When Politics Costs Lives: Trump’s Shutdown and the Healthcare Crisis No One Can Afford

As the federal government remains in shutdown for over a month, what started as a budget stalemate has turned into a national health emergency. We’re hearing from older adults, caregivers, and professionals across our network who are seeing the fallout firsthand —  empty food pantries, canceled telehealth visits, delayed reimbursements,and a growing sense of fear among families who depend on programs like Medicare, Medicaid, and SNAP to survive. 

Behind every policy issue is a real person forced to suffer — a caregiver skipping medication to pay the rent, a senior rationing food, a nurse waiting for her paycheck.

At the heart of this crisis lies a political choice. The Trump administration and Republican leaders in Congress have refused to extend Affordable Care Act (ACA) subsidies and key Medicaid funding. That refusal has not only halted the government — it’s also halted care.

This is not an abstract policy. This is people’s health.

At AgeWise Alliance, our role is to help families make sense of what’s happening. We’re here to translate complex political decisions into real-world consequences and connect people like you with trusted professionals and resources to help them stay afloat.

Healthcare Held Hostage

Every government shutdown has a headline issue, but this one strikes at the foundation of American life: access to healthcare. Democrats have called for the renewal of ACA premium subsidies — the financial assistance that keeps insurance affordable for millions of working families. The Trump administration, backed by a majority of Republican lawmakers, has refused.

These cuts span every safety net program, from health insurance to hospital support to food assistance, hitting the most vulnerable Americans hard.

Without those subsidies, the average annual ACA premium is projected to soar from $888 to $1,904 by 2026. That’s a 114% increase that could push coverage out of reach for up to 24 million Americans. The Congressional Budget Office warns that within a decade, at least 4 million people could lose their ACA plans altogether.

Without ACA subsidies, premiums could more than double — a 114% increase — by 2026!

Meanwhile, Medicaid Disproportionate Share Hospital (DSH) payments, which are a lifeline helping hospitals that serve low-income patients keep their doors open, have already been cut by $8 billion. Many rural and safety-net hospitals are struggling to make payroll or are delaying care altogether.

And with funding for the Supplemental Nutrition Assistance Program (SNAP) — the federal program that helps low-income individuals and families buy groceries — halted since November 1, nearly 40 million Americans have lost access to food assistance. SNAP provides monthly benefits that help people afford essentials like fruits, vegetables, and other staple foods, and it serves as a vital lifeline for older adults living on fixed incomes. Without it, families are now facing hunger on top of rising medical bills, forcing many to make impossible choices between nutrition and healthcare.

The Medicare Ripple Effect

While the political battle plays out in Congress, the consequences are rippling through Medicare, particularly for older adults and rural residents. The shutdown has disrupted not only funding but also the day-to-day functioning of the programs millions depend on. Together, these disruptions reveal how interdependent our healthcare systems have become. When one program stalls, the entire ecosystem, from hospitals to home care, feels the strain.

Telehealth Services: The Digital Lifeline Cut Off

Medicare’s pandemic-era telehealth waivers expired on October 1, 2025, leaving most older adults without coverage for virtual visits. Only a few services are still covered for at-home telehealth, name:

• mental health

• substance-use disorder treatment

• end-stage renal disease (ESRD) assessments

• post-stroke follow-ups 

This means that unless a patient lives in a qualifying rural area or an approved facility, routine primary care, chronic-condition check-ins, and specialty consults now require in-person visits. 

Older adults with mobility challenges, transportation barriers, or limited caregiver support are being forced to choose between skipping care or risking unsafe travel. While some Medicare Advantage plans still offer broader telehealth options, Medigap enrollees have lost nearly all virtual-care access, leading to interrupted treatment, missed refills, and unnecessary hospitalizations. For many, the loss of a simple video call with their doctor feels like losing a lifeline.

Acute Hospital Care at Home: A Safety Net Gone

One of the most innovative Medicare programs to emerge during the pandemic was the “hospital-at-home” waiver, which let qualified providers deliver acute care in a patient’s own home. That waiver expired at the start of the shutdown, and hospitals can no longer bill Medicare for home-based acute care. For seniors with chronic conditions or recovering from surgery, this means long, stressful hospital stays — or no care at all.

Ambulance and FQHC Claims: Reimbursements Frozen

The Centers for Medicare & Medicaid Services (CMS) initially directed contractors to hold payments for all ground-ambulance transports and Federally Qualified Health Center (FQHC) services provided on or after October 1, due to expired payment provisions in the Full-Year Continuing Appropriations and Extensions Act, 2025. These centers are often the only source of care in rural communities, and the pause caused immediate strain on providers and patients alike.

As of October 21, 2025, CMS has lifted the payment hold for ground ambulance transport claims, allowing processing to resume for those services. However, many FQHCs are still experiencing delays and financial uncertainty as other reimbursements remain under review, forcing some to scale back operations or temporarily furlough staff.

Provider Claims Processing: A System Jammed by Delays

While most physician-service claims are technically still being processed, payments for any service tied to an expired waiver, such as telehealth or hospital-at-home, are being held indefinitely. Providers are delaying care, unsure if they’ll be paid. Patients are receiving unexpected bills, and small practices are struggling to stay afloat as the backlog grows.

Customer Service and Administrative Tasks: Lines That Don’t Move

Federal staffing shortages have left seniors stranded on hold. Replacing a lost Medicare card, resolving a billing issue, or checking eligibility now means waiting hours, even days. These are not minor inconveniences; they can cause medical crises for those needing medications or critical supplies.

Audio-Only Telehealth: Silence for Those Without InternetWhen video visits were introduced during the pandemic, Medicare wisely allowed audio-only telehealth for those without broadband or smartphones. That flexibility is now gone, except for limited behavioral health services. 

For millions of older adults, a simple phone call was a lifeline. Now, even that bridge to care has been cut off.

The Breakdown of Trust

The Trump administration is legally obligated to continue existing food aid and certain benefits, yet watchdog groups and members of Congress report that funds are being withheld intentionally. That refusal to administer available resources has deepened the harm and the distrust.

Whether by design or neglect, withholding available resources sends a devastating message to those who rely on these programs: that their well-being is negotiable.This erosion of trust not only harms individuals but also weakens the entire fabric of community care.

When leaders treat healthcare and food assistance as leverage, they erode public confidence in every program built to protect us. For older adults and caregivers who already live on the edge of uncertainty, the message feels cruelly clear: you’re on your own.

We Deserve Better

Every day, we hear from families trying to make sense of what’s happening: “Why did my mother’s telehealth visit disappear?” “Why can’t my father’s claim go through?” “Why did my premium double?”

Healthcare isn’t a bargaining chip. It’s the foundation of a humane society. 

The answers all trace back to one choice, a political decision to let the system fail rather than extend essential funding. If the shutdown continues, experts warn of more cascading disruptions: halted provider payments, deeper Medicaid cuts, and the collapse of key outreach programs that help low-income seniors navigate care.

For families, the takeaway is clear: stay informed, document communications with insurers and providers, and seek verified local assistance whenever possible. Knowing where to turn can make all the difference.

We believe in accountability, not partisanship. What we’re seeing is not about conservative or liberal ideology but rather whether our government fulfills its most basic promise: to care for its people.

So we’ll keep doing what we do best by sharing facts, connecting families to trusted professionals, and offering guidance through the chaos because information is power. Compassion is stability. And community — our community — is how we endure.

Learn more about how to find trusted professionals and resources to help your family during this shutdown at AgeWise Alliance: https://www.agewisealliance.com/