The providers hit hardest by the government shutdown (Advisory Board)

The government shutdown that began October 1, 2025, is hitting rural and safety-net providers the hardest, with funding lapses adding to already thin margins. While Medicare and Medicaid continue to operate, critical flexibilities — like telehealth and hospital-at-home reimbursements — have lapsed, forcing providers to either absorb costs or warn patients they may be billed. Community health centers, federally qualified health centers, and hospitals reliant on Medicare add-ons are under immediate strain, with some only able to sustain operations for 30 days without new federal funds.