President Obama signs the Affordable Care Act

This photo shows President Barack Obama signing the Affordable Care Act into law in 2010. Its provisions, including the Health Insurance Marketplace, will not be affected by the government shutdown. Photo by APHA

Today at 12:01 a.m. EDT, the U.S. federal government partially shut down as Congress failed to pass federal spending bills for fiscal year 2014. Public health workers were among 800,000 federal employees furloughed, but the Health Insurance Marketplace set forth by the Affordable Care Act opened as scheduled in every state.

Public Health Newswire answers four immediate public health questions in light of the government shutdown.

Which public health services are suspended?

Notably, the U.S. Department of Health and Human Services sent home 52 percent of its employees. Numerous public health agencies have either wholly or significantly suspended certain activities, with highlights including:

  • Centers for Disease Control and Prevention, which halted its annual seasonal influenza and outbreak detection programs, updating of disease treatment and prevention recommendations for HIV, tuberculosis and sexually-transmitted diseases and minimized support to state and local partners for infectious disease surveillance;
  • Food and Drug Administration, which halted the majority of its nutrition and safety activities such as the majority of the laboratory research necessary to inform public health decision-making;
  • Health Resources and Services Administration, which halted the Children’s Hospital Graduate Medical Education Program and Vaccine Injury Compensation Claims, and lowered monitoring for comprehensive care and AIDS and emergency relief grants;
  • National Institutes of Health, which will not admit new patients, discontinues some veterinary services and will not take any actions on grant applications or awards; and
  • Centers for Medicare and Medicaid Services, which will complete fewer recertification and initial surveys for Medicare and Medicaid providers.

Which public health services will continue?

Federal work considered “essential” to maintaining health and safety will continue during the shutdown, including the Supplemental Nutrition Assistance Program, disability benefits, National Weather Service functions, meat and poultry inspection and most disaster recovery service provided by the Federal Emergency Management Agency, among others.

The Health Insurance Marketplace was scheduled to open today. Does the shutdown change anything?

Not now, for the most part. Americans can still register for health insurance using the marketplace, which allows Americans and small businesses in every state to obtain health coverage to fit their individual, family or employees’ needs. They can do so online at or, by phone at 1-800-318-2596 or in person at community enrollment locations, which are searchable at

The Affordable Care Act remains at risk as Congress attempts to pass its new budget, but it will be implemented in its entirety during the shutdown.

When will the shutdown end?

It’s hard to say, but the longest government shutdown back in 1996 lasted 21 days. Since 1977, there have been 17 shutdowns.