federal government officially shut down after Congress failed to reach an agreement on legislation to continue funding government services. The first since the longest shutdown in US history—35 days, from December 22, 2018, to January 25, 2019—this shutdown might set a new record for the longest federal government shutdown and cause significant disruptions across the healthcare industry. Surgery centers could be impacted by this shutdown.

Payment and Administrative Delays

Medicare payments are classified as mandatory spending, and the Centers for Medicare & Medicaid Services (CMS) has stated explicitly that Medicare Administrative Contractors (MAC) should “continue to perform all functions related to Medicare Fee-for-Service claims processing and payment.” However, CMS did issue an alert that MACs should implement a temporary, 10-day claims hold to ensure accurate payments. While surgery centers can continue to submit claims, facilities should expect delays in claims processing for the duration of the shutdown.

The shutdown also will cause disruptions to federal administrative processes, as nonessential federal workers are furloughed for the duration of the shutdown. The Department of Health and Human Services (HHS) released a shutdown plan in which approximately 41 percent of its staff—32,460 employees—would be furloughed. The reduction in federal staffing might cause a delay in the release of 2026 payment rules, which are normally expected around November 1. CMS has also said it would pause or limit survey and certification processes as well as contract oversight and outreach to beneficiaries. In addition, facilities that reach out to HHS and/or CMS with questions regarding payment, quality reporting or any other topic might not receive responses.

Patient Volume

The central debate causing the shutdown may have longer-term impacts for the surgery center community. In March 2021, President Joseph Biden signed the American Rescue Plan Act of 2021 into law. The law included new premium tax credits that would make health insurance plans purchased through the state exchanges more affordable. However, the tax credits are set to expire at the end of 2025 unless Congress acts, and Republicans have been resistant to include an extension to the credits in a government funding bill. If the subsidies are not extended, the Congressional Budget Office estimates that nearly 4 million fewer people will be enrolled in the Affordable Care Act plans a decade from now. Another estimate from the Urban Institute projected that 4.8 million people would lose coverage if the tax credits expired, with the coverage loss corresponding to a decline in overall health spending of $14.2 billion on hospital services and $5.1 billion on physician services. Coupled with Medicaid cuts passed as part of budget reconciliation legislation in July 2025, it seems likely that the number of uninsured individuals will rise in the coming years. Surgery centers in rural areas or states with high proportions of individuals covered by exchange plans might see lower volumes as a result.

Write Alex Taira at ataira@ascassociation.org or David Opong-Wadee at dopongwadee@ascassociation.org with any questions.