Federal Shutdown Inhibits Telehealth

Health care providers are uncertain whether telehealth will be reimbursed under Medicaid and Medicare rules to be adopted in the FY 26 federal budget, so they scrambling to convert post October 1st telehealth appointments into physical appointments.  Also, the EPA drinking water clowns who provided the catastrophic advice during the Flint water crisis are furloughed.  From BridgeMI Magazine:

https://bridgemi.com/michigan-government/federal-shutdown-hits-michigan-telehealth-head-start-environment-more/

Federal shutdown hits Michigan telehealth, Head Start, environment, more
By Robin Erb, Paula Gardner, Lauren Gibbons, Kelly House and Kim Kozlowski - October 21, 2025

*    The federal government shutdown began Oct. 1 when Republicans and Democrats failed to agree on a spending plan
*    Now entering its fourth week, the shutdown has begun to affect Michigan programs, from Head Start to Great Lakes research
*    Congress seems nowhere near a deal, with more than 10 failed votes in the Senate on legislation that would have reopened the government

Henry Ford Health on Monday will stop scheduling telehealth appointments for most Medicare patients because the federal government has been shut down for three weeks and there’s no end in sight.

Unsure whether the federal government will pay the hospitals for telehealth visits, “now those patients have to get in their car and come in … versus they could have stayed at home,” Robin Damschroder, Henry Ford’s chief financial officer, told Bridge Michigan on Monday.

Meanwhile, thousands of the most vulnerable children across the country and in Michigan face the potential suspension of Head Start preschool programs, including nine that expect to receive federal grants on Nov. 1.

Researchers trying to reach federal agencies get no one when they call. Jurors could have to serve in federal courtrooms without being paid. Universities can’t access federal grant money. A trick-or-treat event planned at a federal museum in Alpena can’t happen.

While many effects of the shutdown have been muted in Michigan — no major delays have been reported at Michigan airports, for example — cracks have begun to form in many services upon which Michiganders rely.

Officials from various sectors of Michigan’s economy say things will only get worse if the shutdown drags on — which seems increasingly likely given the chasm between Democrats and Republicans in Congress.

The shutdown is “a crisis in slow motion that’s hard to see on a day-to-day basis,” Mike Shriberg, who directs the University of Michigan Water Center, which researches water resources and works closely with federal partners, told Bridge on Tuesday.

Telehealth

For three weeks now at the Saginaw-based Great Lakes Bay Health Centers, clinicians have tried to convert dozens of telehealth appointments to in-person visits, said Jeff Larsen, spokesperson.

“In some cases, we try to reschedule” the visits for patients who can’t show up in person, he said. In other cases, he said, “we do the appointment anyway, because it’s what we should do. And we just probably never see a cent for that visit.”

The confusion over the reimbursement is rooted in coronavirus pandemic-era rules that relaxed limitations on telehealth. Those new rules had been extended repeatedly since the pandemic, but Congress failed to extend them again when they expired Sept. 30.

With a government shutdown, there are no guarantees Medicare will continue to cover telehealth visits that have become routine for so many older Michiganders.

Last week, the US Centers for Medicare & Medicaid Services seemingly paused all Medicare payments to doctors, but then reversed itself a short time later, saying it “will continue to process and pay held claims in a timely manner” — but with several caveats. Behavioral health services and substance abuse disorder treatment would be covered, but not hospital medical appointments for things like diabetes care, for example. Some community clinics could continue billing for all services, but only through Dec. 31.

“We’ve been on a roller coaster,” said Phillip Bergquist, chief executive officer of the Michigan Primary Care Association, which represents the Great Lakes Bay network and about four dozen community health clinics with more than 400 locations across the state.

Head Start

With the shutdown lingering and a $1.5 million grant set to renew on Nov. 1 for the Head Start and Early Head Start programs of the Gogebic Ontonagon Community Action Agency, officials there alerted families last Friday that the program may be temporarily suspended.

That Head Start program serves 85 3- and 4-year-old children in the Upper Peninsula for seven hours a day, four days a week by teaching them school readiness skills and social and emotional skills between serving them breakfast and lunch. That Early Head Start program offers home visits to 30 families and their children up to age 3, said Renee Pertile, the programs’ director.

Funded primarily by the federal government to serve low-income preschoolers and their families with education, nutrition, family support and other services, Michigan has 48 Head Start/Early Head Start programs serving nearly 30,000 children and bringing in $423 million in federal funds, said Robin Bozek, executive director of the Michigan Head Start Association.

Most are making preparations for the 2,944 children who could be impacted if the government shutdown isn’t resolved soon, Bozek said.

A suspension of the programs could be a hardship to the families, especially those who don’t have another parent to rely on for day care, Pertile said.

The environment

Great Lakes scientists whose research is funded by federal grants are left in limbo about whether their projects will continue because federal workers tasked with approving grants are now off the job. Already-funded research is also taking a hit, as academics who collaborate with federal scientists find their collaborators suddenly incommunicado.

Nobody answered the phone at the US Environmental Protection Agency’s national safe drinking water hotline and a full mailbox made it impossible to leave a message.

Likewise, nobody answered at the customer service line for the EPA’s Region 5, which serves the Great Lakes region. After a six-minute hold, someone picked up at the National Response Center, which responds to oil spills, chemical spills and railroad accidents.

Union officials estimate up to 70% of the roughly 900 EPA staff in Region 5 are now off the job.
Those furloughed include lawyers tasked with taking polluters to court, officials who monitor air and water quality and oversee contaminated site cleanups, and workers who inspect factories, power plants and other polluting facilities to make sure they’re complying with environmental laws.

“The longer you don’t have an environmental cop on the beat, there’s going to be more pollution entering the environment, more endangerment of human health,” said Nicole Cantello, president of the American Federation of Government Employees Local 704, which represents EPA workers in the Great Lakes.

Beyond the EPA, furloughs at other environmental agencies left fewer workers keeping tabs on everything from forest pests to toxic Great Lakes algae and invasive sea lamprey to Great Lakes storm patterns.

Federal courts

The US court system proceeded without disruption for the first few weeks of the shutdown, but, as of Monday, federal court operations are limited to necessary expenses, meaning court employees and jurors may be working without pay for the time being.

Both Michigan’s Eastern and Western federal district court systems are still open, and federal judges will still take cases. Court staff are limited to work “necessary for the safety of human life and protection of property, and activities otherwise authorized by federal law.”

Though all court facilities will remain open, “some services may experience delays” and jurors called to serve in federal trials may not get paid until Congress approves a budget, the US District Court for the Eastern District of Michigan posted in notices on its website.

Prospective jurors who would face financial hardships if asked to serve without immediate payment were encouraged by the court to disclose that during the jury selection process.

An Oct. 17 order from Chief US District Judge Hala Jarbou in the state’s Western District noted that court chambers staff will remain on the job without pay until the shutdown concludes, and court staff in other departments will be reduced to essential operations for the duration of the shutdown.

Working without pay

Employees deemed essential to maintaining government operations — including law enforcement, border agents, airport staff and others — are typically asked to work without pay for the duration of the shutdown.

The Veterans Health Administration, the largest federal employer in Michigan, is housed under the Department of Veterans Affairs, which government officials expect to remain 97% operational.

Active-duty military typically also fall under that list, though Trump signed an order last week ordering the Pentagon to use up any remaining funds to pay troops.

Several members of Michigan’s Congressional delegation have backed legislation to pay at least some federal employees required to work during the shutdown.

US Rep. Debbie Dingell, D-Ann Arbor, recently introduced legislation to continue Transportation Security Administration agents’ pay during the shutdown. US Reps. Tom Barrett, R-Charlotte, and Hillary Scholten, D-Grand Rapids, have backed efforts to fund paychecks for law enforcement and Coast Guard members, respectively.

Transportation Secretary Sean Duffy this week warned the ongoing shutdown could cause additional travel delays at airports because of delayed pay for air traffic controllers.

No major delays have been reported out of Michigan’s largest airports.

As of Oct. 17, 773 state unemployment insurance claims were filed this year by federal workers, according to the Michigan Unemployment Insurance Agency. That could include workers laid off since the shutdown began or workers cut during the Trump administration’s earlier efforts to scale back the scope of the federal government.

The state has set up a webpage offering guidance to federal workers seeking unemployment. Federal workers who receive benefits would have to repay the state if they receive back pay when the US government reopens.

The economy

For every week the shutdown extends, the White House Council of Economic Advisers predicts, Michigan’s gross state product will decline by another $361 million.

Under a one-month shutdown, that could increase unemployment by about 1,300 Michigan workers, on top of the roughly 56,000 federal workers furloughed or working without pay, the council estimated. Paused funding for federal contracts is expected to cost Michigan $237 million over the same timeframe.

Michigan businesses seeking Small Business Administration loans are out of luck, as loan distributions are frozen for the duration of the government shutdown. The Council of Economic Advisers estimates Michigan small businesses face a collective $92 million in funding delays.

The longer the shutdown lasts, the higher the risk for Michigan small businesses seeking loans, environmental reviews or federal permits, the Detroit Regional Chamber sent in a statement to members Tuesday.

Delayed wages for federal employees also have businesses bracing for a drop in consumer spending as furloughed workers tighten their budgets. The council’s estimates show a possible $563 million drop in consumer spending for each month the government shutdown extends.

Should the shutdown last for less than one month, Michigan’s economy will likely avoid widespread, long-term economic losses, the East Lansing-based Anderson Economic Group predicted.