As of today, with just days left before fiscal year 2025 funding expires, Congress is racing to avoid a government shutdown. Late last week, the House passed a continuing resolution, mostly along party lines, to fund the government through November 21. However, the Senate has not yet acted on it and seems unlikely to do so, making a government shutdown more likely when current funding expires on October 1.
While Republicans indicate general support for a short-term funding patch without any additional provisions to allow more time for broader negotiations, this is at odds as Democrats advocate that any temporary funding bill must include a permanent extension of expiring health insurance premium tax credits. The President canceled a planned meeting (that was set to take place today, Sept. 25) with Democratic leaders and signaled he would use a shutdown to shrink federal agencies by designating fewer workers as “essential.” His administration also directed agencies to consider firing employees working on unfunded programs that don’t align with his priorities to support additional downsizing once funding resumes.
Meanwhile, lawmakers have yet to reach consensus on a second budget reconciliation package, which could bring damaging cuts to Medicaid and other critical human services. Lutheran Services in America urges advocates to contact their lawmakers now to protect these essential programs.
Amid these debates, the Centers for Medicare & Medicaid Services has announced two major initiatives. First, a $75 million investment in workforce training for skilled nursing facilities, aimed at addressing shortages of nurses and certified nursing assistants. The program will support tuition reimbursement, stipends, and training programs in collaboration with states. Second, CMS has launched the $50 billion Rural Health Transformation Fund, giving states the opportunity to address pressing rural health challenges over the next five years.
Congress is also taking steps to address workforce shortages through new legislation. The bipartisan Healthcare Workforce Resilience Act and the Dignity Act of 2025 seek to expand the pool of authorized healthcare workers through immigration reforms. In addition, new research highlights the role of telehealth and artificial intelligence in expanding healthcare capacity—though neither alone can solve the workforce crisis.
Stay engaged with these fast-moving developments: Join our next Capitol Conversations webinar on Thursday, October 16 at 1 p.m. ET.
Sarah Dobson is Senior Director of Advocacy and Public Policy at Lutheran Services in America.
Rural Voices 2025 kicked off at the end of July in rural South Dakota and Minnesota — two states where older adults are underrepresented in policy and disproportionately impacted by provider shortages, limited infrastructure, and fragmented healthcare systems. In partnership with Public Policy Lab, Lutheran Social Service of Minnesota, and Lutheran Social Services of South Dakota, human-centered interviews were conducted with older adults who are dual-eligible (receiving Medicare and Medicaid) to learn what rural older adults need to age in place, the barriers they face in navigating healthcare systems, and how faith-based nonprofit services contribute to their wellbeing.