The U.S. Government Shutdown Affects Diabetes Care

The United States federal government shut down on October 1 and remains closed after Congress failed to pass a bill to fund the government. As the U.S. enters another week of the government shutdown, people are wondering what diabetes care and research programs are not funded and what might be cut. 

This article explains which programs stop when the federal government closes and explains possible upcoming changes to Affordable Care Act (ACA) subsidies, which currently lower the monthly cost of health insurance for many people who purchase plans through Healthcare.gov or state-based insurance marketplaces.

Why did the government shut down? 

A government shutdown happens when Congress can’t agree on a budget.

Some things the government does are considered “essential” and don’t change, even during a shutdown. Essential responsibilities are things like airport security, border security and the military. Everything else may be paused or frozen. This means a shutdown affects many services, jobs and programs.

The federal budget expired on September 30, 2025. This means money for all the programs it funded must pause. Congress has not yet agreed and voted on a new budget to keep the government open. Congress has also tried to pass a short-term budget known as a Continuing Resolution (CR), but that also failed.

The government will be shut down until Congress can agree on a budget.

A big issue in the budget is the cost of healthcare through Affordable Care Act (ACA) health insurance plan subsidies. A subsidy is money that the government spends to make a good or service less expensive. In this case, the money helps people pay for their health insurance. 

Without these subsidies, Americans who buy health insurance from Healthcare.gov or state-based insurance exchanges will have to pay more. Unless a budget deal is reached, the higher monthly costs for insurance will begin in 2026. 

What programs are stalled or impacted?

Medicare telehealth

Telehealth means getting healthcare using a phone or computer instead of going to a doctor’s office. A person can talk to a doctor, nurse or therapist by video call or phone, which is particularly helpful when it’s hard for people to travel to their doctor or when they live far from a clinic. Telehealth is safe, private and makes healthcare easier for many people.

But with lack of government funding, people who have regular Medicare (not Medicare Advantage plans) can no longer have telehealth visits with their doctors. The telehealth rules that started during the COVID-19 pandemic ended on October 1. (If you have a Medicare Advantage Plan you are still able to see providers by telehealth. We recommend checking your Medicare card to see which type of plan you have.) 

Telehealth is important for people with diabetes. If someone with diabetes needs a prescription refill or needs medical advice, they need to be seen by a doctor right away.

Special Diabetes Program funding

The Special Diabetes Program (SDP) has been part of the National Institutes of Health (NIH) since 1998.

About half of the program’s money ($160 million each year) supports research to prevent, cure and better manage type 1 diabetes (T1D).

This money has helped create new diabetes tools like the artificial pancreas (also called automated insulin delivery, or AID systems) and a treatment that can slow the start of T1D for up to a year. The SDP also funds research looking for a cure, as well as studies that look at what might cause T1D, like the TEDDY study on environmental triggers.

The other half of the program’s money ($150 million each year) supports the Special Diabetes Program for Indians (SDPI). This funding helps support diabetes prevention and care programs through the Indian Health Service.

Without the SDP and SDPI’s total $310 million each year, new research on T1D has slowed down, some current studies have been paused, and programs to prevent and treat type 2 diabetes (T2D) in Native American communities have been stopped.

Supplemental Nutrition Assistance Program (SNAP)

Needed food support programs like SNAP are also likely to run out of money during the shutdown. Also known as food stamps, SNAP provides low-income families with monthly benefits to buy healthy food. One out of every eight people, or 12% of people in the U.S., use SNAP. It is an important program for many families affected by diabetes. 

Benefits for SNAP may continue on for a short time because states are spending from their own budgets. But federal funding is still unclear. News outlets are reporting that SNAP funding may stop as soon as November 1st.

Note: visit FindHelp.org to find food pantries, meal support and other services near you. If you are having trouble getting or paying for insulin, visit GetInsulin.org for cost-saving based on your circumstances.

What happens if the ACA subsidies expire? 

The biggest question right now is whether the ACA subsidies will end when the year is over.

These subsidies help people pay for health insurance through special online marketplaces, also called “exchanges.” These exchanges were created by the Affordable Care Act (ACA) in 2014.

Many people use these state exchange plans. About 24 million Americans have insurance through the ACA markets. Out of those, about 22 million get a subsidy to make their coverage more affordable.

The Kaiser Family Foundation estimates that the average household’s cost for health insurance will more than double next year. Without a fix, insurance costs will go from $888 this year to $1,904 in 2026. The Congressional Budget Office (CBO) estimates 3.8 million people will lose health insurance because of the change. 

George Huntley, CEO of the Diabetes Patient Advocacy Coalition and the Diabetes Leadership Council, says, 

“The most harmful impact of not extending the ACA subsidies will be making health care even more unaffordable to people living with a chronic disease. This will disproportionately impact the poor who struggle to afford their out-of-pocket costs today. Now their premiums will grow exponentially, forcing some to drop coverage altogether. Someone making $35,000 can’t afford a $1,582 increase in their premiums. That’s 4.5% of their total income!”

This is bad news for people living with diabetes. People with diabetes need access to doctors, prescriptions and the tools and technology to stay healthy. Some people might have to drop their health insurance completely. Others who keep their insurance may have to pay much more money each month. 

Because leaders in Congress can’t agree on what to do about the healthcare subsidies, the government is still shut down.

What can we do about this? 

It is important to call or email your elected officials about your concerns. The government shutdown is not good for many people living with diabetes, but losing healthcare subsidies may be even worse.

Reach out to your member of Congress with an email or phone call. Join the Beyond Ambassadors program from Beyond Type 1 and share your story. You can talk about the importance of standing up for people with diabetes. You can also make sure they know about the programs, research dollars and the healthcare that we need to stay healthy.

Resources

• Before your current health insurance plan resets on January 1, Get the Most Out of Your End-of-Year Insurance
• If you need help navigating diabetes without health insurance, check out Tips for Managing Diabetes Without Health Insurance
• If you need help choosing a new health insurance plan, check out Four Things to Compare When Deciding on Health Insurance