The federal shutdown reached its third week as Democrats and Republicans continued a stalemate over how to fund the government.
In an Oct. 10 podcast, Bill Prentice, CEO of the Ambulatory Surgery Center Association, unpacked the impasse and what it means for ASCs across the U.S.
1. ACA premium tax subsidies
On Oct. 8, a pair of funding bills were rejected by the Senate. The House-passed version of the bill, supported by Republicans, did not address the ACA premium tax subsidies that are set to expire Dec. 31, 2025. The Democrats’ proposal does include an extension of the ACA subsidies, and another vote is expected in the Senate on Oct. 14, CBS News reported Oct. 13.
“Hypothetically, if these tax credits went away, you’d see millions of Americans having to pay much more for their health insurance or forgoing health insurance,” Mr. Prentice said. “Millions of Americans not having insurance would have an impact on providers who would otherwise see them as patients.”
2. Medicare payments
“One thing we’ve been assured of is that Medicare payments — which are classified as mandatory spending by the government — will continue to be paid,” Mr. Prentice said. “That’s one good thing that we know.”
While ASCs can rest assured that Medicare payments won’t be delayed other CMS administrative activities may be delayed as non-essential CMS employees remain furloughed, as of Oct. 13.
Mr. Prentice expects that these delays will primarily impact surveys and certification processes.
3. CMS’ 2026 proposed rules
CMS 2026 proposed rules are statutorily required to be released Nov. 1, Mr. Prentice said, which could be delayed if the shutdown continues.
The rules are traditionally finalized on this date to give medical centers two months, or 60 days, to make any necessary changes before a new calendar year rolls in.
“We might find that our payment rule will come out after Nov. 1, giving ASCs less time to apply changes,” Mr. Prentice said.
A delay in rule finalization would affect approximately 6,100 ASCs nationwide. The proposed rule included a 2.4% payment bump for ASCs as well as the addition of hundreds of procedures for the ASC covered procedures list and other administrative updates.
