Congressional Action Ends the Shutdown and Funds the Government through January 30, 2026

Updated November 13, 2025

On Wednesday evening, November 12, President Trump signed H.R.5371, the Continuing Appropriations and Extensions Act, 2026, into law, ending the nation’s longest ever shutdown that had commenced 43 days prior. The House passed the measure in a 222-209 vote on Wednesday evening, following the Senate’s passage on Monday in a 60-40 vote. The appropriations minibus provides full-year FY 2026 funding for three regular appropriations bills (Agriculture-Rural Development, Food and Drug Administration (FDA), Legislative Branch, and Military Construction-Veterans Affairs) and extended funding for all other agencies through January 30, 2026.

As part of the deal, Senate Majority Leader John Thune (R-SD) committed to hold a vote no later than the second week of December on a Democrat-drafted extension of the Affordable Care Act (ACA) enhanced advanced premium tax credits (APTCs), which are set to expire at the end of this year. However, House Speaker Mike Johnson (R-LA) has refused to commit to such a vote in the House.

In addition to providing government funding, the law rescinds more than 4,000 federal worker layoffs that occurred during the shutdown and includes language to provide back pay to those furloughed. Further, it bars further workforce reductions until January 30, 2026.

The legislation also extends or funds several expiring Medicare, Medicaid, and public health provisions through January 30, including but not limited to:

• Extension of Covid-era telehealth flexibilities for Medicare
• Extension of the Acute Hospital Care at Home program
• Funding for the Community Health Center Fund ($1.4 billion), the National Health Service Corps ($115.3 million), and the Teaching Health Center Graduate Medical Education Program ($58.5 million)
• Extension of increased inpatient hospital payment adjustment for certain low-volume hospitals
• Extension of the Medicare-dependent hospital program
• Extension of the work Geographic Price Cost Index floor of 1.0 used to calculate provider payment rates under Medicare
• Funding for Centers for Medicare and Medicaid Services Quality measure development programs ($14 million for fiscal year 2025 and $13.3 million for fiscal year 2026)

FDA Funding and Provisions
The FDA appropriations portion of the package funds the agency at approximately $7 billion, including $3.4 billion in discretionary funding, similar but not identical to the funding measure unanimously advanced by the Senate Appropriations Committee in July. Key provisions include:

• Five-year reauthorization of the Over-the-Counter Monograph Drug User Fee program
• Requirement for the agency to report on its progress toward the use of alternatives to animal testing for the clearance of new sunscreens and topical over-the-counter drugs
• Enhanced enforcement provisions against illegal tobacco products

Next Steps in Congressional Action
Senate Majority Leader Thune has stated that the chamber will move quickly to begin passage of additional FY 2026 spending measures this week, including funding for the U.S. Department of Health and Human Services (HHS).

ACA Enhanced Premium Tax Credits: Ongoing Discussions
Discussions are underway among the White House and congressional Republicans about how to address the spike in health care premiums that will result from the expiration of the enhanced ACA tax credits on December 31. The President has expressed support for paying Americans directly for their health care expenses, shifting from the current tax credit system to one of cash payments to individuals. The idea has been praised by a number of Republicans on Capitol Hill, several of whom have indicated plans to draft legislation in line with the proposal. House committee chairs are scheduled to hold listening sessions with Republican members about the party’s health care policy agenda and the expiring tax credits this week. On Wednesday, the Senate Finance Committee is holding a hearing to consider solutions to address the rising cost of health care.

Looking Forward: The Need for Continued Advocacy
While the Continuing Appropriations and Extensions Act, 2026 provides much-needed relief by ending the shutdown and funding the government through January 30, 2026, this stopgap measure underscores the ongoing uncertainty facing critical health programs. Continuing Resolutions are by design temporary funding mechanisms that maintain current spending levels rather than establishing long-term policy or providing agencies with the certainty needed for strategic planning and program development.

For echo, the extension of Medicare telehealth flexibilities only through January 30 means these vital services remain in limbo, subject to repeated short-term extensions rather than the permanent authorization that would give providers, patients, and health systems the stability to fully integrate telemedicine into care delivery models. Similarly, research institutions and the NIH community face continued budgetary uncertainty that hampers multi-year research planning and workforce retention.

As we approach the January 30 deadline, continued advocacy will be critical to push for full appropriations legislation that permanently extends telemedicine flexibilities and provides the NIH with stable, predictable funding for long-term research planning.

Previous ASE Advocacy 

• Telemedicine
  • ASE believes these critical patient-services should not be vulnerable to disruptions from government shutdowns. The Society continues to advocate for permanent legislation to protect telehealth access. ASE supports the CONNECT Act (Creating Opportunities Now for Necessary and Effective Care Technologies) (S.1261/ H.R.4206) , which would permanently extend Medicare telehealth flexibilities, allowing patients to receive care from their homes regardless of location, and preserving audio-only services that many rely on for accessible healthcare. The CONNECT Act would eliminate geographic restrictions, expand the types of providers who can deliver telehealth services, and ensure patients can continue receiving high-quality cardiovascular care without unnecessary barriers.
  • Take action: We encourage ASE members to contact their members of Congress to urge support for the CONNECT Act and other permanent telehealth legislation. Your voice matters in protecting patient access to telemedicine. Visit ASE’s Advocacy Resources or contact your representatives directly to share how telehealth flexibilities have improved care for your patients.
• National Institutes of Health (NIH) Funding 
  • ASE considers robust and sustained funding for the NIH is essential to advancing medical research, maintaining America’s global leadership in science, and ensuring life-saving discoveries that benefit patients nationwide. Even amid the ongoing government shutdown, the Society continues to actively advocate for predictable NIH funding growth that supports groundbreaking research, preserves our nation’s research infrastructure, and trains the next generation of scientists. 
  • The Society has joined coalition letters urging Congress to prioritize NIH funding in the FY 2026 appropriations process.  
    • In October 2025, the Society signed onto a letter with nearly 300 organizations from the Ad Hoc Group for Medical Research requesting at least $47.2 billion for NIH, in addition to funding for the Advanced Research Projects Agency for Health (ARPA-H). 
    • In September 2025, the Society joined 164 national organizations in supporting the Joint Associations Group’s Financial Accountability In Research (FAIR) model, which seeks to enhance transparency and accountability in research funding while blocking arbitrary caps on essential research costs and ensuring a transition period of at least two years for any new funding model implementation.  
  • As budget negotiations continue, the Society will work with congressional appropriators to ensure any final spending agreement includes the robust NIH investment necessary to maintain American scientific excellence. 

Additional Information and Resources:

• ASE Overview on NIH Funding: NIH Research Funding and Echocardiography
• CMS operations: HHS CMS Contingency
• NIH operations: HHS NIH Contingency
• Congress.gov: Past Government Shutdowns: Key Resources
• Committee for a Responsible Federal Budget: Government Shutdowns Q&A: Everything You Should Know
• Bipartisan Policy Center: What Happens if the Government Shuts Down?

ASE continues to monitor the impact of the government shutdown, and any impacted providers who have questions or need assistance are encouraged to email ASE advocacy staff at [email protected].