How a Government Shutdown Could Affect Audiologists, SLPs, and Those You Serve

Update: November 13, 2025

Congress has passed and the President has signed a bill to fund the federal government through next January.

Medicare telehealth authority for audiologists and SLPs has now resumed until January 30, 2026. ASHA will continue advocating for permanent extension of that ability in the next government funding bill before the current authority expires. ASHA advocates can join in advocacy by writing your legislators.

The Centers for Medicare & Medicaid Services has indicated that the agency will provide subsequent guidance on claims processing. ASHA will provide updates and resources once that information is released.

Although all federal departments and agencies will begin resuming normal operations, response times could be delayed as agency staff work through backlogs caused by the shutdown and as previously fired federal workers are reinstated as required by the new law.

Update: November 11, 2025

The Senate has passed legislation to reopen the federal government and forwarded it to the House for consideration, which is expected Wednesday.

If passed by the House without changes, funding for federal programs will resume through January 30, 2026, except those administered by several agencies whose funding would be extended through September of next year.

The bill would restart and extend Medicare telehealth authority for audiologists and SLPs through January 30 next year with the expectation that the next government funding bill would also include such authority. The bill requires the Centers for Medicare & Medicaid Services (CMS) to pay telehealth claims that have been on hold retroactive to October 1, 2025. CMS will likely issue guidance on claims processing once the legislation is signed into law, after which ASHA will update relevant resources accordingly.

The legislation also rescinds the previous firing of federal workers since October 1, 2025, across departments and agencies who administer key programs like IDEA while preventing the Administration from future wide-scale reductions in force through at least January 30. The bill also will ensure that federal workers who were forced to work during the shutdown without pay will be compensated for their service during that period.

Democrats secured a promise from Senate Republicans to vote on legislation in December extending expiring subsidies to lower health insurance premiums, though without guarantee of its approval by the Senate or consideration in the House.

ASHA has called for the resumption of Medicare telehealth authority, extension of the health care subsidies, and reinstatement of fired federal workers throughout the shutdown.

Update: November 5, 2025

The federal government shutdown is now the longest in history at 36 days and counting.

Election results in Virginia, New Jersey, and elsewhere (where Democrats overperformed expectations up and down the ballot) could prompt progress toward reopening the government. The election results could convince Republicans to seek a quick resolution to the shutdown while alternatively emboldening Democrats to continue opposing GOP funding legislation (which the Senate has rejected 14 times) until achieving their policy objectives. House and Senate Democratic leaders wrote President Trump today asking for a meeting to discuss options while the President met with Senate Republicans at the White House to discuss the situation.

The President has called on Senate Republicans to eliminate the filibuster (which effectively requires 60 votes take a final vote on passage of legislation) so the House-passed continuing resolution could be enacted.

More than two dozen Senate Democrats have written to Health and Human Services Secretary Robert F. Kennedy, Jr. about rising health care costs to pressure the Administration and congressional Republicans into capitulating to their policy demands.

Meanwhile, some Republicans and Democrats in the Senate are discussing the outline of an agreement to reopen the government, which could include passing bills to fund the entire federal government for the remainder of the fiscal year and voting on an extension of expiring health care subsidies.

ASHA continues to highlight the importance of reopening the government and restarting Medicare telehealth authority and will have more than 300 members on Capitol Hill soon to advocate for policies beneficial to audiologists and SLPs, regardless of whether the government is open or not.

Update: October 28, 2025

There are some small signs of progress toward ending the government shutdown even as the Senate continues voting against moving forward on the House-passed funding bill.

The American Federation of Government Employees, which represents 820,000 federal and D.C. government workers, called on Congress to end the shutdown by passing a clean continuing resolution, putting pressure on Senate Democrats vote for the House bill while continuing to push for broader policy priorities. Meanwhile, the federal district judge who temporarily stopped the firing of about 4,000 federal employees last week indefinitely blocked those layoffs today, likely setting up review by higher courts.

Senators in both parties have expressed support for proposals to pay federal workers, members of the military, and air traffic controllers, while others are expressing concern about funding shortfalls for critical programs.

House Speaker Mike Johnson also announced that House leaders are working with relevant committees to craft a health care plan to address the expiration of enhanced health care subsidies, though that chamber remains recessed. Join ASHA Advocacy in action [PDF] by contacting your congressional representative to urge them to pass legislation that will extend this assistance and maintain access to critical audiology and speech-language pathology services.

ASHA signed another letter calling on Congress to immediately reinstate Medicare telehealth access and ensure retroactive payment for practitioners that maintained patient access to crucial services during this lapse.

Update: October 23, 2025

The Senate voted for the twelfth time against advancing the House-passed bill to fund the federal government. The chamber also rejected efforts to provide paychecks to members of the military and certain federal employees forced to work during the shutdown. Following those votes, the Senate adjourned until next week, while the House remains out of session pending Senate action on its funding proposal.

Senate Democratic Leader Chuck Schumer and his House counterpart, Hakeem Jeffries, continue to seek a meeting with President Trump to discuss their desire to add health care provisions to the House bill, including renewal of tax credits to help people purchase health insurance on Affordable Care Act marketplace exchanges, which expire at year’s end.

Separately, thirteen House Republicans sent a letter [PDF] to House Speaker Mike Johnson on Tuesday calling for the chamber to “immediately turn our focus to the growing crisis of healthcare affordability” and address the looming lapse in the tax credits once the government reopens.

ASHA continues to call on Congress to reopen the federal government, restart Medicare telehealth authority [PDF], and rescind the firings of federal workers at the U.S. Department of Education who administer and oversee programs like the Individuals with Disabilities Education Act that are crucial to the ability of ASHA’s school-based professionals to support students with disabilities. ASHA has also urged passage of a bipartisan bill [PDF] that would extend the tax credits for one year to give Congress time to develop a longer-term solution.

Update: October 16, 2025

CMS announced that it has instructed Medicare Administrative Contractors (MACs) to continue to hold claims for services paid under the Medicare Physician Fee Schedule that were provided on or after October 1, 2025. This hold only applies to claims for services impacted by expired legislative provisions such as telehealth and those subject to the work floor for the geographic price cost index. All other claims will be paid moving forward.

Additionally, a federal district judge ruled [PDF] on Wednesday, October 15, 2025, that widespread reduction-in-force notices sent to about 4,000 employees last Friday were “both illegal and in excess of authority,” and granted a temporary restraining order blocking most agencies from proceeding with those layoffs. The order stops the Administration from “taking any action to issue any reduction-in-force notices to federal employees … during or because of the federal government shutdown” if they are covered by the unions that filed the suit.

ASHA urges advocates to continue contacting your members of Congress during the shutdown, particularly in support of protecting the Department of Education and reinstating Medicare telehealth authority for audiologists and SLPs.

Update: October 15, 2025

The Senate has voted several more times (nine in total) against advancing the House-passed government funding proposal as both parties remain entrenched in their respective positions. Senate Leader John Thune has acted to bring up bills that fund parts of the federal government, such as the Department of Defense, to try to make Democrats take politically unpopular votes and force fissures in the party’s position against funding the government until their policy demands are addressed. The Senate is expected to take additional government votes throughout the week, while the House remains recessed.

The Administration has indicated the desire to find funding for some popular programs and ensure that members of the military and federal law enforcement officers continue to get paid during the shutdown. Doing so could lengthen the shutdown by removing forcing mechanisms that might prompt negotiations that could end the impasse.

Several members of ASHA’s Board of Directors spent today on Capitol Hill calling on Congress to reopen the federal government, restart Medicare telehealth authority for audiologists and SLPs, and rescind the firings of federal workers who administer programs like IDEA that help ASHA's school-based members support students with disabilities. Join us in taking action!

Update: October 13, 2025

According to media reports, the U.S. Department of Education (ED) made another round of layoffs this past weekend amid the ongoing federal shutdown. Reporting indicates that the cuts heavily affect the Office of Special Education Programs (OSEP), which oversees special education, further shrinking federal capacity for oversight under the Individuals with Disabilities Education Act (IDEA).

During previous reductions in force (RIF), courts ruled that ED needed to retain enough personnel to carry out its legally mandated duties. The most recent round eliminates even more staff than before, and lawsuits are already challenging the legality of both waves of layoffs.

For this fiscal year, most IDEA funding has already been released by ED. However, ASHA members should expect slower responses on guidance, monitoring, and OSEP-administered discretionary grants and technical assistance due to both the staffing reductions and the shutdown.

If staffing losses and the shutdown persist, states and districts could face prolonged delays in monitoring and enforcement, as well as uncertainty around future OSEP grant competitions.

Take Action Now: Protect the U.S. Department of Education to Ensure Access to Services and Supports Necessary for Student Achievement and Success!

Update: October 10, 2025

Congress and the President have not yet reached agreement on legislation to reopen the federal government. The Senate voted several times this week on the House-passed measure to extend funding, but neither that bill nor a Democratic alternative secured enough votes for passage.

The House remains in recess, with Speaker Mike Johnson saying that “we will come back, and get back to legislative session, as soon as the Senate Democrats turn the lights back on.” House Democratic Leader Hakeem Jeffries countered that "House Republicans canceled votes last week. House Republicans canceled votes this week. House Republicans appear ready to cancel votes next week. These people are not serious about reopening the government." The Senate is not expected to vote again on the House-passed bill until Tuesday evening, making it likely the shutdown will continue into early next week.

Meanwhile, the Office of Management and Budget (OMB) has indicated that widespread layoffs of federal workers—referred to as Reductions in Force or RIFs—have begun across federal agencies. A spokesperson for the OMB confirmed the RIFs have begun and that they are "substantial.” It is unclear at this time how many employees at which agencies are subject to the RIFs and what impact that will have on agency operations.

Republicans maintain that negotiations on Democratic proposals to extend or make permanent expiring Affordable Care Act tax credits—used to help individuals pay health insurance premiums—should occur only after the government reopens. Although some senators have held informal discussions on this issue, formal negotiations have not yet begun.

ASHA recently endorsed bipartisan legislation to extend these tax credits before the end of the year and hopes this action will help break the current funding impasse.

Update: October 7, 2025

The Senate has again voted against advancing the House-passed funding bill or Democratic alternative, though additional votes could take place later this week. The House remains adjourned pending potential Senate action on its funding proposal. ASHA has sent a letter [PDF] to House and Senate Republican and Democratic leaders urging them to restore the ability of audiologists and SLPs to provide covered telehealth services to Medicare beneficiaries, noting that this authority has become a casualty of unrelated policy disagreements that is leaving many patients without the necessary coverage for services ASHA members provide.

Join ASHA in asking Congress to restore Medicare beneficiaries' access to the telehealth services audiologists and SLPs provide. Write your legislators today!

Update: October 3, 2025

The Senate has voted several times since Wednesday on the House-passed funding bill that would reopen the government (and restart Medicare telehealth authority) but those votes have failed to achieve the threshold needed for passage. The Senate has now recessed for the weekend and will reconvene on Monday to vote again on the House's funding proposal and the Democratic alternative. The House has cancelled planned votes for next week in an effort to pressure Senate Democrats to support the House funding bill. ASHA will provide further updates as warranted.

Update: October 1, 2025

Unfortunately, Congress failed to pass legislation funding the federal government by the midnight deadline, triggering a government shutdown and pause in the ability of audiologists and SLPs to provide Medicare covered services through telehealth. Although it is possible that subsequent congressional action to fund the government and end the shutdown will restore this authority, neither audiologists nor SLPs should bill Medicare for telehealth services in the interim. Facility-based clinicians should discuss options with their employers.

The U.S. Department of Health and Human Services and U.S. Department of Education [PDF] have released contingency plans for operations during a lapse in appropriations. CMS has announced that it has instructed Medicare Administrative Contractors to hold claims for 10 business days in an effort to avoid reprocessing claims in the event a funding bill is enacted during this time. It also advised clinicians who are no longer authorized to provide telehealth services to consider using an Advanced Beneficiary Notice. Clinicians who are not authorized telehealth providers may choose to hold claims for telehealth services pending Congressional action. See also: Providing Audiology and Speech-Language Pathology Telehealth Services Under Medicare.

It is unclear currently how this guidance, and directives [PDF] and instructions from the Office of Management and Budget outlining agency operations during the shutdown, will impact the ability of patients, clients, and students to access the services audiologists and SLPs provide. We will provide updates here as they become available.

September 26, 2025

Congress must pass legislation to fund the federal government by October 1, 2025. If it fails, the government will shut down, potentially impacting some programs and services relied upon by audiologists, speech-language pathologists (SLPs), and the people you serve.

In past shutdowns, most federal agencies worked to minimize disruptions to the programs they administer and the services they provide. However, the Office of Management and Budget (OMB) has directed federal agencies [PDF] to use any lapse in appropriations to reduce the federal workforce and halt programs lacking alternative funding sources.

While programs with mandatory funding, such as Medicare and Medicaid, typically continue with limited disruption, there are few details about how this new approach would be implemented.

Here’s what you need to know about the potential impact across key federal agencies:

U.S. Department of Health and Human Services (HHS)

HHS and its operational agencies, including the Centers for Medicare & Medicaid Services (CMS), oversee Medicare and Medicaid. During a shutdown:

• Medicare telehealth authority would end: Audiologists and SLPs would no longer be recognized as eligible telehealth providers. Other payers, including Medicaid and private insurance, would remain unaffected.
• Claims and payments to providers should continue as normal.
• Essential functions related to public health and safety will remain in place.
• Some services—such as beneficiary casework, outreach and education, and policymaking and rulemaking—could be delayed due to decreased staffing.

If you have questions about claims processing, patient eligibility, provider enrollment, or other reimbursement issues, contact your local Medicare Administrative Contractor (MAC) or state Medicaid agency. ASHA also provides resources on Medicare telehealth services, including guidance for private pay arrangements for services not covered by Medicare. You can also support continued access by urging Congress to extend Medicare telehealth authority.

U.S. Department of Education

The Department of Education administers and provides federal funding for various education, student loan, and grant programs. During the shutdown:

• Most K-12 public education funding (e.g., to Title I, IDEA Part B) is “forward funded,” meaning that states and local districts should already have access to formula funds in the short term. However, in the event of an extended shutdown, states and districts may have problems accessing some of those funds.
• Higher education programs, including Pell Grants, federal direct student loans, and loan repayments, will continue.
• Program and research grants should see little or no disruptions during a short-term shutdown.
• However, schools on federal lands (Department of Defense schools and those on federal Native American reservations) could face immediate disruptions.

U.S. Office of Management and Budget (OMB)

OMB manages the federal budget and oversees federal policy implementation and agency performance. Recently, it issued a memorandum [PDF] to agencies on shutdown planning:

• The memo instructs agencies to prepare reductions-in-force (layoffs of federal workers) for programs, projects, or activities that meet certain criteria or circumstances.
• The memo also asserts that the Administration is not required to carry out programs whose funding expires on October 1 if they do not have other sources of federal mandated by law.
• It is unclear whether and/or how this directive could impact programs HHS and ED administers in the event of a shutdown as neither agency has detailed their respective plans.

U.S. Office of Personnel Management (OPM)

• OPM manages human resources policies for the federal government. In the event of a shutdown:
• Federal employees and contractors may be subject to furlough.
• It is unclear whether OPM will provide uniform guidance across agencies and/or consistent application of procedures nationwide.

ASHA members who are federal employees or contractors should consult OPM’s shutdown furlough information page for more information.

What’s Next?

House and Senate leaders are still negotiating how to fund the government. Any legislation to provide short- or long-term funding must be passed in both chambers and then signed by the president before the October 1 deadline to prevent disruption.

ASHA Advocacy is closely monitoring developments and will provide updates as they occur.

Questions?

ASHA encourages you to contact the relevant federal or state agency for inquiries about your specific situation.

For questions about the congressional budget process and updates on legislative efforts to avoid a federal government shutdown, contact the federal and political affairs team at federal@asha.org. 

For questions about the potential impact on Medicare, Medicaid, and education programs, contact the health care and education policy team at reimbursement@asha.org.