Why Is There a Partial U.S. Government Shutdown?

A partial government shutdown took effect on January 31 after Congress failed to meet a January 30 deadline to pass a revised federal funding package.

• The U.S. Senate approved the funding deal with a 71–29 vote on January 30.
• However, the package must still pass the House of Representatives and then be signed by the President to fully restore funding.
• Until that happens, certain parts of the federal government are operating under reduced capacity or temporary funding extensions.

The package under consideration:

• Fully funds five federal agencies, including the Department of Health and Human Services (HHS), through September 30.
• Provides only a two-week stopgap extension for the Department of Homeland Security (DHS), which has been at the center of political disagreements, especially around immigration and enforcement operations.

For international nurses who plan to work in the U.S., these developments matter because they can affect hospital operations, public health programs, and the broader policy environment in which you will practice.

1. HHS Lapse Plan: What’s Open and What’s Furloughed?

The U.S. Department of Health and Human Services (HHS) is the umbrella agency for many health-related programs and organizations, including the Centers for Medicare & Medicaid Services (CMS), Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), and Food and Drug Administration (FDA).

HHS released its fiscal 2026 lapse plan summary, which outlines how it operates during a funding lapse:

• Total furloughed staff: 23,128 employees (about 31% of HHS staff)
• Staff retained: 51,082 employees
• The situation is better than earlier projections, largely because:
• The FDA has full-year appropriations.
• The Indian Health Service is also fully funded for the year.
• These agencies will not experience a funding lapse during this shutdown.

While this may sound like internal government detail, it has real implications for hospitals, clinics, and public health programs where international nurses often work.

CMS: Medicare, Medicaid, and Federal Marketplace Still Running

The Centers for Medicare & Medicaid Services (CMS) administers major U.S. health programs that pay hospitals and providers programs that international nurses should become familiar with:

• All 5,733 CMS employees are being retained thanks to non-discretionary funding.
• Key programs continuing to operate include:
• Medicare
• Medicaid (funded through the second quarter of fiscal year 2026)
• Children’s Health Insurance Program (CHIP)
• The Federal Marketplace (Affordable Care Act exchanges)
• Healthcare fraud and abuse control efforts

However, some activities are paused, such as:

• Most survey and certification activities
• Exception: investigations related to serious patient harm
• Contract awards and other obligations that rely on discretionary funds

For nurses, this means patient coverage through Medicare and Medicaid continues, but some regulatory and administrative processes may temporarily slow. Hospitals continue routine care, but back-office operations tied to new contracts or certain certifications may be delayed.

CDC: Outbreak Response Continues, Some Public Health Services Paused

The Centers for Disease Control and Prevention (CDC) plays a critical role in infection prevention, outbreak response, and public health guidance areas particularly important to nurses working in acute and community care.

During the shutdown:

• 4,111 staff at the CDC and the Agency for Toxic Substances and Disease Registry are retained.
• 1,784 employees are exempt because their positions are already funded or otherwise protected.
• 2,327 employees are classified as excepted because their roles are “deemed necessary by implication” for safety and health.

Activities that continue include:

• Disease outbreak response
• President’s Emergency Plan for AIDS Relief (PEPFAR)
• World Trade Center Health Program
• Energy Employees Occupational Illness Compensation Program Act activities
• Vaccines for Children program

Activities put on hold include:

• Some guidance to state and local health departments
• Public health communications and some applied public research
• Surveillance data analysis and certain data reporting
• Handling of public inquiries
• Many grant funding announcements

For international nurses working in the U.S., this means essential outbreak management continues, but new guidance and data-driven updates might be slower, potentially impacting how quickly hospitals receive updated public health recommendations.

NIH: Research Slows, Clinical Care Continues

The National Institutes of Health (NIH) is central to medical research, clinical trials, and many of the scientific advances that shape U.S. healthcare practice.

Under the shutdown:

• 5,283 NIH staff (about 31.53% of its workforce) are retained and excepted.
• No NIH staff are currently classified as exempt; they are retained due to their essential roles.

Clinical operations:

• The NIH Clinical Center operates at about 90% capacity.
• Ongoing care for existing patients continues.
• New patients are admitted only when medically necessary.

Activities currently halted:

• Grant peer review meetings
• Advisory council meetings
• Issuance of new research awards
• Launching new protocols at the Clinical Center
• Much basic and translational research
• Training programs conducted on NIH campuses
• Many scientific meetings and administrative functions

International nurses involved in research settings or academic medical centers may see delays in research projects, grant-dependent programs, and training initiatives during prolonged funding gaps.

FDA: Fully Funded and Fully Operational

The Food and Drug Administration (FDA) oversees drug approvals, medical devices, vaccines, and food safety all crucial to everyday clinical practice.

• All 16,089 FDA employees are continuing normal operations through September 30, thanks to full-year appropriations.

For practicing nurses, this means:

• Ongoing drug and device regulation remains stable.
• Medication supply, vaccine oversight, and safety surveillance continue unaffected by this particular funding lapse.

2. Hospital-at-Home Programs Disrupted by Shutdown

One of the most direct clinical impacts of the partial shutdown has been on hospital-at-home programs innovative models that allow patients to receive acute-level care at home instead of staying in an inpatient hospital bed. These programs have become increasingly important in the U.S., and international nurses may see growing career opportunities in this area.

The current funding deal:

• Extends pandemic-era telehealth flexibilities through 2027, which is crucial for remote monitoring and virtual visits.
• Extends the CMS hospital-at-home waiver through 2023.

However, even a temporary lapse in the hospital-at-home waiver forces hospitals to pause services to remain compliant with federal regulations.

Dr. Constantinos “Taki” Michaelidis, medical director of UMass Memorial Health’s Hospital at Home program, explained the operational challenges:

“It takes weeks to plan for a shutdown and weeks to turn the program back on. With Hospital at Home, when we lose the waiver, if we still have patients with us, it becomes a compliance issue. We would be in violation of Medicare Conditions of Participation if a patient is still on service at 12:01 a.m. Saturday morning [Jan. 31].”

For nurses, this has practical implications:

• Care teams may need to rapidly discharge or transfer patients from home back to inpatient settings when a waiver ends.
• Program staffing, scheduling, and care coordination can become unstable when the policy environment is uncertain.
• For international nurses interested in telehealth, remote monitoring, or home-based acute care, policy stability is critical to long-term job planning.

3. DHS Funding and Immigration Politics: Why It Matters Indirectly

While the Department of Homeland Security (DHS) is not a healthcare agency, its funding is closely linked to *immigration policy, border operations, and enforcement activities all of which are important to international nurses seeking to live and work in the U.S.

Here is what has happened:

• The House of Representatives initially passed a six-bill funding package on January 22, which many expected the Senate to approve.
• Momentum stalled after a federal immigration agent fatally shot 37-year-old registered nurse Alex Pretti in Minneapolis on January 24.
• Following this incident, Senate Democrats advocated advancing DHS funding without reforms to immigration enforcement operations.
• This sparked an impasse, leading to pressure to separate DHS funding from the broader appropriations package.
• Lawmakers eventually agreed on a revised deal:
• Fully funds five agencies through September 30 (including HHS).
• Provides a two-week extension for DHS.

While this shutdown does not directly change visa rules or licensing processes, it highlights how immigration-related debates can disrupt broader federal funding negotiations. For international nurses, it underscores the importance of:

• Working with trusted partners, like NurseContact, to navigate visa timelines and employer sponsorship.
• Understanding that political events can influence immigration-related processing even if the laws themselves do not change overnight.

What This Means for International Nurses and U.S. Employers

For international nurses exploring U.S. nursing jobs, the current shutdown offers several key takeaways:

1. Core clinical services continue

• Medicare, Medicaid, and major federal health programs remain operational.
• Hospitals, clinics, and long-term care facilities are still hiring and delivering patient care.

1. Public health and research may slow, but do not stop

• Outbreak response and essential safety functions continue at agencies like CDC and NIH.
• Some research, grants, and training activities are temporarily paused or delayed.

1. Innovative care models are sensitive to policy changes

• Hospital-at-home programs depend on federal waivers and can be disrupted by funding lapses.
• Telehealth remains supported under extended flexibilities, creating opportunities for nurses skilled in virtual care.

1. Immigration-related debates can shape the broader landscape

• DHS funding disagreements don’t directly rewrite immigration rules, but they signal the political sensitivity around enforcement and border policy.

How NurseContact Supports International Nurses in a Changing Policy Environment

At NurseContact, we’re dedicated to helping internationally educated nurses match with U.S. healthcare employers through a streamlined, transparent hiring process. In periods of political uncertainty like a U.S. government shutdown having a knowledgeable partner becomes even more important.

Through NurseContact, international nurses can:

• Connect with pre-vetted U.S. hospitals, health systems, and long-term care facilities
• Receive guidance on licensing steps, NCLEX planning, and employer-specific requirements
• Get help coordinating with U.S. employers navigating federal reimbursement, telehealth models, and workforce planning
• Stay informed about policy changes that may affect programs you work in, such as hospital-at-home or telehealth services

Planning Your U.S. Nursing Career Amid Policy Uncertainty

Government shutdowns are disruptive, but they are temporary. The demand for qualified international nurses in the U.S. remains strong, driven by:

• An aging population
• Ongoing workforce shortages
• The expansion of care models beyond traditional hospital walls

By staying informed and partnering with platforms like NurseContact, you can:

• Position yourself for stable, long-term U.S. nursing employment
• Understand how federal agencies shape the healthcare environment you will work in
• Prepare for roles in inpatient care, community health, telehealth, and hospital-at-home models as they evolve

If you’re an international nurse interested in working in the U.S., or a U.S. employer looking to connect with global nursing talent, NurseContact provides the tools, connections, and support to move forward regardless of short-term policy turbulence.