The longest government shutdown in history officially came to a close after 43 days on Wednesday night, when President Trump signed a funding package shortly after it passed the House. The package extends last year’s spending levels through January 30, 2026 for most of the government, and provides funding for some agencies through the end of the fiscal year in September, including the SNAP food benefit program.  

Below are answers to some of the most pressing questions: 

Did Congress extend the Affordable Care Act subsidies? 

Not yet. This month, Americans began shopping for their Marketplace insurance for next year, and many are seeing their premiums skyrocket. This is due to Covid-era enhanced premium tax credits that are set to expire at the end of the year; Democrats maintained that they would not agree to a spending package that did not include an extension of the enhanced subsidies. Ultimately, that was not included in the package passed Wednesday night. However, there has been a commitment by Senate Majority Leader John Thune (R-SD) to vote on extending the subsidies in December. Speaker Mike Johnson (R-LA) on the House side has made no such commitment. It is estimated that without extending these subsidies, up to 5 million Americans could lose health coverage, and 22 million Americans will see their Marketplace premiums go up. 

What was included in the spending package for health systems? 

Extensions of some of the programs we have been tracking closely have been included through January 30, 2026. These include: 

  • Extension of Medicaid Disproportionate Share Hospital (DSH) relief 
  • Extension of Medicare telehealth flexibilities  
  • Extension of Hospital-at-Home flexibilities  
  • Extension of rural payments: Low-Volume Adjustment and Medicare Dependent Hospital (guaranteed full retroactive pay) 
  • Exemption of PAYGO requirements, which prevents cuts to Medicare and other mandatory programs 

Does this mean that SNAP benefits will be fully restored? 

Yes. This week, a USDA spokesperson said that most states will see SNAP funds released within 24 hours of the government reopening; states will then be able to distribute these funds to beneficiaries. This follows a dramatic few weeks of uncertainty for millions of SNAP recipients who rely on these benefits as the Trump Administration fought efforts to force them to utilize contingency funds to pay out benefits during the shutdown, a fight that the Administration took to the Supreme Court. 

Will backdated Medicare/Medicaid claims get paid? 

Yes, the Medicare Dependent Hospital and Low Volume Hospital claims will be retroactively paid. The bill also authorizes CMS to provide retroactive coverage for telehealth claims. CMS should soon release a guidance with further details on how they plan to proceed. 

Will federal workers get back pay and when will they return to work?  

Yes, federal law requires that workers whose paychecks were paused during the shutdown receive back pay. In the past, this has taken about a week. Many furloughed federal workers were notified Wednesday to return on Thursday. 

Does this mean the government is fully funded through the next fiscal year? 

No. Of the 12 appropriations bills that require full year packages, three (Agriculture, Legislative and Military/Veterans Affairs) were included in addition to the continuing resolution that passed Wednesday night. This means that the other nine bills must either pass Congress or be continued at their current spending levels by the end of January 2026 to avoid another shutdown. 

AHPA’s policy team will continue to track these funding packages and their impact on health systems.