Sarah Elgatian is a graduate student in rural Iowa, who like about 16 million women of reproductive age, uses Medicaid insurance and at times has relied on Planned Parenthood for routine gynecological treatment for infections and birth control, both in person and through its growing telehealth program. (Photo by Todd Welvaert for States Newsroom)

Fourth in a five-part series.

Sarah Elgatian was in too much pain to feel awkward. 

That morning in 2019, she was hunched over her toilet, feeling what she described as a “weird burning nausea,” abdominal pain and other symptoms. She remembered the Planned Parenthood telehealth ad she’d seen recently. Elgatian downloaded the app, and within a couple hours from her bathroom, she was video chatting with a health provider. She recalled that the doctor could tell she had a urinary tract infection just by looking at her face.

“They were like, yeah, those are textbook symptoms, and you are cringing,” said Elgatian, 35, who lives on the outskirts of Davenport, Iowa, where the nearest pharmacy is at least a 20-minute drive. But luckily, Elgatian’s spouse was able to get the antibiotics the Planned Parenthood provider prescribed, and with it, relief. “That was really scary, just because, if you’ve ever had a UTI, when they’re bad, they’re so bad.”

Elgatian, like about 16 million women of reproductive age, has Medicaid, the federal and state medical insurance program for people with low incomes, and therefore limited options when it comes to reproductive health. With even fewer options in rural Iowa, Elgatian, who is a graduate student, said at times she has relied on Planned Parenthood for routine gynecological treatment for infections and birth control, both in person and through its growing telehealth program.

Now that a new rule has eliminated hundreds of millions in Medicaid reimbursements to Planned Parenthood, reproductive health providers have turned to telehealth as part of the solution to offer low-cost health services due to reductions in clinic staff and services, or closures.  

Telemedicine gained momentum in the wake of the COVID-19 pandemic and the increasing health care deserts around the country. In the reproductive health space, it has expanded in the last few years, as the overturn of Roe v. Wade and the resulting policies prompted the closure of many physical clinics. By the end of 2024, 1 in 4 abortions was provided via telehealth, according to the Society of Family Planning, though there are ongoing efforts at the federal and state level to prohibit telehealth abortions.

“We’ve — overall as a trend — seen more patients taking advantage of telehealth, and I think it’s a combination of factors, particularly in rural areas where access to care can be very, very limited,” said Ruth Richardson, president and CEO of Planned Parenthood North Central States, which covers Iowa, Minnesota, Nebraska, North Dakota (which has no physical clinics) and South Dakota, and recently closed eight clinics after the Trump administration froze their federal family planning Title X grant funding. “That is something that we’ve seen as a trend even before the Medicaid defund occurred.”

At the same time, providers and advocates warn that telehealth — the virtual delivery of care using technology from video conferencing, phone- or computer-based apps, to text messaging — still leaves a huge gap in reproductive health care access, especially for patients without reliable Internet or who don’t have the financial resources necessary to participate, like a debit or credit card. Much of the care cannot be delivered virtually, such as treating certain STIs, intrauterine device insertion, performing vasectomies and procedural abortions, which are optional in the first trimester and necessary later in pregnancy.

“There’s a lot of people for whom telemedicine is not an option, and so I think it’s really important to note that it’s not a quick fix,” said Amy Hagstrom Miller, president and CEO of Whole Woman’s Health, which manages five physical clinics in Maryland, Minnesota, New Mexico, and Virginia that specialize in abortion and offer some gynecology services. It also has a virtual care practice in 10 states that offers primarily medication abortion. “It’s not the only fix, right? It’s got to be both and so that people truly have choice.”

Turning to telehealth 

In 2023, one-third of Iowa’s counties were considered maternal health deserts, according to the March of Dimes. That number will likely increase in the nonprofit’s next report. Earlier this year, Planned Parenthood North Central States shrunk its physical presence in Iowa from six to two clinics. The affiliate, Richardson said, stands to lose $11 million from the latest federal Medicaid change, after having served about 27,000 people on Medicaid — about one-third of their total patients — in 2024. 

Richardson said the affiliate’s health centers will continue to serve patients regardless of their insurance status and will work with them to understand their payment options. She said she is expecting their telehealth program to keep growing, especially after shuttering clinics in more rural areas like Bemidji, Minnesota. 

In the past year, the North Central States affiliate reported it saw 4,204 patients during 8,241 visits on the Planned Parenthood Direct app, a 12.9% increase in virtual care visits, and about 5% of the 87,631 total patients seen. Services offered during telehealth visits include birth control counseling and prescriptions, UTI treatment, gender-affirming care, emergency contraception and the abortion pill. Newer virtual care services were launched this past year, related to menopause, sexual wellness and early pregnancy complications.

Planned Parenthood has increased its telehealth presence across the nation in the last two years. Planned Parenthood Direct, launched about a decade ago and expanded nationally in 2019, is an asynchronous app that provides some services and accepts Medicaid in some states.

Separately, Planned Parenthood affiliates run virtual health centers, which have expanded to more than 50 nationwide, said a Planned Parenthood Federation of America spokesperson. According to Planned Parenthood’s 2023-2024 annual report, patients booked more than 47,000 appointments through virtual health centers in the last fiscal year, and, on average, virtual health center patients are accessing care more than two days sooner than in-person appointments. Across all telehealth platforms, there were 142,000 appointments made, the spokesperson said. 

In Michigan the most popular Planned Parenthood clinic has no real walls or windows. The virtual clinic launched in 2023, and now sees the highest number of patients compared to the state’s 10 physical health centers, said Ashlea Phenicie, the chief external affairs officer at Planned Parenthood of Michigan, which in April closed three clinics in underserved areas and consolidated two health centers in Ann Arbor because of Title X cuts. 

Phenicie said Michigan’s virtual clinic is always more than 100% booked and offers evening and weekend appointments.

“I think that not only is it filling a need in communities where we don’t have brick-and-mortar health centers, but for many patients, this is how they prefer to access care,” Phenicie said. “It’s convenient. A lot of our patients will do it on their lunch break or, you know, before school or between work and picking up their kids. It lets them fit their health care into their everyday lives. It can also provide a degree of privacy and security. There’s no protesters who walk by when you’re visiting a telehealth provider or getting birth control through the PPDirect app.” 

In a new study in the journal Contraception, researchers from the Guttmacher Institute found that while many publicly funded family planning clinics offer some services via telehealth, Planned Parenthood clinics offer telehealth most frequently, and offer a wider variety of services. The researchers, who surveyed nearly 500 publicly supported family planning clinics, wrote that many health departments and federally qualified health centers need more support and infrastructure to implement telehealth, especially for contraceptive care. They noted that while the benefits of telehealth include convenience, low cost, and improved patient outcomes, difficulties include loss of patient-provider rapport, technology and workflow issues, and regulatory barriers.

And they warned: “If telehealth is implemented inequitably, it may deepen existing disparities.”

Barriers 

Research is still limited when it comes to telehealth delivery of broad reproductive health services. A 2023 study by researchers at Oregon Health & Science University found evidence suggesting telehealth care for intimate partner violence and contraceptive care can produce “equivalent clinical and patient-reported outcomes as in-person care.”

But many reproductive health care advocates and researchers agree that telehealth will likely not be enough to fill the gap left by closing physical clinics, and that there remain many barriers to accessing telehealth generally, related to age, language, financial resources, digital literacy, and access to technology and internet.

In 2023, the National Telecommunications and Information Administration reported that roughly 12% of people lived in households with no internet connection, while a National Digital Inclusion Alliance analysis of 2022 data showed that 24% of households lacked a home internet connection.

Last month the Journal of Medical Internet Research published a study examining telehealth usage patterns of nearly 10,000 adults in rural California that found people who are older, speak Spanish or rely on public insurance struggle the most to access virtual care. The researchers reported that rural health disparities are often more pronounced among rural populations of color, who make up about 20% of rural U.S. residents.

For Elgatian, her occasional use of telehealth has not erased her need for affordable in-person reproductive health care, something she’s currently worried is about to change in Iowa following the new Medicaid rule. In a pinch, her fail-safe — at least until recently — had been Planned Parenthood, the closest being more than an hour away in Iowa City, followed by just one other in-state option: the Des Moines clinic nearly three hours away. But it was the latter clinic that Elgatian was closest to while driving through last year and suddenly bleeding vaginally. It turned out to be related to uterine polyps and her IUD, something she likely wouldn’t have discovered via telehealth.

“I don’t yet know, personally, how this will pan out for me, but it seems likely that there will be a time when I will struggle to find care without being able to use Planned Parenthood,” she said.

Efforts to expand and improve telehealth

Since its founding four years ago, telehealth provider Hey Jane, which is not affected by the government’s new Medicaid exclusion, has provided care to more than 100,000 people and expanded beyond medication abortion to provide birth control, emergency contraception, treatment for vaginal infections, herpes, and UTIs, according to co-founder Kiki Freedman. Hey Jane operates in the District of Columbia and 22 states (California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Hampshire, New Jersey, New Mexico, New York, Ohio, Oregon, Rhode Island, Vermont, Virginia and Washington). It recently became a Medicaid provider for people in Illinois. 

Freedman said their services are offered on a sliding fee scale. And she said the platform allows patients to text with clinicians, which is popular with patients.

“They could be on their couch, watching a movie with their partner by their side, or whomever they need, and then just be chatting with us,” Freedman said. “That’s not something that you could get if you receive care in person and take the medication home with you, and then don’t have those ongoing touch points.”

Freedman said that Hey Jane has already seen an influx in patients since Congress passed the federal tax and spending cut bill and more clinics have closed, and that they are working on becoming Medicaid providers in more states — something that can be challenging for telehealth businesses without a physical facility. 

“We’ve continued to grow really fast over the past several years, and have just been hiring a lot and doing a lot of work on sort of our technical automation so that we can continue to meet the demand that has been rising,” Freedman said. “These acute events, like these terrible clinic closures, have definitely exacerbated that.”

Coming Friday: Democratic-led states try to backfill funding losses.

Taylor Swift performs at Soldier Field in Chicago on The Eras Tour on June 5, 2023 (Photo by Baylor Spears/Wisconsin Examiner)

Ahead of Taylor Swift’s latest album being released Friday, Sen. Kelda Roys (D-Madison) is proposing that Wisconsin exile practices in the ticket selling industry that disadvantage fans trying to attend shows and events.

The bill “Stop Wildly Inflated Fees and Ticketing Industry Exploitation” — yes, that really is SWIFTIE for short — would require sellers to disclose the total cost of ticket prices to potential buyers, put a cap on how much resellers can charge for tickets and prohibit ticket-buying bots that resellers use. Sen. Jamie Wall (D-Green Bay) and Rep. Jill Billings (D-La Crosse) are also coauthors on the bill.

The bill comes ahead of Swift releasing her 12th studio album — titled “The Life of a Showgirl” — on Friday.

Many states and lawmakers, including some of Wisconsin’s neighbors, started taking an interest in new laws to help regulate the live event ticket marketplace after Ticketmaster crashed during the initial sale of tickets to Swift’s The Eras Tour. Many of the mega pop star’s huge and dedicated fan base were down bad as secondary ticket prices for her tour soared, with some individual ticket prices rising to even more than $4,000.

The Michigan House passed a proposal in June that would curb bots for hoarding concert and event tickets. The Minnesota state government enacted legislation to help protect online ticket buyers in 2024.

“My daughters and I are Swifties. I would’ve loved to have taken them to see Taylor Swift live on the Eras Tour, but instead we saw the movie,” Roys said in a video with Style (Taylor’s Version) playing in the background and clips from the tour flashing on screen. “I didn’t even try to get tickets because I had heard the horror stories from so many friends of mine. This is not how it’s supposed to be. Live events should be for fans, not for profiteers.”

Roys is also seeking the Democratic nomination in the 2026 election for Wisconsin governor.

Several provisions in the bill seek to prevent fans from encountering a ticket hoax by barring resellers from listing tickets for resale before tickets have been put on sale, from putting tickets on sale if they don’t already own them and by capping secondary ticket sales, prohibiting a fee from exceeding 10% of the ticket’s initial price.

The bill also includes a provision to ensure ticket buyers can feel fearless when they make a purchase on the secondary market. Under it, resellers would be required to issue a full refund within 10 days of a request to a purchaser if a ticket is counterfeit, the event is canceled, the ticket doesn’t fit the description provided or the date or time of the event is moved. 

Bots — devices or software that get around security measures or access control systems on a ticket selling platform to bypass purchasing limits — would also be prohibited under the bill from purchasing more than eight tickets for one event and circumventing the ticket queue, presale codes or waiting periods when a sale is going on. 

“If you’re a fan, you deserve the chance to go see your favorite artist without being exploited by unscrupulous scalpers, by third-party bot farms that drive up prices and other practices that exploit fans and venues and artists,” Roys said. “All of us deserve to come together and share these wonderful live events without these kinds of consumer protection violations.” 

Under the bill, violators would be subject to civil forfeitures of at least $15,000 for each day the violation occurs; $1,000 per ticket listed, advertised, sold or resold in violation of the provisions;  and an amount equal to five times the total price of each ticket. 

A person could also be subject to a civil forfeiture of at least $10,000 per ticket listed, advertised, sold or resold in violation of the provisions.

A sign on the entrance to the U.S. National Arboretum says it is closed due to the federal government shut down on Oct.  1, 2025 in Washington, D.C. (Photo by Kevin Dietsch/Getty Images)

WASHINGTON — The first federal government shutdown in seven years has left hundreds of thousands of workers furloughed and members of the public struggling to understand what’s open, what’s closed and what might be delayed.

States Newsroom’s Washington, D.C. Bureau scoured agency plans published by the Trump administration and the courts, and produced this guide to help you understand what’s going on:

Agriculture Department 

The USDA plans to furlough about half, 42,300, of its nearly 86,000 employees, though workers at several programs for farm communities and rural areas will keep working without pay.

Operations will continue on some farm loans, certain natural resource and conservation programs, essential food safety operations related to public health and wildland firefighting activities. 

Agriculture Department employees working on animal and plant health emergency programs — including African swine fever, highly pathogenic avian influenza, exotic fruit flies, new world screwworm and rabies — are exempt from furloughs.  

But dozens of USDA programs addressing everything from disaster assistance processing to trade negotiations to long-term research on animal diseases will cease until Congress reaches a funding deal. 

Employees working on those programs will be furloughed until the government is once again funded, but both working and non-working federal employees in all agencies are required to receive back pay under the law. 

Agencies housed within the USDA have varying levels of furloughs. The Food and Nutrition Service, Office of the Inspector General and Natural Resources Conservation Service are among those with higher numbers of furloughed workers.

Commerce Department

The Department of Commerce will retain just over 19% of its nearly 43,000 employees during the shutdown, and most will have to stay on without pay, as outlined in its government funding lapse plan. 

The department oversees a wide range of federal government activities — weather forecasting, issuing patents and trademarks, regulating fisheries, enforcing export laws, managing government-owned and -controlled spectrum frequencies, and collecting demographics and other population data.

Notably, the department houses the National Oceanic and Atmospheric Administration, and will continue providing “weather, water and climate observations, prediction, forecasting, warning and related support.” But research activities will largely stop.

The U.S. Census Bureau, also part of the department, will cease most operations, including providing monthly economic indicators and updated data about disaster-impacted areas. Certain preparations for the 2030 Census will stop, as will any data collection for the American Community Survey.

Funding outside of annual appropriations may keep some U.S. Patent and Trademark Office units open, but the timelines will be variable, according to the department. When funding runs out, the office will continue “a bare minimum set of activities necessary to protect against the actual loss of intellectual property (IP) rights.”

Defense Department 

The Defense Department’s contingency plan calls for the nearly 2.1 million military personnel to keep working as normal and says 406,500 of its roughly 741,000 civilian employees will work without pay, while the others will be furloughed.  

The plan says the Defense Department believes operations to secure the U.S. southern border, Middle East operations, Golden Dome for America defense system, depot maintenance, shipbuilding and critical munitions are the “highest priorities” in the event of a shutdown. 

Medical and dental services, including private sector care under the TRICARE health care program, would largely continue at the Defense Department, though “(e)lective surgery and other routine/elective procedures in DoW medical and dental facilities are generally not excepted activities, unless the deferral or delay of such procedures would impact personnel readiness or deployability.”

Education Department 

The Department of Education said it would furlough roughly 95% of employees outside its federal student aid unit. 

The agency will continue disbursing Federal Direct Loans as well as Pell Grants, which help low-income students pay for college. 

Borrowers still have to make payments toward their student loan debt during the shutdown. 

Title I and Individuals with Disabilities Education Act, or IDEA, grant funding would continue to be available as usual, according to the department. Title I provides funding for low-income school districts, while IDEA guarantees a free public education for students with disabilities. 

But the agency is ceasing several operations, including any new grantmaking activities. Still, the department said the majority of its grant programs “typically make awards over the summer and therefore there would be limited impact on the Department’s grantmaking.”

The agency’s Office for Civil Rights also has to pause investigations of any civil rights complaints. 

Energy Department 

The Energy Department will furlough a little over 8,100 of its 13,800 federal workers – nearly 60% of its workforce, according to its contingency plan. 

The National Nuclear Security Administration would continue maintenance and safeguarding of nuclear weapons. 

Some programs, like the medical isotope program, will require DOE to “produce additional isotopes in order to protect human life.” 

“The need to do this will depend on the length of the lapse and the stockpile of individual isotopes,” according to DOE. 

Certain programs are self-funded, such as the Bonneville Power Administration, which provides hydropower in the Columbia River Basin of the Pacific Northwest.

Environmental Protection Agency 

EPA, according to its contingency plan, will have the biggest percentage of federal employees furloughed. Nearly 90% of its workforce, or 13,400 out of 15,000, will be furloughed. 

Only agency activities that revolve around protecting human life, such as monitoring some Superfund sites and responding to emergency environmental disasters, will continue. 

Some EPA functions that will halt include issuing of new grants, publishing new research, pausing of cleanup of Superfund sites that don’t pose an imminent threat to human life, enforcement inspections and issuing of permits.

Health and Human Services Department 

The department, one of the larger ones within the executive branch that houses many of the country’s best-known public health agencies, has furloughed about 32,500 of its nearly 80,000 employees, according to its contingency plan.

Many of HHS’ activities fall under the life and property or even the national security exceptions during a funding lapse, though dozens of programs will still be affected.

HHS officials plan to ensure “minimal readiness” at the Administration for Strategic Preparedness and Response for “all hazards, including pandemic flu and hurricane responses.”

Certain employees at the Centers for Disease Control and Prevention will keep working, albeit without pay, to monitor for any disease outbreaks. But the contingency plan says the CDC’s “communication to the American public about health-related information will be hampered.”

The Centers for Medicare and Medicaid Services plans to keep 3,300, or about 53%, of its employees during the shutdown in order to keep running core programs.

Since many of the country’s major health care programs are funded outside of the annual government funding process, they shouldn’t be affected by the shutdown, even though the employees who run the programs often rely on full-year or stopgap spending bills for their salaries.

CMS’ contingency plan says “the Medicare Program will continue during a lapse in appropriations” and that it has “sufficient funding for Medicaid to fund the first quarter of FY 2026,” which includes October, November and December.  

Additionally, it “will maintain the staff necessary to make payments to eligible states for the Children’s Health Insurance Program (CHIP).”

Department of Housing and Urban Development 

The Department of Housing and Urban Development’s website opens with a message that reads: “The Radical Left in Congress shut down the government. HUD will use available resources to help Americans in need.”

The department says the majority of its annual grant programs, including those that provide for emergency housing for people experiencing homelessness and people living with HIV/AIDS, “continue to operate in States and local communities across the country when such grant funding has already been obligated.” 

The agency also said many of its programs “addressing imminent threats to the health and welfare of HUD tenants and children will continue where such grant funding has already been obligated before the lapse occurs.”  

For as long as the funding remains available, “monthly subsidy programs such as the public housing operating subsidies, housing choice voucher subsidies, and multifamily assistance contracts will continue to operate,” according to the department.  

However, the agency said nearly all of its “fair housing activities” will halt during the shutdown. 

Internal Revenue Service 

The Internal Revenue Service will continue normal operations using supplemental funding enacted under the Democrats’ 2022 budget reconciliation law, known as the Inflation Reduction Act.

The IRS will retain its 74,299 employees, according to the latest available shutdown contingency plan. 

The Trump administration has shrunk the IRS significantly this year, down from its roughly 95,000 employees, and has turned over the agency’s top leadership six times.

The agency processes about 180 million income tax returns each year.

The body that independently oversees the IRS will not operate at full capacity during the shutdown. Only 40% of employees in the department’s Treasury Inspector General for Tax Administration will remain on, with a small fraction required to stay without pay if necessary, according to the agency’s plan.

As of Thursday afternoon Eastern time, the home page for that agency, tigta.gov, was blank except for the message “Due to a lack of apportionment of funds, this website is currently unavailable.”

Interior Department

A little more than half of the federal workforce for the Interior Department will be furloughed – 31,000 out of 58,600 employees – according to its contingency plan.

Some services within the agency will continue, such as the Bureau of Indian Affairs’ wildland fire management, but programs that provide social services to foster children and residential adults will pause.

As for national parks, the trails, open memorials and overlooks will generally remain open. The National Park Service will retain minimal staff to allow for visitors. But general maintenance, trash pick-up and educational programs, will cease during the shutdown. 

Hunters or people seeking access to public lands will not be able to have their permits processed by U.S. Fish and Wildlife Services. 

Justice Department

The Justice Department will keep a majority of its federal workers during the shutdown, according to its contingency plan. Out of roughly 110,000 employees, nearly 13,000 will be furloughed. 

Because the judicial branch will continue to function, the Justice Department will retain most of its attorneys for criminal and civil litigation. Federal law enforcement agencies and their agents will continue to work, such as the FBI, Drug Enforcement Administration and Bureau of Alcohol, Tobacco, Firearms and Explosives. 

A shutdown typically means that immigration cases would be rescheduled and courts not located in an Immigration and Customs Enforcement detention center will be shut down. But the Trump administration has prioritized the Executive Office for Immigration Review, housed within the Department of Justice, as essential. 

The contingency plan points to the president’s national emergency, “citing the threat to the national security and economy of the United States caused by illegal migration.”

Labor Department 

More than 75% of the Department of Labor’s employees will be furloughed, according to the agency’s contingency plan. 

Several units will come to a halt, such as the Bureau of Labor Statistics, Veterans’ Employment and Training Service, Office of Federal Contract Compliance Programs, Office of Disability Employment Policy, Women’s Bureau, Office of Administrative Law Judges, Administrative Review Board, and Benefits Review Board, as well as the Employees’ Compensation Appeals Board.

The agency said it will continue to support states and other agencies when it comes to administering and paying unemployment insurance benefits. 

The department notes that “unless excepted or exempt, agencies’ technical assistance, compliance assistance, regulatory, policy, research, advisories, responding to inquiries, most oversight, hearing preparation, and cooperative activities will cease.”

Job Corps centers that house students “will remain in operation while funds remain available,” and “federal oversight of those centers related to safety and property will continue,” per the department. 

Homeland Security Department 

Homeland Security will retain most of its workforce without pay. About 14,000 employees will be furloughed among its nearly 272,000 workforce, according to its contingency plan. 

That means ports of entry will remain open for inspections from Customs and Border Protection, but there could be delays in paperwork at U.S. borders. 

Most federal workers responsible for security at airports across the country – more than 61,000 Transportation Security Administration employees – would be required to work without pay. 

Another agency within DHS that will remain most of its workforce is the Federal Emergency Management Agency, or FEMA. About 21,000 employees out of 24,000 will continue to work. 

The office involved in departmental oversight, the Office of Inspector General, will pause its work on reports and investigations. 

And the Trump administration’s aggressive immigration crackdown will continue, with nearly all employees from Immigration and Customs Enforcement considered non-exempt, about 19,600 out of 21,000.

Several agencies within the Department of Homeland Security will remain running because they are fee-based, such as U.S. Citizenship and Immigration Services. Some visa programs within USCIS are tied to appropriations funding, so those programs will be suspended. 

That includes E-Verify, which verifies immigration status; visas for foreign doctors; and visas for non-minister religious workers. 

State Department 

A little more than half the employees in the State Department will be furloughed, about 16,600 out of its nearly 27,000-employee workforce, according to its contingency plan.

Because visa and passport services are fee-funded, they will likely not be impacted. Consular operations will be affected and diplomatic visas will only be issued in “life or death” emergencies.

Social Security Administration 

The program for America’s seniors and some people with disabilities is largely funded outside of the annual government spending process, which makes it mostly exempt from shutdowns. 

One big caveat is that the federal workers who administer the program are paid through one of the 12 congressional appropriations bills, which can cause issues during a funding lapse. 

SSA’s contingency plan says it will furlough about 6,200 of its nearly 52,000 employees until the government is fully operational again. 

The agency plans to continue “accurate and timely payment of benefits” as well as taking applications, requests for appeal, issuing and replacing Social Security cards and fraud prevention activities, among others. 

The SSA during the lapse will not conduct certain activities, including benefits verification, replacement of Medicare cards, or addressing overpayments processing during the funding lapse. 

Transportation Department

Slightly more than 11,000 of the department’s nearly 45,000 employees will be furloughed for the remainder of the government shutdown, but its leaders plan to keep several activities essential for the traveling public going during a shutdown, according to its contingency plan.

Air traffic control services and hiring, hazardous materials safety inspections, airport inspections and much more will continue, though many activities will cease. 

Some agencies within the Transportation Department will see little impact on their staffing, even though workers will not be paid until the shutdown ends. 

For example, no one at the Federal Highway Administration, the Federal Motor Carrier Safety Administration, the National Highway Traffic Safety Administration, the Federal Transit Administration, or the Great Lakes St. Lawrence Seaway Development Corporation will be furloughed. 

Treasury Department 

The department has individual contingency plans for its various components, including departmental offices, the Alcohol and Tobacco Tax and Trade Bureau, the Bureau of the Fiscal Service, the Financial Crimes Enforcement Network, the Internal Revenue Service, the Office of the Inspector General and the Treasury Inspector General for Tax Administration.

Treasury officials expect to keep about 1,850 of its more than 2,700 employees working in the departmental offices without pay during the shutdown, in part to “support the president” with “market and economic updates, economic policy options and recommendations, including those related to national security incidents.”

The Office of Inspector General, which oversees officials’ actions for waste, fraud and abuse, will keep about 30 of its roughly 150 employees working throughout the shutdown and furlough the rest. 

Department of Veterans Affairs

Large parts of the Department of Veterans Affairs, including the processing and payout of benefits, are funded outside of the annual appropriations process and will continue through the shutdown.

The department projects 97% of its staff will continue to work, and most will be paid, according to its latest publicly available shutdown contingency plan. 

Health care will continue uninterrupted at VA medical centers and outpatient clinics, and vets will still receive benefits, including compensation, pension, education and housing.

Veterans suicide prevention and homelessness programs will remain in operation, and the Veterans Crisis Line will continue to answer calls. The crisis line can be reached by dialing 988 followed by pressing 1, or by texting 838255.

The MyVA411 and PACT Act call centers will operate “as necessary to prevent disruption to mandatory VA benefit programs,” according to the department’s guide.

The National Cemetery Administration will continue to inter veterans and eligible family members, as well as schedule burials, determine eligibility and process headstone applications. However, headstone and marker installation and groundskeeping will cease, and the application assistance unit call center will be closed.

All Transition Assistance Programs, including career and financial counseling, are suspended, and the GI Bill hotline is not taking calls. 

The department’s whistleblower program is also not accepting or investigating complaints. 

Executive Office of the President

The first Trump administration posted a contingency plan in March 2018, though it doesn’t appear there is a current one and the White House did not respond to a request from States Newsroom about how it’s implementing the shutdown. 

The earlier three-page plan said the president planned to place “1068 of the 1759 EOP staff in furlough status (“Non-Excepted Staff’), while an estimated 691 EOP staff would continue to report to duty.”

President Donald Trump continues to be paid during a shutdown, as are members of Congress, under the law.

Judicial branch 

The Supreme Court will remain functioning during the shutdown, as well as the federal courts. 

By using court fees, the judiciary branch can continue with paid operations until Oct. 17, according to the Administrative Office of the U.S. Courts. Most proceedings and deadlines set in cases will continue, but if Department of Justice attorneys representing the executive branch are furloughed, then those cases will be rescheduled. 

Supreme Court judges and federal judges will continue to be paid due to Article III of the U.S. Constitution that specifies judge’s compensation “shall not be diminished” during their term. 

“We don't have a direct way to overrule what the Republican regime has done in the big, ugly bill,” Sen. Kelda Roys said. “We certainly can do everything we can in Wisconsin to make sure that the existing two independent clinics that provide abortion services are able to see as many patients as they possibly can." (Photo by Baylor Spears/Wisconsin Examiner)

Planned Parenthood of Wisconsin paused abortion services Wednesday at its Madison, Milwaukee and Sheboygan locations due to the megabill signed by President Donald Trump in July. The law — officially titled the “One Big Beautiful Bill” Act — included a provision that would take away federal funding from the organization if it continues providing abortion services. 

The organization announced the pause last week, saying that it was looking to see as many patients as possible before the Oct. 1 deadline. Wisconsin is the first state in the country where Planned Parenthood has taken this step in response to the federal law. 

In reaction, Democratic lawmakers called Wednesday morning for the state to reverse other restrictions on the books to help increase accessibility to the remaining independent abortion providers in the state.

“We’re sounding the alarm, but we’re also saying we can do something about this,” Rep. Lisa Subeck (D-Madison) said at a press conference. “We know that this is going to be a legal battle, and there will be other means by which Planned Parenthoods are fighting this change, but in the meantime, we cannot let Republicans block access for Wisconsin women to the care that they need.” 

This is the second time that Planned Parenthood is halting abortion services in Wisconsin since Roe v. Wade was overturned by the U.S. Supreme Court, ending federally protected abortion rights. The group stopped providing abortions from June 2022 until September 2023, when a Dane County court held that a 19th century state statute did not ban abortions. The Wisconsin Supreme Court also ruled in July that the same 19th century law was invalid and unenforceable and had effectively been repealed by other laws passed after it. 

Planned Parenthood’s decision to pause services again leaves just two independent clinics that provide abortion care in Milwaukee. Abortion providers in neighboring Illinois have declared that they are prepared to provide services for Wisconsin women.

“We know that people in Wisconsin can go to other states that do not have these restrictions to access abortion care, but we think that that’s unacceptable, and that no matter who you are or where you’re from you deserve the freedom to get the health care that you need here in Wisconsin,” Sen. Kelda Roys (D-Madison) said at the press conference.

The public health department for Madison and Dane County offered to help patients in need of services navigate their limited options. 

“Losing Planned Parenthood clinics as an option for abortion care means the full spectrum of reproductive health care will become very difficult to access in Wisconsin,” said Public Health Supervisor Sarah Hughes. “We know this changing landscape can be confusing and overwhelming, that’s why our Nurse Navigators are standing by to help people understand all options around pregnancy and reproductive health care.”

Planned Parenthood has been able to use federal funds via Medicaid payments and Title X, a federally funded family planning program, to help provide services other than abortion care, including contraceptives, STI testing, pregnancy testing, and gynecological services to low-income and uninsured individuals. The Hyde Amendment has barred federal money from being used to fund abortion care across the country for decades. 

The new federal law puts the other services that Planned Parenthood offers at risk by barring Medicaid payments for one year for organizations that received more than $800,000 in Medicaid reimbursements in fiscal year 2023 and primarily engage in family planning services and reproductive health and provide abortions.

“This was targeted directly at Planned Parenthood,” Subeck said. 

“Let me be clear, Republicans in the federal and state governments will stop at nothing short of a full abortion ban,” she added.

Planned Parenthood Federation of America and its member organizations in Massachusetts and Utah filed a legal challenge in July, but an injunction that was blocking the law from taking effect was lifted in September.

Attorney General Josh Kaul has also joined with other state attorneys general on a legal motion that argues the provision “impermissibly and unconstitutionally targets Planned Parenthood health centers for their advocacy and their exercise of associational rights” and also that “Congress ran afoul of limits on its spending power” because of its ambiguity. It argues the provision “fails to adequately define the scope of providers who qualify as “prohibited entities”; fails to provide clear notice of the timing of its implementation; and constitutes a change that [states] could not have anticipated when joining Medicaid.” 

Planned Parenthood of Wisconsin has said that ongoing litigation could change what the organization is allowed to do and that it  will continue to monitor the legal landscape and will be prepared to act the moment it is able to resume care.

Roys and Subeck introduced legislation Wednesday to help the last two clinics in Milwaukee take in patients. 

The Democratic bill would repeal several of the other restrictions on the books in Wisconsin, including a requirement that patients attend two appointments with the same physician 24 hours apart before receiving care, requirements that a patient have a physical exam and that a physician be physically present when medication is taken, and a requirement for an ultrasound. It would expand the number of providers allowed to provide abortion care from just physicians to physician assistants, nurse practitioners and advanced practice registered nurses. 

The lawmakers said the bill would help the two independent Milwaukee clinics — Care for All Community Clinic and Affiliated Medical Services — reach as many patients as possible while Planned Parenthood no longer offers services by removing barriers to providing access. 

“We don’t have a direct way to overrule what the Republican regime has done in the big, ugly bill,” Roys said. “We certainly can do everything we can in Wisconsin to make sure that the existing two independent clinics that provide abortion services are able to see as many patients as they possibly can and try to absorb some of the loss of service [provided by] Planned Parenthood, and open the door to make sure that patients in Wisconsin don’t suffer access restrictions that patients in other states don’t have to suffer.” 

Roys said the purpose of the restrictions “has always been to make abortion as onerous and as difficult for people to access as possible. It has nothing to reduce the need for abortion.” By lifting the restrictions, she said, the bill could help “increase abortion access, despite the federal backdoor abortion ban.”

However, in a Republican-led Legislature, the bill is unlikely to move ahead.

Conservative groups and some Republican lawmakers celebrated the news of the pause in abortion services last week. Rep. Joy Goeben (R-Hobart) called the pause in services at Planned Parenthood of Wisconsin a “hopeful moment” in a statement last week.

“Every heartbeat silenced by abortion was a life full of possibility,” Goeben said. “This pause means more of those lives may now have a chance.”

Goeben and 11 of her Republican colleagues recently introduced a bill that seeks to narrow the definition of  abortion in Wisconsin. According to a bill summary, it would amend the definition of abortion to make an exception for “physician’s performance of a medical procedure or treatment designed or intended to prevent the death of a pregnant woman and not designed or intended to kill the unborn child, including an early induction or cesarean section performed due to a medical emergency or the removal of a dead embryo or dead fetus, or an ectopic, anembryonic, or molar pregnancy, which results in injury to or death of the woman’s unborn child when the physician makes reasonable medical efforts under the circumstances to preserve both the life of the woman and the life of her unborn child according to reasonable medical judgment and appropriate interventions for the gestational age of the child.” 

“Democrats should be lining up to sign on to this bill,” Goeben said in a statement about the bill. “This is what liberals have been shouting about from the rooftops for decades. However, they continue to perpetuate the notion women are not going to get the care they need in a heart wrenching emergency situation.”

Physicians, Democratic lawmakers and others have spoken to concerns since the overturn of Roe v. Wade that restrictive state laws governing abortion would result in women not receiving adequate medical care, even when there is an emergency. ProPublica has reported on the preventable deaths of Amber Thurman and Candi Miller, both of whom were denied timely care due to confusion created by Georgia’s six-week abortion ban. It has also reported on two women in Texas, Josseli Barnica and Nevaeh Crain, who died under the state’s restrictive abortion ban after care was delayed for their miscarriages.

Roys said the bill is an example of Republicans trying to distance themselves from the impact of restrictive abortion policies. 

“Republicans know that their abortion bans hurt women, and they kill women, and Americans are horrified to see women being arrested and jailed instead of taken to the hospital for treatment when they have a miscarriage. They are horrified to see pregnant people turned away from emergency rooms so that they can bleed out and almost die in Walmart parking lots… and now Republicans are desperately searching for a way to distance themselves from the terrible effects of the laws that they passed. And [to] simply say if you need to end your pregnancy, we’re going to call it something different than abortion is nonsense.” 

Roys said the bill is “pernicious” because it would essentially tell providers to provide a C-section or induce labor rather than provide an abortion. Those procedures, she said, are “much more difficult, painful, and risky and invasive than doing an abortion.” 

“It affects a woman’s future ability to birth and be pregnant the way that she wants to be, and it is incredibly cruel,” Roys said.

A nurse holds a vial of COVID-19 vaccine and syringe. (Getty Images)

Wisconsin clinics and hospitals are stepping up the rollout of the newest version of the COVID-19 vaccination.

UW Health started offering the new edition vaccine to patients Wednesday and will start scheduling COVID-19 shots beginning Monday.

The Madison-based hospital and clinic system previously began giving the vaccine to people older than 65, considered the highest-risk population for the respiratory infection, according to Dr. Jim Conway, an infectious disease specialist and medical director for the UW Health immunization program.

The 2025-26 version of the vaccine is “built around the most current, circulating strains of COVID that are out there,” Conway said in an interview Wednesday. “As we all learned during the entire pandemic, these strains are mutating constantly, and so they’re constantly changing . . . You try to keep up with what’s the most prevalent.”

Major pharmacy chains typically get the first available allotments of the vaccine and have already, Conway said. In the meantime, UW Health and other health systems have been preparing to offer the shot and preparing their scheduling systems.

The vaccine’s components are developed following discussions among health experts for the World Health Organization and other agencies, Conway said. Both the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) take part in those discussions.

In the weeks leading up to Sept. 19, when the CDC’s Advisory Committee on Immunization Practice (ACIP) opened its most recent meeting, public health professionals were apprehensive that the body might limit access to the COVID-19 vaccine.

Robert F. Kennedy Jr., secretary of the Department of Health and Human Services, has a long history of embracing unfounded claims critical of vaccines. Kennedy replaced the members of the ACIP with people viewed as skeptics of vaccination. Susan Monarez, appointed CDC director earlier this year by President Donald Trump, testified at a congressional hearing in September that Kennedy fired her for refusing to agree to his demand that she endorse ACIP’s recommendations without reviewing them.

Ahead of ACIP’s meeting, “we were all really nervous,” Conway said. Medical professional groups emphasized their endorsement of the COVID-19 shot to counter messaging from Kennedy and other HHS officials that appeared to cast doubt on the vaccine.

“Our professional societies make recommendations every year, but this year we really leaned into making sure people were aware of those and really were promoting those as … evidence-based, data driven,” he said.

When ACIP met just two days after Monarez’s testimony, the panel left in place the CDC’s recommendation for COVID-19 vaccinations from the age of six months to 64. While the panel’s recommendation highlighted concerns about risk, ACIP rejected a proposal to require a prescription for the shot.

“It’s actually in some ways reassuring that even people that may come across as skeptics and doubters at some level as they were repopulating the ACIP — even they couldn’t be swayed from how clear the evidence and the data is that these vaccines are really valuable and really safe,” Conway said. “It was a very pleasant surprise.”

Wisconsin Gov. Tony Evers issued an executive order to ensure COVID-19 vaccine access and the state Department of Health Services followed up with a health order that functions as a statewide prescription for the shot. The Office of the Commissioner of Insurance also issued guidance that insurance companies in Wisconsin are expected to cover the vaccine without requiring a patient co-pay.

Conway said with those actions insurers began announcing in the last week their coverage plans, which set the stage for providers to set up their vaccine programs.

The first objective of a vaccine is “to prevent you from getting serious disease,” Conway said, so patients don’t have to go to a doctor, “or aren’t getting admitted to the hospital or aren’t getting in the ICU [intensive care unit] or aren’t going on a ventilator or, God forbid, aren’t dying. That’s the ultimate goal, and that’s what the vaccines are really very good at.”

If the shot prevents a person from getting sick from the virus at all, that’s a bonus,  “but we know that that’s never completely possible with these kinds of respiratory viruses,” he added. “But we know that even if you get ill, you’re much more likely to have a very, very mild case.”

Vaccination also helps prevent the spread of disease as it reduces the amount of virus infected people are shedding, Conway said. That can reduce the chances that others will be exposed to the virus, helping to protect people whose immune systems are suppressed due to age or an underlying medical condition.

With enough people vaccinated, that allows  community immunity — “what used to be called herd immunity” — to develop, Conway said. That reduces the risk of outbreaks, “but it also starts to protect the really vulnerable parts of your population.”

The vaccine’s availability came as good news Wednesday to Patricia Fisher, a graduate student and the mother of a six-month-old. Fisher was disappointed this week when the vaccine wasn’t available at her baby’s check-up.

“It’s not just about my baby,” said Fisher,  who is enrolled in a sociology Ph.D. program at the University of Wisconsin. “The community is safer if more people are vaccinated.”

Fisher has a master’s degree in public health. While her own research focuses on food systems, climate change and health, she said she’s learned enough about population health outcomes to make her alarmed at the prevalence of anti-vaccine attitudes.

“I find it really, really frightening how anti-vaccine some people are, and that people are particularly worried about [vaccines for] COVID, flu and RSV [respiratory syncytial virus],” Fisher said. “COVID is a very clear and present threat to infant health and so it’s very worrying to me.”

Between the national upsurge in measles that has surfaced in Wisconsin, surges in pertussis (whooping cough) in the last couple of years, influenza and COVID-19, “there’s a lot of threats out there,” she said. “I just didn’t think that infectious disease would be the thing about parenting that would be the most stressful, but it definitely is.”

On Wednesday she made an appointment for her child’s COVID-19 shot in mid-October. “I’m thrilled it’s going to be available,” she said.

Conway said the flood of both information and misinformation about the vaccine can overwhelm people. “Sometimes the natural human response is to just hunker down and do nothing,” he said.

He counsels patience and keeping messaging simple: pointing to the decades of data on the safety and effectiveness of vaccines along with the number of professional medical organizations that have made recommendations on the basis of scientific evidence.

“I think people should understand that there’s an opportunity here to protect themselves and their families from these really potentially very unpredictable diseases that can devastate individuals, families and communities,” Conway said.

Jess Deis, a nurse practitioner and nurse midwife in Kentucky and Indiana, learned she had cervical cancer after she qualified for Medicaid insurance in 2014. (Sarah Ladd/Kentucky Lantern)

Third in a five-part series.

It had been a decade since Jess Deis’ last women’s wellness exam when Kentucky expanded Medicaid and she finally qualified for the state insurance program.

Physicians recommend a cervical cancer screening — also referred to as a Pap smear, which is a swab of the cervix — as part of a wellness exam once every three to five years for women between the ages of 21 and 65. Deis, 43, was in her last semester of nursing school in 2014 when the test came back with abnormal results. Her doctor ordered additional testing.

“Then I got a call on a Sunday evening from a physician letting me know I had cervical cancer and I needed to see a specialist,” Deis said.

Cervical cancer is one of few cancers that has a known path of prevention after the approval of the first HPV vaccine in 2006. But that also means it falls at the intersection of three cultural issues that are facing strong political opposition — broad access to low-cost or free reproductive health care, access to vaccines for children, and sex education.

Kentucky had the highest cervical cancer incidence rate in the country between 2015 and 2019, according to medical research, and a mortality rate twice as high as the rest of the country. The state tied with West Virginia for the second-highest rate of 9.7 cases per 100,000 residents between 2017 and 2021. Oklahoma topped the list for that five-year period with 10.2 cases per 100,000, according to the National Cancer Institute.

Deis delayed the surgery to remove her uterus until after graduation, and later became a certified nurse practitioner. Now she provides Pap smears to patients multiple times a day at Planned Parenthood clinics in Kentucky and Indiana and other care via telehealth. She recently helped a patient who hadn’t been seen for a screening in 15 years discover she had advanced cervical cancer.

She is troubled by what could happen in the wake of the new Medicaid rule passed by Congress and signed by President Donald Trump in July that barred nearly all Planned Parenthood affiliates from receiving Medicaid reimbursements because some clinics in the nonprofit network provide abortions. Kentucky and Indiana both have abortion bans, but still have Planned Parenthood clinics to provide other reproductive health care.

“I don’t just worry; I know that there’s going to be more folks with stories like mine, but without the happy ending,” Deis said.

‘What we’re really talking about is our daughters getting cervical cancer’

The American Cancer Society recently reported the number of early cervical cancer cases has declined sharply among young people since the vaccine’s introduction nearly 20 years ago. But vaccine adoption rates for children are low in the states where rates are highest — about one-third of boys and girls between the ages of 13 and 17 were vaccinated in Mississippi as of 2020.

The vaccine is most effective when given before engaging in any kind of sexual activity for the first time, because it can prevent the sexually transmitted strains of HPV that present the highest risk of cervical cancer. More than 98% of cervical cancer cases are caused by HPV, and a 2024 study from the Journal of the National Cancer Institute found zero cases of cervical cancer in Scottish women born between 1988 and 1996 who were fully vaccinated against HPV between the ages of 12 and 13.

“We could make (cervical cancer) an eradicated disease,” said Dr. Emily Boevers, an Iowa OB-GYN. “But everything is falling apart at the same time.”

Boevers said limitations on Medicaid coverage and the loss of Title X family planning funding will make screenings and vaccines less accessible for the populations that need them the most, even if clinics don’t close as a result. But it will take years to see the consequences of these changes, she said, because it takes about 15 years on average for HPV to become cancer. 

“So what we’re really talking about is our daughters getting cervical cancer,” she said. 

Kentucky’s legislature acknowledged the importance of HPV vaccines as recently as 2019, when representatives passed bipartisan House Resolution 80, which encouraged females and males between the ages of 9 and 26 to get the HPV vaccine and everyone to “become more knowledgeable of the benefits of the vaccine.” Only four legislators voted against it.

But today, the U.S. Department of Health and Human Services is led by Secretary Robert F. Kennedy Jr., who has made false statements about the HPV vaccine’s safety and effectiveness and played a leading role in organizing a mass lawsuit against one of the vaccine’s manufacturers, Merck. The Associated Press reported the judge dismissed more than 120 claims of injuries from Gardasil, the name of one HPV vaccine, because of a lack of evidence. 

“Secretary Kennedy supports renewing the focus on the doctor-patient relationship and encourages individuals to discuss any personal medical decisions, including vaccines, with their healthcare provider,” a Health and Human Services spokesperson wrote to States Newsroom in September. “The American people voted for transparency, accountability, and the restoration of their decision-making power, and that is exactly what HHS is delivering.”

The response did not clarify whether Kennedy still thinks the vaccine is unsafe and what basis there is for that claim. 

Dr. Linda Eckert, a University of Washington School of Medicine professor and practicing OB-GYN, has an extensive background in immunizations and cervical cancer prevention. She served as a liaison for the American College of Obstetricians and Gynecologists to the CDC’s Advisory Committee on Immunization Practices until 2024. Members of the committee were recently dismissed by Kennedy’s agency and replaced by new members, several of whom have reportedly expressed anti-vaccine views. Eckert said the group had plans in motion to present to the ACIP in June a case for administering the HPV vaccine at the earliest age of 9 before it was disbanded. 

Although Black and Hispanic women are affected by cervical cancer at disproportionate rates because of systemic inequities, Eckert said the fastest rising group experiencing late-stage cancer is white women in the Southeast. But she added that Alabama was the first state in the country that launched a targeted campaign to eliminate cervical cancer. 

Treatment for the cancer once it develops can also be difficult to obtain, Eckert said. It can be expensive and require many follow-up visits, and usually leads to infertility either through hysterectomy or invasive radiation treatments. 

“It is a really devastating disease to treat,” Eckert said. “Even if you live, you are permanently changed.”

Recent study showed zero cases of cervical cancer after HPV vaccine 

Dr. Aisha Mays, founder and CEO of a Dream Youth Clinic in Oakland, California, said the services her clinic offers to young people for free includes most of the same services that Planned Parenthood clinics provide, including the HPV vaccine.

“That’s the work of Planned Parenthood and clinics like mine that are encouraging and doing regular Pap smear screenings and vaccines, and having really clear conversations with young people around the importance of these procedures,” Mays said.

The recent turn against vaccines by some segments of the public and members of President Donald Trump’s cabinet who doubt their effectiveness and baselessly claim that they cause injury and developmental issues like autism has made the promotion of HPV vaccines more difficult for Mays. Overwhelming evidence, including from the Centers for Disease Control and Prevention, shows that they are safe and effective.  

The vaccine can also protect against genital warts, anal cancer and oropharyngeal cancer, Mays said. There are about 40 strains of HPV in total that are known to infect the genitals, and more that can attach to certain patches of skin. Most people who have sex will come in contact with one or more of the strains by the time they reach their mid-20s or early 30s.

Mays’ clinic is largely funded by state and local grants, but it received more than $100,000 in federal funding for a sexual health education program through the U.S. Department of Health and Human Services’ Office of Population Affairs. It was a nationally distributed podcast hosted by adolescents, Mays said, and they chose topics to talk about related to sexual health, including HPV.

The program’s grant was one of many that have been cancelled under the Trump administration. An objective laid out in Project 2025, the blueprint document for the next Republican presidency written by conservative advocacy group the Heritage Foundation, was to ensure no subgrantees of sex education programs were promoting abortion or “high-risk sexual behavior” among adolescents. It also stated that any programming should not be used to “promote sex.”

HHS also terminated funding for one of California’s sexual health programs in August over the state’s refusal to remove references in the programming related to gender, including the idea that biological sex and gender identity are distinct concepts. Another directive of Project 2025 was to make sure biological sex is never conflated with gender identity or sexual orientation.

States with high rates of cervical cancer have low density of physicians

States with the lowest incidences of cervical cancer, including Massachusetts, New Hampshire, Connecticut and Minnesota, also have the highest density of physicians per capita. According to the Association of American Medical Colleges’ state physician workforce data, Massachusetts has the highest number of physicians per 100,000 people, and Oklahoma ranks in the bottom three.

Kentucky is in the bottom 15, and so is Indiana, where Marissa Brown works as a Planned Parenthood health center manager in Bloomington. Brown described her clinic as “an oasis in a desert” because there are few options for gynecological care in the area, and even fewer for obstetrics. Brown said they routinely see patients from rural areas two or more hours away, and many of them are coming for wellness exams that include cancer screenings.

Indiana used to have 38 Planned Parenthood clinics, but through 15 years of funding cuts and targeted anti-abortion legislation, the organization closed 21 of them between 2002 and 2017. In the years since then, another seven shut down to consolidate services. Many of them did not provide abortions.

“We hear a lot about patients coming in who can’t get into their gynecologist for four to 12 weeks,” Brown said. “We can do that in a few days to two weeks, and we have walk-in appointments too.”

Health Imperatives, a nonprofit network of seven community health clinics in southern Massachusetts, can no longer bill for Medicaid because they provide medication abortions and received about $800,000 in reimbursements for other services in 2023, like Planned Parenthood. One of Health Imperatives’ clinics is in Martha’s Vineyard, whose working-class residents have to work three to four jobs just to afford to live on the affluent island, said Julia Kehoe, the organization’s president and CEO.

More than a decade ago, she said she noticed a pattern: Their patients would come in for an annual gynecological exam, receive an abnormal cervical cancer screening, but not follow up, because the closest available specialist would require expensive travel off the island. Kehoe said that once their Martha’s Vineyard clinic purchased a colposcopy machine, from privately raised funds, in 2012, they started diagnosing some of their regular patients with now-advanced cancer.

“In the first year that we did colposcopies, we found four individuals who had stage three or four cancer, who we luckily were then able to connect up to Boston for critical care,” she said. “But if we had had that capacity earlier … we would have caught it earlier.”

States Newsroom reproductive rights reporter Sofia Resnick contributed to this report.

Coming Thursday: Telemedicine could help narrow the care gap in rural communities.

Stephanie Johnson, whose husband died after living with Parkinson's Disease for 13 years, speaks at a news conference Wednesday, Oct. 1, about legislation to create a state Parkinson's registry. (Photo by Erik Gunn/Wisconsin Examiner)

A bipartisan group of Wisconsin lawmakers announced legislation Wednesday to  create a statewide registry for Parkinson’s Disease.

Parkinson’s, a neurological condition that is characterized by tremors, but also by a variety of other symptoms, has been increasing disproportionately, according to Dr. Brian Nagle, a movement disorder specialist.

“It’s the second most common neurological disease after Alzheimer’s disease, but it’s the fastest growing,” Nagle said in an interview Wednesday.

The speed with which Parkinson’s diagnoses are increasing is outpacing the aging of the population, “which suggests that it’s not just due to our population getting older, but that there may be some sort of risk factor that is causing it to grow more rapidly,” Nagle said.

A statewide registry of Parkinson’s patients could help provide clues about factors, such as environmental conditions, that may be at the root of the illness, he said.

State Sen. Rachael Cabral-Guevara (R-Fox Crossing) and state Rep. Lisa Subeck (D-Madison) began circulating a draft bill Wednesday to create the proposed state registry.

“Right now, when patients and their doctors are looking for answers, we struggle a little bit,” said Cabral-Guevara, who is a nurse practitioner, at a press conference to announce the legislation.

“We simply don’t have the data that we need,” she said. “We don’t know who is infected. Where the disease is hitting the hardest. Are there environmental factors that impact this, that cause this, that make it progress even faster? That lack of the clear picture of this is a barrier.”

The legislation was the brainchild of Stephanie Johnson, director of the Parkinson’s Disease Alliance of Wisconsin. Johnson told reporters Wednesday that her husband, Rick, was diagnosed with Parkinson’s 15 years ago when he was 61. After living with the illness for 13 years, he died in December 2023.

“I think we typically think of Parkinson’s as tremors or shuffling,” Johnson said, “but Rick had dangerously low blood pressure that would cause him to pass out. He had cognitive changes that made it very, very challenging for him to communicate. And he had visual hallucinations and many other non-motor symptoms.”

Johnson said she was also diagnosed with Parkinson’s three months after her husband’s death — a finding that astonished her. Then she learned that in the neighborhood where they had previously lived for 20 years, they were two of six residents who developed Parkinson’s disease, she said.

“And I thought, this can’t be a coincidence,” Johnson said, “And I wondered, is this a disease cluster? I didn’t know.”

“We don’t have a systematic way of tracking the incidence and prevalence of Parkinson’s in Wisconsin,” Johnson said.

The proposed legislation is aimed at filling that gap. The bill’s authors have named it in memory of Johnson’s husband at her request.

Fourteen U.S. states have some form of registry for Parkinson’s Disease, with some tracking other conditions as well, according to the Michael J. Fox foundation, a national research nonprofit named for the TV actor who was diagnosed with Parkinson’s disease when he was 30.

The draft legislation calls for the establishment of a registry at the Department of Population Health Sciences at the University of Wisconsin-Madison School of Medicine and Public Health. The registry would include a website with annual reports on the incidence and prevalence of Parkinson’s Disease in Wisconsin.

Health care providers would file information with the directory about patients they treat for Parkinson’s or closely related conditions. If patients don’t consent for their information to be shared, the incidence would be reported and nothing else, according to the bill.

Parkinson’s Disease is the subject of “a lot of mysteries,” Subeck said. “The reality is we are not going to get closer to curing Parkinson’s unless we do the research, unless we collect the data, and unless we enable that data to be used in meaningful ways.”

A closed sign is seen on the Washington Monument on Oct. 1, 2025 in Washington, D.C. The federal government shut down many operations overnight after Congress failed to pass a stopgap funding bill. (Photo by Kevin Dietsch/Getty Images)

WASHINGTON — Vice President JD Vance said Wednesday the administration is looking for ways to get a handful of additional U.S. Senate Democrats to vote for Republicans’ stopgap spending bill to reopen government. 

But, in the meantime, White House officials plan to lay off federal workers en masse, a dramatic and unsettling step that’s not traditionally been taken during past shutdowns. 

“We’re going to have to take extraordinary measures to ensure the people’s government operates — again not perfectly because it’s not going to operate perfectly in the midst of a shutdown — but operates as well as it possibly can,” Vance said.

Any Democrats concerned about the impacts of layoffs on federal programs or people’s lives, Vance said, should vote to advance a seven-week stopgap spending bill that has stalled in the Senate.  Senate and House Democrats say they will not support a GOP path to reopen the government unless Republicans agree to negotiate on rising health care costs. 

Typically during a shutdown, some federal employees are categorized as exempt, meaning they work throughout the funding lapse. Others are furloughed. All receive back pay once Congress funds the government, under a 2019 law.  

Widescale layoffs were not part of the 2013 shutdown or the 2018-2019 shutdown that took place during the first Trump administration. 

Vance during the White House briefing placed blame for the shutdown on Democrats, as the Trump administration ramped up similar rhetoric, including on government agency websites that said the “radical left in Congress” is at fault.

“Three moderate Democrats joined 52 Republicans last night. We need five more in order to reopen the government and that’s really where we’re going to focus, is how to get those five additional Democrats,” Vance said. 

White House press secretary Karoline Leavitt said during the same briefing that layoffs for federal employees are “imminent” but declined to say what percentage of workers would be let go or share any other details. 

Leavitt indicated that White House budget director Russ Vought would release those details “soon,” saying she didn’t want to get ahead of that office.  

“These (Reductions in Force) are unfortunately going to have to happen very soon,” Leavitt said. 

Effects on key programs

The administration expects several programs will be impacted by the shutdown, including new enrollees in the Special Supplemental Nutrition Program for Women, Infants, and Children, or WIC. 

Leavitt said the funding lapse means “1.3 million active duty troops will work now without pay; critical food assistance for low-income women, infants and children will now lapse, no new mothers or children are allowed to join this critical program because of the Democrats’ decision to shut down the government; telehealth services for seniors and in-home treatment options for Medicare patients will now come to an end; nearly 50,000 members of the United States Coast Guard are going to have to work unpaid; over 13,000 air traffic controllers will work without pay as well as TSA agents, which will very likely create flight disruptions; and pay will now stop for over 150,000 federal law enforcement officers. 

“These are not just numbers and statistics, these are real Americans who have families at home. And I saw some Democrat members today saying they’re still going to accept their paychecks because they have three kids at home and they have mouths to feed. Well, so do these federal workers.”

Members of Congress, the president and federal judges must receive their salary under various provisions in the Constitution. While some lawmakers have publicly asked for their paychecks to be withheld until the government reopens, that’s not a legal option. 

They could, however, donate their salaries to charity, which they can do regardless of whether the government is shut down.  

‘Mafia-style threat’

The threat to fire federal workers en masse has already prompted a lawsuit in a Northern California district court, arguing the executive branch has no statutory authority to fire federal workers during a government shutdown.

There were roughly 2.2 million federal workers throughout the country as of July 1, with large portions of them living in California, Florida, Georgia, Maryland, Texas and Virginia. Roughly 30% of the workforce is made up of veterans. 

Maryland’s Democratic Sen. Chris Van Hollen told States Newsroom on Wednesday morning that his office has not heard of any federal workers in his state being fired, and even if it were the case, “it’s illegal.” 

“The president has no additional authority, in a shutdown, to fire people,” Van Hollen said. “This is just a mafia-style threat and blackmail.”

He didn’t detail what plans Democrats have to prevent those potential firings, but called them unlawful and pointed to the lawsuit filed in California by labor unions representing more than 1 million federal employees. Those unions are the American Federation of Government Employees and the American Federation of State, County and Municipal Employees.

Virginia Democratic Sen. Mark Warner made similar remarks, saying “the president has no enhanced powers during the shutdown so his ability to randomly and arbitrarily fire is not enhanced.”

North Dakota Republican Sen. Kevin Cramer said Democrats “don’t have the high ground in this situation” and need to pass the GOP stopgap bill so that the government can reopen. 

But Cramer said he’s concerned the White House budget office will go too far in implementing a shutdown, including mass layoffs, and could create challenges for Republican lawmakers. 

“I worry a little bit that they could be counterproductive for us politically in the long run, because other things are going to require 60 votes again,” Cramer said.

Legislation needs the support of at least 60 senators to advance toward final passage, a rule that typically leads to compromise and bipartisanship in that chamber. 

Sen. Tim Kaine, Democrat of Virginia, said he hopes lawmakers can strike a deal to prevent the Trump administration from firing more federal workers. He said Congress has specifically carved out protections for federal workers, such as in 2019 when lawmakers included a provision to give back pay to furloughed federal workers.  

“So it used to be we had to fight about back pay after the shutdown,” he said. “Now everybody’s guaranteed back pay, so they have that as a backstop that they can count (on).”

House Minority Leader Hakeem Jeffries said during a press conference Wednesday President Donald Trump’s administration “has been engaging in” the mass firings of federal workers since Trump took office on Jan 20.

“The Trump administration has been killing jobs,” the New York Democrat said. “This is a job-killing administration. Job creation is down, but you know what’s up? Costs. They promised to lower costs on day one. Costs aren’t going down. Costs are going up.” 

Here are department shutdown plans

The Trump administration has been steadily posting its plans for how many federal workers in each department will keep working without pay during a shutdown and which employees will be furloughed. 

The plans, listed below, also detail which programs the Trump administration believes it can legally continue during a funding lapse without violating federal law. 

They do not explain how many federal workers could be laid off and the White House declined to provide additional details about those plans or whether they’ll be posted publicly following the briefing, 

• Agriculture Department contingency plan
• Commerce Department contingency plan
• Defense Department contingency plan
• Education Department contingency plan
• Energy Department contingency plan
• Health and Human Services contingency plan
• Homeland Security Department contingency plan
• Housing and Urban Development contingency plan
• Interior Department contingency plan
• Labor Department contingency plan
• Justice Department contingency plan
• State Department contingency plan
• Social Security Administration contingency plan
• Transportation Department contingency plan
• Treasury Department contingency plan
• Veterans Affairs Department contingency plan

Attack banners

The Trump administration has taken a new approach to letting people visiting their websites know about the shutdown, adding banners laying the blame at Democrats’ feet. 

The Agriculture Department’s website states that “(d)ue to the Radical Left Democrat shutdown, this government website will not be updated during the funding lapse. President Trump has made it clear he wants to keep the government open and support those who feed, fuel, and clothe the American people.”

The website for the Department of Housing and Urban Development includes a pop-up and a banner on the homepage that reads, “The Radical Left in Congress shut down the government. HUD will use available resources to help Americans in need.”

The Defense Department had a more measured message: “The most recent appropriations for the Department of War expired at 11:59 p.m. EDT on Sept. 30, 2025. Military personnel will continue in a normal duty status, without pay, until such time as a continuing resolution or appropriations are passed by Congress and signed into law. Civilian personnel not engaged in excepted activities will be placed in a non-work, non-pay status.”

The message posted by the Department of Health and Human Services was similar. 

“Mission-critical activities of HHS will continue during the Democrat-led government shutdown. Please use this site as a resource as the Trump Administration works to reopen the government for the American people.”

The messages could be in violation of a longstanding rider in federal spending law that states “(n)o part of any funds appropriated in this or any other Act shall be used by an agency of the executive branch … to support or defeat legislation pending before the Congress, except in presentation to the Congress itself.” 

Shauneen Miranda contributed to this report.

The U.S. Capitol on the evening of Tuesday, Sept. 30, 2025, just hours before a federal government shutdown. (Photo by Ashley Murray/States Newsroom)

WASHINGTON — U.S. Senate Democrats and Republicans remained at a stalemate Wednesday as government offices closed and hundreds of thousands of federal workers faced furloughs on the first day of a government shutdown that showed no sign of ending.

Proposals from each side of the aisle to fund and reopen the government failed again during morning Senate votes, mirroring the same vote breakdowns as Tuesday evening, when lawmakers could not reach a deal hours before the government ran out of money.

The nonpartisan Congressional Budget Office projected up to 750,000 federal workers could be furloughed, leading to a $400 million per day impact on the economy.

Locked in their positions, Republicans failed to pick up enough Democrats to reach the 60 votes needed to advance their plan to fund the government until Nov. 21. 

Senators will break Thursday to observe Yom Kippur but will return Friday to again vote on the funding proposals.

Democratic Sens. Catherine Cortez Masto of Nevada and John Fetterman of Pennsylvania, along with independent Angus King of Maine, again joined Republicans in the 55-45 vote for the House-passed stopgap spending bill. GOP Sen. Rand Paul of Kentucky voted no.

Democrats also failed to find support to move forward their bill to fund the government through Oct. 31, roll back GOP cuts on Medicaid and permanently extend subsidies that tie the cost of Affordable  Care Act health insurance premiums to an enrollee’s income level. 

The Democrats failed to advance their plan in a party-line 47-53 vote. King, who caucuses with Democrats, voted in favor.

Shutdown tied to health care tax credits

Senate and House Democrats say they will not support a GOP path to reopen the government unless Republicans agree to negotiate on rising health care costs. 

House Minority Leader Hakeem Jeffries said at a press conference that Democrats are “ready to sit down with anyone at any time and at any place in order now to reopen the government, to enact a spending agreement that meets the needs of the American people and to address the devastating Republican health care crisis that has caused extraordinary harm on people all across the country.”

The New York Democrat pointed to harms in “rural America, working class America, urban America, small-town America, the heartland of America and Black and brown communities throughout America.” 

Democratic leaders blitzed Capitol Hill with their message on health care, holding press conferences and attending an evening rally Tuesday on the lawn outside the U.S. House. 

They pointed to new data published this week showing annual insurance premiums could double on average in 2026 if the subsidies expire at year’s end, according to an analysis from the nonprofit health policy research organization KFF. 

Open enrollment for next year’s ACA health insurance plans opens Nov. 1 in most states, and Oct. 15 in Idaho.

Uptake of ACA health insurance plans has more than doubled to over 24 million, up from 11 million, since the introduction of the subsidies in 2021, according to KFF. 

During their own budget reconciliation deal in 2022, Democrats extended the insurance premium tax credits until the end of 2025. The majority of ACA enrollees currently rely on the credits.

Democrats also want assurances that the White House and Senate Republicans will not cancel any more funds that have already been approved by Congress, as was the case this year when the administration and GOP lawmakers stripped funding for medical research, foreign aid and public broadcasting, among other areas.

‘This can all end today’

GOP leaders in the House and Senate continued to blame Senate Democrats for the government shutdown at the expense of furloughed federal workers and Americans who rely on their services. 

At a Wednesday morning press conference, House Speaker Mike Johnson said “troops and border patrol agents will have to go to work, but they’ll be working without pay.”

Johnson also claimed at the press conference that veterans benefits would stop. The claim is false, as Veterans Administration medical care will continue uninterrupted and vets will also continue to receive benefits, including compensation, pension, education and housing.

“As we speak here this morning, there are hundreds of thousands of federal workers who are getting their furlough notices. Nearly half of our civilian workforce is being sent home — these are hard-working Americans who work for our federal government,” the Louisiana Republican said, flanked by fellow GOP leaders on the Upper West Terrace of the U.S. Capitol overlooking the National Mall. 

Johnson decided in late September the House will be out until Oct. 6, canceling this week’s votes. 

The speaker said he will bring House members back next week, even if the government is still shut down.

“They would be here this week, except that we did our work — we passed the bill almost two weeks ago out of the House, sent it to the Senate,” Johnson said. “The ball is literally in (Senate Minority Leader) Chuck Schumer’s court, so he determines that.” 

Senate Majority Leader John Thune said “this can all end today” and “needs to end today.”

The South Dakota Republican said the funding lapse can cease when Senate Democrats vote for the GOP’s “clean” short-term funding bill. 

“We will continue to work together with our House counterparts, with the president of the United States, to get this government open again on behalf of the American people,” Thune said. 

Bipartisan deal and Trump

Virginia Democratic Sen. Tim Kaine said later in the day that a bipartisan group huddled on the floor during votes to talk about a possible path forward on “health care fixes” and ensuring that if a bipartisan deal is brokered, the Trump administration will stick to it. 

Republican senators, he said, could give Democrats assurances they won’t vote for any more rescissions requests from the White House, which ask Congress to cancel already approved government spending. But other issues, like laying off federal workers by the hundreds or thousands, have to be a promise from the president. 

“If I find a deal, should Congress have to follow it? Yes. Should the president have to follow it? Yes. Well, what if the president won’t follow it? Oh, yeah, you got a problem,” Kaine said. “So you know, rescission, impoundment, those are Senate words. But a deal is a deal — people get that.”

Kaine also emphasized that it’s not a “clean” stopgap funding bill if the Trump administration unilaterally cancels some of the spending. 

“In the past, we voted for clean (continuing resolutions), but the president has shown that he’ll take the money back,” Kaine said, referring to the technical name for a short-term funding bill. “I mean, just in Virginia, canceling $400 million to our public health, $40 million economic projects just pulled off the table, firing more Virginians than any president. 

“So we just want you to agree, if we do a deal, then you’ll honor the deal,” Kaine said. “It’s not that much to ask.”

‘People are suffering’

North Carolina Republican Sen. Thom Tillis said he doesn’t expect the shutdown will have long-term ramifications for senators’ ability to negotiate bipartisan deals — a necessity in the upper chamber, which has a 60-vote threshold to advance legislation. 

“It’s all transactional,” Tillis said. “I think there’s going to be opportunities for some bipartisan work, but none of that happens, you can’t even really consider it when you’re in a shutdown posture.”

Cortez Masto, who voted to advance Republicans’ seven-week stopgap bill, said the GOP “created this crisis” on health care and “need to address it.”

“They have no moral standing — no moral standing —- to say that this is all on the Democrats. They are in control. They’ve created this crisis,” Cortez Masto said. “People are suffering and they need to come to the table.” 

Missouri Republican Sen. Josh Hawley, who was sworn in for the first time during the last shutdown, said he worries about longer-term effects. 

“My concern is it’s going to poison the well on negotiations going forward on a lot of things,” Hawley said. “I can’t speak for anybody but myself, but I would just say that these tactics are very destructive. And it’s destructive, not just for relationships, but for real people.”

Ariana Figueroa contributed to this report.

Fred Clark announced Wednesday he's running for Wisconsin's 7th Congressional District. (Screenshot)

Fred Clark, a former Democratic state legislator and executive director of Wisconsin Green Fire, announced Wednesday he’s running for Wisconsin’s 7th Congressional District

The 7th District covers much of northern and central Wisconsin. It is currently held by Republican Rep. Tom Tiffany, who recently announced he is running for governor. Clark served in the Legislature from 2008 to 2015. After leaving the Legislature, he worked for Green Fire, a non-profit organization dedicated to protecting Wisconsin’s environment. 

In a video announcing his run, Clark complained that Congress is allowing President Donald Trump to institute tariffs that are harming the northern Wisconsin economy while cutting federal benefits and failing to keep the government funded. 

“We’re all starting to pay more for the things we need because this Congress refused to stop an insane tariff war against our best trading partners,” Clark said.  “And unbelievably, they just voted for a massive handout to billionaires that will add $3.4 trillion to our national debt while taking health care away from 270,000 Wisconsinites who need it the most, leaving the rest of us to pay more for health care that’s just getting worse.” 

On his campaign website, Clark says his priorities are rebuilding rural economies, maintaining secure borders while providing a pathway for immigrants to live and work in the country, expanding health care coverage and responsibly managing the state’s farms and forests. 

Jessi Ebben, a Republican from Stanley had filed to run for the seat before Tiffany announced his gubernatorial campaign. Republican state lawmakers from the area, including Senate President Mary Felzkowski (R-Tomahawk) could also get in the race.

Some USDA office functions will be suspended during the government shutdown. (USDA Photo by Lance Cheung)

Nearly half of U.S. Department of Agriculture employees will be furloughed during the federal government shutdown, though key programs that support nutrition, forest preservation and wildfire prevention, the most pressing plant and animal diseases and agricultural commodity assessments will continue.

Many offices, including county USDA service centers, will be closed or operating with minimal staff until Congress agrees on a temporary spending package. Support, payment processing and other functions of these offices are also suspended during the shutdown.

Congress failed to pass a stopgap spending bill Tuesday which resulted in the start of a government shutdown at midnight and federal agencies had to implement the contingency plans required by the Office of Management and Budget.

According to the contingency plan filed by the U.S. Department of Agriculture, only a handful of agency operations will continue during the shutdown. The primary objective is that agencies cannot incur financial obligations if the funding source has lapsed and any planned or in-the-works activities that would incur new obligations, must cease. 

Activities that may continue during the shutdown include those that are financed by something other than current year appropriations, expressly authorized to continue, either by law or by necessary implication, necessary to the presidential duties and powers or related to emergencies that endanger human life or the protection of property.

According to the plan, more than 42,000 USDA employees are expected to be furloughed during the shutdown. That’s about half of the more than 85,000 employees the agency said would be “on board” prior to the shutdown. 

USDA programs that will continue despite the shutdown: 

• Farm loan processing.
• Certain natural resources and conservation programs that are mandatory under the farm bill or to protect human life and private property, like the Emergency Watershed Protection Program, dam safety and rehab work, the National Water and Climate Center which tracks flooding and weather risks and the National Soil Survey Center. 
• “Core” nutrition safety net programs. This includes SNAP and child nutrition programs which have funding appropriations through October. The Women Infants and Children, or WIC, program is set to continue through the shutdown “subject to the availability of funding.” According to the plan, WIC can “recover and reallocate” unused grant funding from previous years to cover gap in coverage. 
• Food safety operations, like inspections and laboratory testing.
• Wildfire preparation and response. 
• Activities like grading, assessment, inspection, import and export for farm commodities. These activities are supported by user fees and therefore not impacted by the shutdown.
• Emergency programs under USDA’s Animal and Plant Health Inspection Service that address new world screwworm, highly pathogenic avian influenza, African swine fever, rabies and exotic fruit flies. Surveying for other plant and livestock diseases will cease during the shutdown. 
• Prior obligations in the Section 521 rental housing agreement program. This is the program element of USDA Rural Development offices that will persist.
• Operational requirements like human resource policies, cybersecurity and critical IT infrastructure. 

Under the contingency plan, USDA functions like ongoing research, reports, outreach and technical assistance are suspended. The agency will also stop processing payments and disaster assistance. 

Trade negotiations, hazardous fuel treatments, special use permits, regulatory work, training and travel by USDA employees and agencies are also suspended. 

According to the contingency plan, most functions are suspended for the Risk Management Agency, Natural Resources Conservation Service, Foreign Agricultural Service, Food and Nutrition Service, National Institute of Food and Agriculture, Economic Research Service, National Agricultural Statistical Service, Rural Development, and staff offices.

Website updates are also suspended under the shutdown. A banner atop the USDA website informs visitors that the website will not be updated “due to the Radical Left Democrat shutdown.” 

“President Trump has made it clear he wants to keep the government open and support those who feed, fuel, and clothe the American people,” the banner reads. 

According to the plan, “all activities will cease” for the U.S. Secretary of Agriculture and her office during the shutdown. 

Approximately 67% of Farm Service Agency, or FSA, employees will be furloughed. According to the plan, selected leadership at headquarters and USDA offices will stay on during the shut down. This means county service centers, and the majority of the services they offer, will not be available during the shutdown. 

Nearly all, 1135 out of 1237 employees, at the Food and Nutrition Service offices were projected to be furloughed during the shutdown, though according to the plan, enough employees remain to facilitate SNAP, child nutrition programs and WIC. WIC must make unspent funds from past years available in order to continue operations through October.

Close to 20,000 of the 32,390 Forest Service employees will continue to work on certain approved areas of agency work, like wildfire prevention, protection of federal land and federal directives to expand timber production. Public access to recreation sites managed by the department will be reduced, according to the plan. 

A significant portion of Agricultural Marketing Service operations are funded by previous farm bill appropriations or by user fees, so services like the Federal Grain Inspection Service and dairy grading will continue, as will market news information.

Operations like country of origin labeling, the packers and stockyards program, the national organic program, shell egg surveillance and the pesticide data program will be suspended. 

The plan calls for a number of reconsiderations in the event the shutdown persists longer than 5 days. This could include, for example a farm loan employee or other staff member on call at USDA service centers, or the reinstatement of some furloughed employees to deal with wildfire management. 

Glenn “GT” Thompson, chair of the House Committee on Agriculture, blamed Democrats, who demanded extentions to the Affordable Care Act be added to the stopgap spending bill, for shutting down the government and putting “critical USDA services in jeopardy.”

“These political games harm rural America through disruptions to farm payments, disaster relief, food assistance, and other critical services,” the Republican from Pennsylvania said in a statement. “Performative photo ops at state fairs and lip service to the producers who feed, fuel, and clothe our country won’t hide the truth—Democrats forcing a government shutdown only inflicts more pain on our agricultural economy.”

Chair of the Federal Reserve Jerome Powell, left, administers the oath of office to Lisa Cook, right, to serve as a member of the Board of Governors at the Federal Reserve System during a ceremony at the William McChesney Martin Jr. Building of the Federal Reserve May 23, 2022 in Washington, D.C.  (Photo by Drew Angerer/Getty Images)

WASHINGTON — The U.S. Supreme Court will take up in January the question of President Donald Trump’s firing of Federal Reserve Board governor Lisa Cook, according to an order filed by the court Wednesday.

The unsigned order states Trump’s application to stay a lower court’s decision to keep Cook on board while the case plays out will be deferred until oral arguments on an unspecified date in January. 

Trump tried to remove Cook from the Federal Reserve Board of Governors in late August, alleging she lied on a mortgage application. A federal district judge sided with Cook in early September after she challenged the president in court.  

A three-judge panel then split 2-1 in rejecting Trump’s appeal to overturn the lower court decision and affirmed on Sept. 16 that Cook could keep her position as the case plays out. 

Trump asked the Supreme Court to intervene, adding to his series of petitions to the justices since his second term began. The decision could have major bearing on Trump’s powers as the chief executive.

White House press secretary Karoline Leavitt told reporters during Wednesday’s briefing that the administration remains confident about the legality of Cook’s firing.  

“Look, we have respect for the Supreme Court but they’re going to hear the actual case and make a determination on the legal argument in January. And we look forward to that because we maintain that she was fired well within the president’s legal authority to do so. She was removed from the board. And we look forward to that case being fully played out at the Supreme Court,” Leavitt said.

The legal battle is occurring against a backdrop of Trump’s ongoing pressure to insert himself in the decisions of the independent central bank. 

For months Trump and his allies have attacked Federal Reserve Chair Jerome Powell with antagonizing social media posts amid Trump’s continued campaign for lower interest rates.

The president and Senate Republicans recently installed White House economist Stephen Miran on the board. Miran is taking a leave of absence as chair of the White House Council of Economic Advisers while he serves in the role.

The Fed lowered interest rates for the first time in 2025 by a quarter percentage point on Sept. 17. Miran was the only board governor to vote against the change after lobbying for a half-point cut.

Cook, the first Black woman to serve on the Fed board, was appointed by former President Joe Biden in 2023 and confirmed by the Senate in a 51-47 vote.

The Federal Reserve’s dual mandate is to maximize the nation’s employment while also stabilizing prices by keeping inflation low and steady over a long period of time. Among the tools the central bank uses to accomplish the two missions is regulating interest rates to cool inflation or stimulate the economy.

In a video posted to X, Appeals Court Judge Maria Lazar announced she's running for the Wisconsin Supreme Court. (headshot courtesy of Wisconsin Court System)

Appeals Court Judge Maria Lazar announced she’s running for a seat on the Wisconsin Supreme Court Wednesday morning.

Since her election to the District II Court of Appeals in 2022, Lazar has been a reliable vote for right-wing causes on the panel — which is controlled by a 3-1 conservative majority. 

Lazar joins fellow appellate Judge Chris Taylor in the race for an open seat on the Court, which is being vacated by Justice Rebecca Bradley. Bradley has been one of the Court’s most right-wing members and announced earlier this year she would not run for re-election. 

In a video posted to X, Lazar said she was running for the seat to reduce the “politicization” of the Court. 

“We need to draw a line in the sand and stop the destruction of our courts, especially our state Supreme Court,” Lazar said. “I am an independent, impartial judge who strives to follow the law and Constitution in every decision I make from the bench. It is time to restore that level of judicial dedication to the Court.”

Lazar, a former Waukesha County judge and assistant district attorney, also noted that she’s been elected to her seats on the circuit and appeals courts while Taylor, a former Democratic state lawmaker, was first appointed to a seat on the Dane County Circuit Court by Gov. Tony Evers. 

While her campaign announcement sought to establish her nonpartisan bonafides, Lazar has a history of fighting for Republican causes. In her last campaign for her seat on the court of appeals, Lazar touted endorsements from prominent election deniers. 

Those endorsements included former Supreme Court Justice Michael Gableman, who recently agreed to have his law license suspended for three years over his widely derided review of the 2020 presidential election, Jim Troupis, who is facing criminal charges for his role in the plot to cast false Electoral College votes on behalf of President Donald Trump, and Bob Spindell, a Republican member of the Wisconsin Elections Commission who cast one of those fraudulent ballots and has regularly used his position to spread conspiracy theories about election administration. 

Lazar was also endorsed in that race by Pro-Life Wisconsin, an organization dedicated to banning all abortions in the state. That endorsement is a stark contrast with Taylor, who previously worked as policy director for Planned Parenthood of Wisconsin. 

“Just like Rebecca Bradley, Maria Lazar has spent her career rolling back people’s rights, attacking reproductive health care and voting rights, and doing the bidding of powerful special interests and her billionaire friends,” Ashley Franz, Taylor’s campaign manager, said in a statement. “If elected, Maria Lazar would be the most extreme member of the Wisconsin Supreme Court. It’s no surprise that she’s backed by the same right-wing billionaires who tried unsuccessfully to buy a seat on our supreme court this last April, which Wisconsinites overwhelmingly rejected.”

Rachel LaCasse-Ford, right talks to Sen. Tammy Baldwin about her use of the Affordable Care Act marketplace to buy insurance during a meeting Baldwin held with small business owners and others in Mount Horeb, Wisconsin, on Sept. 25. (Photo by Erik Gunn/Wisconsin Examiner)

Matt Raboin owns Brix Cider, a farm-to-table restaurant, and brews apple cider in the Dane County village of Mount Horeb.

His wife’s full-time job with benefits provides the family with health insurance, but for Raboin, the Affordable Care Act (ACA) has made an important difference for some of his employees.

“We don’t offer insurance ourselves,” Raboin said during a recent round table discussion set up by Sen. Tammy Baldwin (D-Wisconsin). “A lot of small businesses in small towns aren’t in a financial place to do that.”

Like Raboin, some of his employees get their coverage through a spouse or because they also work another full-time job that provides benefits. But over the years, the ACA and the HealthCare.gov marketplace created under the law have been a critical source of health coverage for many of his employees, Raboin said.

Recently he polled a number of them. One memorable response came from a part-time employee who also has a part-time job with a local church. She buys her health insurance on HealthCare.gov. Thanks to an increase enacted in 2021 in tax credit subsidies, she’s been able to afford the premiums, Raboin said she told him.

“So without it, she’s like, ‘I can’t keep working for you. And I don’t think I keep working for my church. I think I have to find a different job,’” Raboin recalled.

The ACA and HealthCare.gov have made it possible for millions more Americans and thousands more Wisconsin residents to obtain health insurance.

But less visibly, the health care marketplace that the ACA created has also helped support many small businesses. If the enhanced tax credit subsidies that lowered the cost of health insurance for millions over the last three years aren’t renewed, small business owners and employees say they could be especially hard hit.

Nearly half of people who get their health insurance through the HealthCare.gov marketplace are self-employed or small business owners, or else work for small businesses, according to KFF, an independent nonprofit that researches and reports on health policy.

To expand access to health care, the ACA created the HealthCare.gov marketplace to make buying health insurance easier for people whose jobs don’t provide coverage and who don’t qualify for government programs such as Medicaid.

To make coverage more affordable, the law provides tax credit subsidies for people with incomes up to 400% of the federal poverty guideline. Those subsidies were increased in 2021 and expanded to people with higher incomes.

The enhanced subsidies will expire at the end of 2025 unless Congress extends them — driving up the cost of health insurance for millions.

The enhanced subsidy “saves more than 230,000 Wisconsinites an average of $500 every single month,” Baldwin said during a Zoom press conference Tuesday.

For Chrysa Ostenso and her late husband, the enhanced subsidies lowered their premiums from nearly $2,000 a month to about $300 a month, Ostenso said.

Ostenso lives in Ladysmith, Wisconsin, where she and her husband operated an optometry clinic for more than three decades, raising four children along the way.

“We always struggled to afford health insurance but of course we had to buy it,” Ostenso said in an interview. “As a family of four kids with a small business, you can’t go without health insurance.”

The family’s high deductible plans required them to pay $6,000 a year out of pocket before insurance would cover their health care. By 2020, when the children were grown and the health plan just covered Ostenso and her husband, they were paying $1,979 a month, she said.

They hadn’t qualified for the original ACA subsidies. When the enhanced subsidies were enacted in 2021, however, Ostenso said their premiums went down to $300 a month, increasing to $500 a month in subsequent years.

“It actually meant freedom to go to the doctor, because we were spending so much money on our premiums [previously] that we actually couldn’t afford to go to the doctor,” she said.

Standoff over extending subsidies

In the weeks leading up to Tuesday night’s federal shutdown, Democrats in Congress demanded that Republicans rescind sweeping changes to Medicaid that were part of the major tax- and spending-cuts megabill that President Donald Trump signed July 4.

They also demanded an extension of the enhanced ACA subsidies.

Baldwin has coauthored legislation that would make the enhanced subsidies permanent. She spent part of the just-concluded congressional recess traveling Wisconsin and meeting with people who expect to see their health costs go up sharply if the increased subsidies end.

During Tuesday’s press conference, Baldwin related a conversation with a  bakery owner who worried about how she and her family will afford health insurance, “but also that increased costs on the [HealthCare.gov] exchange will mean that her employees at her bakery may have to quit to work for big companies that offer insurance.”

During Baldwin’s press conference, Gigi Gastevich, an artist who owns a retail space in Stoughton, said the ACA and the enhanced subsidies had made it possible for her to launch and grow her business.

Gastevich is a 15-year cancer survivor. When starting her business, she qualified for BadgerCare — Wisconsin’s main Medicaid program — which covered the ongoing medical monitoring she requires as a cancer survivor.

In 2025, with her income above the limit for BadgerCare, she found an insurance plan on HealthCare.gov that included her existing health care professionals in its network and had an affordable deductible.

The plan’s premium was $481 a month, Gastevich said, but the enhanced subsidy  brought it down to about $100 a month.

Without the subsidy, she said, she will have to switch plans — possibly losing her long-standing group of providers if they aren’t in the network. She said her choices include taking a high-deductible plan that would put some of the regular care she’s been recommended as a cancer survivor out of reach financially; or closing down her business. 

“[That] would mean not only abandoning my dream of entrepreneurship and being a self-employed artist, but taking away an income source for the dozens of artists and artisans whose American-made work I sell here,” Gastevich said.

It would also forestall her plans to scale up her business to sell her own line of textiles and employ others. “I won’t be able to do that if my health and well-being is tied to being on an employer-based health care plan,” she added.

Uncertain future

During her tour of the state, Baldwin stopped in Mount Horeb on Thursday, Sept. 25, where she spoke with Brix owner Matt Raboin and four other business owners as well as local health care providers.

The round table took place at the Upland Hills Health Mount Horeb clinic. The urgent care clinic is part of a broader system that includes a hospital in Dodgeville and clinics in surrounding communities.

Dr. Mark Thompson, Upland Hills CEO, said system executives expect to see about $400,000 a year in additional uncompensated care based on projections of people leaving the insurance rolls because they don’t think they can afford the new ACA premiums.

Jay Goninen sat in as a board member of the Upland Hills system, but he’s also an employer for whom the ACA has made it possible to provide health benefits.

Goninen owns a business that helps connect the auto repair industry with high schools and technical schools. For the last few years, he’s opted to have employees of the firm purchase health insurance on the ACA.

The company pays a portion of the cost. Goninen likens the arrangement to a common practice of employers who offer a group health plan and split the cost with their employees.

“I do really worry about just the individual person and their ability to afford to live right now, in general,” he told Baldwin. “It is tough.”

In addition to worrying about what will happen to employees who bought coverage at HealthCare.gov if they lose their subsidies, Raboin said he’s also concerned about the broader ripple effect in the community.

“Our clients aren’t rich,” Raboin said. “Not everybody can go out to eat all the time, and if you start taking away that expendable income, that’s less people coming out to eat. So I think it would depress the whole economy.”

Rachel LaCasse-Ford owns a campground with her husband and also heads the Mount Horeb Chamber of Commerce.

“I’ve never really had a job that offers health care,” LaCasse-Ford told Baldwin. “I’ve always worked in small business, so we have always used health care from the ACA.”

The enhanced tax credits “definitely benefited” the couple, she said. “And if those go away, that will make our budgets tighter, and it will make things more challenging for us.”

With every new job, LaCasse-Ford said, she considers its impact on their health coverage and whether she can stay with a nonprofit employer such as the chamber, work for a small business, “or if I need to look for a larger employer that offers benefits.”

Democratic Senators called attention to cuts to two veterans programs taking effect in October due to funding being left out of the state budget by Republican lawmakers. The Wisconsin Senate passing the 2025-27 budget bill in July. (Photo by Baylor Spears/Wisconsin Examiner)

State lawmakers have failed to find a solution to stop cuts taking effect in October to two Wisconsin Department of Veterans Affairs programs that help veterans struggling with homelessness and mental health issues. 

The Veterans Housing and Recovery Program (VHRP) is closing two of its locations, one in Chippewa Falls and the other in Green Bay, and the Veterans Outreach and Recovery Program (VORP), which serves veterans dealing with mental health and substance use issues and aims to reduce the suicide rate among veterans, is set to lose seven positions.

The VHRP has been the center of back and forth between Democrats and Republicans for months since the announcement of the closures in July. 

A Republican bill to fund the program received a hearing in September, but it was too late to stop the closures. 

VORP launched in 2015 with the help of a federal mental health grant. It is now state funded and Evers used American Rescue Plan Act funds in 2023 to expand the reach of the program, but those funds have run out. 

Gov. Tony Evers had requested seven positions and more than $1.1 million to help support the program, but Republican lawmakers stripped that proposal from the state budget. Those seven positions were set to expire in October without the additional funds, though the cuts have already taken effect with the state Department of Veterans Affairs reducing the number of regions under the program from 16 back to 11.

The additional employees had helped the agency reach more veterans, provide support in a more timely manner and give veterans more individual attention, according to the Legislative Fiscal Bureau. In 2023-24, the program provided services to 2,222 people — a nearly 70% increase compared to the prior year.

Senate Minority Leader Dianne Hesselbein (D-Middleton) and Sen. Jamie Wall (D-Green Bay) called attention to the cuts during a press call on Tuesday, blaming Republicans for the failure to provide the needed funding. 

“I’m frustrated, and I’m devastated at the same time,” Hesselbein said. “As of today, these facilities are closed and the veterans they once housed have been relocated.” 

Hoey said at the hearing on the bill from Sen. Andre Jacque (R-New Franken) that the earliest the Chippewa Falls facility would be able to reopen is sometime after Oct. 1, 2026. The Green Bay location, he said, could be reopened relatively quickly if there was funding and depending on whether the federal government would approve a request for a change to its scope. 

Hesselbein noted that Evers and Democratic lawmakers have provided several opportunities for Republicans to keep the VHRP sites open and provide funding to VORP. 

Democratic lawmakers, led by Hesselbein and Rep. Robyn Vining (D-Wauwatosa), introduced a bill to provide funding for the VORP positions, but it hasn’t received a hearing in the Republican-led Legislature. No Republican lawmakers have signed on to it, nor have they introduced their own version that would provide the funding.

A separate bill, authored by Wall, Sen. Jeff Smith (D-Brunswick) and Rep. Jodi Emerson (D-Eau Clare), would provide the necessary funding for the VHRP sites. It previously would have provided $1.9 million, but an amendment to the legislation increases that to $2.6 million, which, Wall said, would be necessary to restart the programs. 

“My disappointment is with the leadership of legislative Republicans that has not made this program, has not made that bill, has not made homeless veterans a priority over the last few months,” Wall said. “They’ve run out the clock until here we are on Sept. 30, with the funding going away now. It’s possible to revive these programs… but it’s going to take a little bit more money and a lot more time. In the best case, we’re looking at next fall before we can stand up these programs again.” 

Sen. Eric Wimberger (R-Oconto) blamed Evers for the closures, again, in a statement on Tuesday, claiming that there is money available to fund the programs.

“The Legislature appropriated enough funding to support the Veterans Housing and Recovery Program,” Wimberger said. “Evers simply refused to spend it. The closing of veterans’ homeless shelters is his decision alone, and he quite literally is refusing to use available funding in the exact same manner as he did last year to run those facilities.”

Evers has previously rejected Wimberger’s claim, noting that a paper from the nonpartisan Legislative Fiscal Bureau to the Joint Finance Committee warned lawmakers that additional funds were needed for the program. 

A letter from Republican lawmakers also noted that there has been a balance that the Department of Veterans Affairs  returns to the state treasury at the end of the year, though Hoey has noted that the agency is “only allowed to spend the money [the Legislature] tell[s] us to spend.”

Wall made a similar point during the press conference, saying that “we don’t just write a blank check to the Department of Veterans Affairs or any other part of the state budget. What we do is say that there’s so much money in this budget line for this program and so much money in that budget line for this other program, and so the fact that the Department of Veterans Affairs had surplus money and other budget lines doesn’t mean that they could just willy-nilly take that and spend that any way they wanted to for the benefit of this program.”

Hesselbein said this is a continuation of Republicans’ “strange finger pointing.” 

Hesselbein used the deadline for the closures and cuts as an opportunity to talk about what Democrats would do if they were in the majority. Democrats are seeking to flip the Senate in 2026 and need to win two additional seats to do it.

“Republicans chose to do nothing,” Hesselbein said. “Rest assured in a couple of years, when I’m the majority leader, these kinds of antics won’t be tolerated in a Democratic majority, but unfortunately, while that day is on the horizon, it’s not here yet.”

Donna Powell, 66, a resident of Austin, Texas, who is temporarily living in the nation's capital, holds a sign at the "Healthcare Over Billionaires" rally hosted by Fair Share America and nearly three dozen other advocacy organizations outside the U.S. Capitol on Tuesday, Sept. 30, 2025, hours before federal government funding ran out at midnight. (Photo by Ashley Murray/States Newsroom)

WASHINGTON — A large crowd gathered on Capitol Hill Tuesday hours before a federal government shutdown to protest rising health care costs — the crux of Democrats’ stand against approving a temporary Republican funding bill.

More than a dozen Democratic lawmakers joined activists and people who shared stories of rising health insurance premium costs at the “Healthcare Over Billionaires” rally hosted by the advocacy group Fair Share America, along with nearly three dozen labor unions, political advocacy groups and other organizations. 

Senate Democrats again on Tuesday blocked Republicans’ temporary government funding bill, citing the expiration of Affordable Care Act enhanced premium tax credits that since 2021 have lowered health insurance costs tied to an enrollee’s income. 

The standoff means a federal government shutdown will begin after midnight Tuesday.

Tony Gonzales, of Indiana County, Pennsylvania, told the crowd he worries how losing the premium tax credits will affect his family’s finances as he continues treatment for thymic carcinoma, a rare cancer he was diagnosed with two years ago.

“I need these subsidies. If the rich and the Republicans can go out there and have money for tax cuts, to buy another yacht, to go out in space, why can’t I at least have health care to address my needs, my wife’s needs, and maintain a lifestyle that we deserve as an American family?” said Gonzales.

Sen. Amy Klobuchar of Minnesota said her constituents are “standing on a health insurance cliff right now” and she will not support a Republican funding proposal until GOP lawmakers agree to extend the health insurance subsidies.

“When I hear them say, ‘oh, we’ll look at this in December, we’ll look at this in January.’ This is not a December thing. This is not a January thing. This is a now thing,” she said.

Open enrollment for health care plans begins Nov. 1 in most states, except Idaho, where it begins Oct. 15.

Annual insurance premiums could double on average in 2026 if the subsidies expire at year’s end, according to an analysis published Tuesday by the nonprofit health policy research organization KFF.

The enhanced premium tax credits were extended through 2025 under the Democrat-led budget reconciliation law in 2022, otherwise known as the Inflation Reduction Act.

Participation in Affordable Care Act health insurance exchanges has more than doubled to over 24 million, up from 11 million, since the introduction of the tax credits, which the majority of enrollees receive, according to KFF. 

U.S. Senate Majority Leader John Thune, R-S.D., speaks to the media at the U.S. Capitol on Sept. 30, 2025 in Washington, D.C. Thune was joined by Sen. Tom Cotton, R-Ark., Sen. Shelley Moore Capito, R-W.Va., Sen. John Barrasso, R-Wyo., and Sen. James Lankford, R-Okla. (Photo by Kevin Dietsch/Getty Images)

This report has been updated.

WASHINGTON — The federal government started shutting down early Wednesday after Congress failed to approve a funding bill before the beginning of the new fiscal year — resulting in widespread ramifications for hundreds of programs and giving the Trump administration an avenue to fire federal workers en masse.

The U.S. Senate was unable to advance two short-term government funding bills Tuesday when Democrats and Republicans deadlocked for the second time this month, with just hours to go before the midnight Tuesday shutdown deadline.

Senators voted 55-45 on Republicans’ bill that would fund the government for seven weeks and 47-53 on a Democratic stopgap proposal that would keep the lights on for a month and included several health care provisions that they said were needed for their support. Neither had the 60 votes needed to advance. 

Nevada Democratic Sen. Catherine Cortez Masto, Pennsylvania Democratic Sen. John Fetterman and Maine independent Sen. Angus King voted with GOP senators on their stopgap bill. Kentucky GOP Sen. Rand Paul voted against it.

White House Office of Management and Budget Director Russ Vought said in a memo to departments and agencies Tuesday night after the Senate vote that “affected agencies should now execute their plans for an orderly shutdown.” Vought said federal employees should report for their next regularly scheduled tour of duty to undertake shutdown activities.

The consequences of a shutdown will be sweeping in the nation’s capital and across the country, where states are bracing for the impact. About 750,000 federal workers could be furloughed, leading to a $400 million impact a day, the nonpartisan Congressional Budget Office reported. All federal employees would go unpaid until the shutdown is over.

Additionally, the Trump administration plans to lay off thousands of federal employees, which would reshape the federal workforce. President Donald Trump again vowed Tuesday to undertake layoffs and a major government employee union filed suit in federal court in advance of such a move.

More votes on GOP bill planned

Senate Majority Leader John Thune, R-S.D., said hours before the votes there wouldn’t be any talks with Democrats during a shutdown. 

“The negotiation happens when the government is open. So let’s keep the government open and then we will have the negotiations,” Thune said. 

“We’re happy to sit down and talk about these issues that they’re interested in,” he said. “But it should not have anything to do with whether or not for a seven-week period we keep the government open, so that this government can continue to do its work and that we can do our work through the regular appropriations process to fund the government.” 

After the votes failed, Thune expressed his frustration with Democrats during a press conference. 

“This is so unnecessary and uncalled for,” he said. 

Thune said he plans to bring up a vote on the continuing resolution again. He said as soon as Wednesday the federal government can be funded if five Democrats voted with Republicans. 

“Democrats may have chosen to shut down the government, but we can reopen it tomorrow,” Thune said. 

Republican Whip John Barrasso of Wyoming said the “cracks in the Democrats are already showing,” noting that three Democrats voted with Republicans Tuesday night. 

“There is bipartisan support for keeping the government open,” Barrasso said. “We’re happy to see that the Democrats are already starting to break from (Senate Democratic Leader Chuck Schumer) and we’re going to continue to offer a clean (continuing resolution) on the floor of the Senate to open the government for the next seven weeks.”

Health care tax credits at center of standoff

The disagreement isn’t entirely about GOP lawmakers writing their short-term funding bill behind closed doors and then expecting Democrats to help advance it in the Senate, where bipartisanship is required for major legislation.

Democratic leaders have raised concerns for weeks about the end-of-year sunset of enhanced tax credits for people who buy their health insurance on the Affordable Care Act Marketplace, arguing a solution is needed now ahead of the open enrollment period starting on Nov. 1. 

Democrats have also grown increasingly frustrated with the White House budget office’s unilateral actions on spending, arguing Vought is significantly eroding Congress’ constitutional power of the purse. Sen. Susan Collins of Maine, the Republican chairwoman of the U.S. Senate Appropriations Committee, said Tuesday the Government Accountability Office should sue the Trump administration over its efforts to freeze or unilaterally cancel spending approved by Congress. 

Senate Minority Leader Chuck Schumer said Democrats need an agreement with Republicans to extend the enhanced tax credits. 

Schumer said people will begin getting notices in October telling them how much the cost of their ACA plans will increase during the next year, which he expects will ratchet up pressure on Republican leaders to broker a bipartisan agreement. 

“We’re going to be right there explaining to them it’s because the Republicans wouldn’t negotiate with us,” Schumer said, referring to consumers. “We’re ready to do it anytime. And there will be huge heat on (Republicans) on this issue.”

People who buy health insurance on the ACA marketplace and receive subsidies through enhanced ACA tax credits could expect to pay on average more than double for annual premiums in 2026 if the credits expire as scheduled at the end of this year, according to an analysis released Tuesday by the nonprofit health policy research organization KFF. 

The analysis found premiums could increase from an average of $888 this year to $1,904 in 2026.

Claims about immigrants 

Schumer also rebuffed GOP leaders saying that Democrats want to include people without legal immigration status in federal health care programs. 

“They say that undocumented people are going to get these credits. That is absolutely false. That is one of the big lies they tell, so they don’t have to discuss the issues,” Schumer said. “The federal government by law that we passed does not fund health insurance for undocumented immigrants in Medicaid, nor the ACA nor Medicare. Undocumented immigrants do not get federal health insurance premiums.” 

Immigrants in the country without legal authorization are not eligible for Medicaid, and neither are most immigrants with legal status, such as those with student visas or enrollment in the Deferred Action for Childhood Arrivals program, known as DACA. 

Only immigrants with a “qualified status,” such as legal permanent residents, asylees and refugees, are able to get Medicaid benefits, and they usually have to wait five years before their coverage can even begin. 

Democrats explain why they voted with GOP 

Cortez Masto of Nevada wrote in a statement explaining her vote to advance the GOP stopgap bill that she could not support “a costly shutdown that would hurt Nevada families and hand even more power to this reckless administration.”

“We need a bipartisan solution to address this impending health care crisis, but we should not be swapping the pain of one group of Americans for another,” she added. “I remain focused on protecting health care for working families, and I call on my colleagues on both sides of the aisle to work together to tackle this problem.”

Pennsylvania’s Fetterman wrote in a statement of his own that his vote on the Republican bill “was for our country over my party.

“Together, we must find a better way forward.”

Collins said during a brief interview before the vote she is worried about the broad authority the White House holds during a shutdown and how the Office of Management and Budget has indicated it will use that power. 

“I’m much more concerned about OMB sending signals that there should be mass firings of federal employees who have the misfortune to be designated as non-essential, when in fact they’re performing very essential work, they’re just not being paid,” Collins said.  

North Dakota Republican Sen. John Hoeven, chairman of the Agriculture spending subcommittee, said lawmakers will have to sort through how various departments implement their contingency plans as well as the possibility of mass layoffs during a shutdown. 

“We’ll have to work through those things and figure out how we do keep things going as best we can during this Democrat shutdown,” Hoeven said.

West Virginia Sen. Shelley Moore Capito said Republicans are “unified in the belief that this is an easy choice” to fund the government with a stopgap bill that doesn’t include any contentious or political provisions. 

Capito — who chairs the Appropriations subcommittee that funds the departments of Education, Health and Human Services, and Labor — said there are several programs that will be “missed” during a shutdown. 

“And that’s concerning. So I think the option is to keep the government open so we can avoid this pain,” Capito said. 

‘I’m not optimistic that we’re going to get a path forward’

Missouri Republican Sen. Josh Hawley said he is worried about the possible impacts of a shutdown on his home state and that keeping the government open is the only way to avoid that.  

“I’m sure the administration will do everything they can,” Hawley said. “But the solution is to not shut the government down. I mean, why would you punish working people because you’re not getting what you want on any issue, whatever it is.”

South Dakota Republican Sen. Mike Rounds said he doesn’t expect a shutdown will end until after Democrats have sent a message to their voters. 

“I’m not optimistic that we’re going to get a path forward until they’ve had a shutdown,” he said. 

Rounds, who negotiated a handshake agreement with the White House budget director this summer to preserve some funding for rural tribal radio stations after Congress eliminated funding for the Corporation for Public Broadcasting, said that deal could be affected by a shutdown. 

“They’re putting the administration in a position where they can pick and choose what they’re going to do, and a shutdown is not going to be beneficial to these Native American radio stations,” Rounds said. 

Democratic Sen. Elissa Slotkin of Michigan said she wants Democrats and Republicans to negotiate on health care provisions.

“I’ve been making the case constantly, that (it) is literally my obligation to try and fight for health care, and I’m willing to talk to anyone,” she said. “I’m willing to accept that I certainly will not get everything I want.”

Senate Minority Whip Dick Durbin of Illinois said that while Democrats agreed to help advance what’s known as a continuing resolution in March, they can’t now because of “what President Trump is doing to this country, particularly when it comes to health care costs for families.”  

The shutdown will significantly affect the operations of the federal government as lawmakers have not passed any of the dozen full-year appropriations bills that finance agency operations. Oct. 1 is the beginning of the new fiscal year for the federal government.

Shutdown plan for national parks

Departments began releasing updated contingency plans this weekend, detailing how many of their employees would work during a government shutdown and how many would be furloughed.

The Interior Department, which includes the Bureau of Land Management, U.S. Fish and Wildlife Service and National Park Service, posted its updated plans late Tuesday. 

The National Park Service plans to furlough 9,300 of its 14,500 workers. 

The Trump administration will allow several activities necessary for the protection of life or property to continue, including fire suppression for active fires, permitting and monitoring First Amendment activities, border and coastal protection and surveillance, and law enforcement and emergency response.

The contingency plan says that roads, lookouts, trails, and open-air memorials will generally remain accessible to visitors,” but it adds that if “access becomes a safety, health or resource protection issue … the area must be closed.”

Union files suit

In anticipation of layoffs by the Trump administration, labor unions representing more than 1 million federal workers filed a lawsuit in the Northern District of California on Tuesday to block the Trump administration from carrying out mass firings. The suit argues that there is no statutory authority to fire federal employees during a government shutdown.

“These actions are contrary to law and arbitrary and capricious, and the cynical use of federal employees as a pawn in Congressional deliberations should be declared unlawful and enjoined by this Court,” according to the suit filed by the American Federation of Government Employees and the American Federation of State, County and Municipal Employees.

Ashley Murray and Shauneen Miranda contributed to this report. 

Congressional Hispanic Caucus Chair Adriano Espaillat, a New York Democrat, speaks at a press conference outside the U.S. Capitol in Washington, D.C., on Sept. 30, 2025. (Photo by Shauneen Miranda/States Newsroom)

WASHINGTON — A group of Democratic caucus leaders on Tuesday blasted a vulgar deepfake of Senate Minority Leader Chuck Schumer and House Minority Leader Hakeem Jeffries posted by President Donald Trump on social media. 

The chairs of the Congressional Hispanic Caucus, Congressional Black Caucus, Congressional Asian Pacific American Caucus, Democratic Women’s Caucus, New Democrat Coalition, Congressional Progressive Caucus and Congressional Equality Caucus also refused to back down on their health care demands as the federal government barrels toward a shutdown.

The GOP and Democratic lawmakers are in a deadlock, and funding is set to run out by midnight Tuesday, when the new fiscal year begins.

“We won’t vote for anything that doesn’t restore the cuts to Medicaid and doesn’t protect people that will be paying higher premiums,” Congressional Hispanic Caucus Chair Adriano Espaillat said at a press conference outside the U.S. Capitol, referring to Medicaid reductions made in the “big, beautiful” law enacted by Republicans earlier this year.

The New York Democrat said “we won’t mess around with Americans’ health care — people that are sick that deserve to have a first-quality health care system providing assistance to them in one of the most serious periods of their lives.” 

While Republicans want a “clean” stopgap funding bill to keep the government open, Democrats are calling for the extension of enhanced Affordable Care Act tax credits set to expire at the end of 2025 and the reversal of sweeping health care changes brought by the GOP’s mega tax and spending cuts law, including the massive funding cuts to Medicaid. 

‘Racist meme’ by Trump slammed

Trump posted the deepfake on his social media platform Truth Social just hours after his White House meeting with Schumer, Jeffries, Senate Majority Leader John Thune of South Dakota and House Speaker Mike Johnson of Louisiana, which failed to yield any funding deal. The Congressional Budget Office estimated Tuesday that some 750,000 federal employees could be furloughed if the government shuts down. 

The 35-second video appears to be AI-generated and uses the setting of Schumer and Jeffries, both New York Democrats, speaking to reporters outside the White House after their meeting with Trump. 

The fake video shows Jeffries with a sombrero and mustache and Schumer ranting that “if we give all these illegal aliens free health care, we might be able to get them on our side so they can vote for us.” 

Espaillat of the Congressional Hispanic Caucus described the video as “insulting,” saying it shows Trump is “out of touch with the health care challenges of the American people.” 

The New York Democrat said “with your health care on the line, all he could do is put out this deepfake racist meme — not funny at all, not for any of us here, particularly for people that are ill and fighting for their lives that need health care.” 

Democratic Women’s Caucus Chair Teresa Leger Fernández also blasted the video, saying “that’s not how you get to a deal.” Instead, the New Mexico Democrat said Trump’s decision to post it “looks like a little 6-year-old having a temper tantrum.” 

‘Bigotry will get you nowhere’

Congressional Black Caucus Chair Yvette Clarke, a New York Democrat, said “the juvenile behavior coming out of the White House should not be dignified by any American.”   

Clarke noted that her caucus “will not support a partisan spending bill that slashes health care, guts federal jobs and raises costs, all while targeting the very communities that keep this country running.” 

In a social media post Monday responding to the fabricated video, Schumer said “if you think your shutdown is a joke, it just proves what we all know: You can’t negotiate. You can only throw tantrums.” 

Jeffries also responded to Trump on social media Monday, saying “bigotry will get you nowhere” and “we are NOT backing down.” 

Child abuse, neglect or endangerment laws were used to charge hundreds of pregnant people with crimes in the two years after the U.S. Supreme Court overturned Roe v. Wade, underscoring the rise of fetal personhood laws, according to a new report. (Getty Images)

More than 400 people were charged with pregnancy-related crimes during the two years after the U.S. Supreme Court overturned federal abortion rights, research released Tuesday shows.

Prosecutors across the country often charged people with some form of child neglect, endangerment or abuse based on allegations of substance use during pregnancy, according to an annual report from the nonprofit Pregnancy Justice. 

Nearly three dozen cases were brought against people who miscarried or delivered stillborns, and in nine cases, pregnant people were accused of obtaining, attempting or researching abortion. 

“Prosecutors are wielding criminal laws to surveil and criminalize pregnant people, their behavior and their pregnancy outcomes,” Dana Sussman, Pregnancy Justice’s senior vice president, told States Newsroom.

Although charges against those experiencing pregnancy loss are less common, Sussman said she fears they could lead people to avoid seeking miscarriage care. 

For instance, a woman who miscarried at home was charged with abuse of a corpse in September 2023, Ohio Capital Journal reported. 

Brittany Watts was around 21 weeks pregnant when she went to the hospital but waited for hours and didn’t get help, according to the Capital Journal, and after she miscarried at home, she returned to the hospital, where staff called police. She was never indicted, and she filed a federal lawsuit in January against the city of Warren, police, hospital officials and hospital staff. 

“Rather than being able to grieve her loss, she was taken away in handcuffs. She was interrogated in her hospital bed while she was still tethered to IVs, and so she wants compensation for her own trauma, but most importantly, wants to make sure that this doesn’t happen to anyone else,” Rachel Brady, Watts’ attorney, told States Newsroom in June.

Watts’ lawsuit alleges local law enforcement and the hospital violated the Fourth and Fourteenth Amendment and the Emergency Medical Treatment and Active Labor Act (EMTALA), which requires hospitals that receive Medicare funding to provide stabilizing medical treatment regardless of a person’s ability to pay or insurance status. The defendants denied liability and the plaintiff’s claims, according to court documents filed in September. 

In this year’s report, pregnancy-related cases cropped up in 16 states, and states with strict abortion bans topped the list again: Alabama (192), Oklahoma (112) and South Carolina (62).

“If you are doing anything that exposes your pregnancy, your fetus to some real risk, perceived or assumed risk, in certain parts of the country, that is a felony,” Sussman said. 

Fetal personhood — the notion that fetuses, zygotes and embryos should have the same legal rights as human beings — comes into play when pregnant people struggling with addiction are drug tested during checkups or at labor and delivery units, Sussman said. 

“In several states, it’s become relatively common practice for people to be charged with a felony for child endangerment or neglect for simply testing positive” on toxicology tests, Sussman said. “And that carries years in prison, and of course, immediate family separation from your newborn and even from your other children in your home, in your family.” 

An investigation by The Marshall Project, Mississippi Today and three other news outlets in 2023 found that local law enforcement and prosecutors in Alabama, Mississippi, Oklahoma and South Carolina applied child abuse and neglect laws to fetuses when pursuing charges against pregnant women. 

Lawmakers in a few states have pitched legislation seeking to curb punitive approaches to addiction among expectant and new mothers. 

A bill advancing in the New York Legislature would require informed consent for drug testing and screening pregnant and postpartum patients unless it’s medically necessary. Legislation took effect in Washington state this summer that prevents the criminalization of pregnancy loss, and requires officials at jails, prisons and immigrant detention centers to report miscarriages and stillbirths to the state annually. Massachusetts legislators passed a law in December that prevents medical professionals from automatically referring substance-exposed newborns to the state Department of Children and Families. 

Prosecutors obtained information about pregnancy-related crimes from health care facilities in 264 out of 412 cases, even in incidents that did not allege substance use, according to the Pregnancy Justice report.

“If people are worrying about losing their children because of family separation through the child welfare system or by going to jail, they are not going to get the care that they need,” Sussman said. “Pregnancy is seen as a moment and a window of opportunity for people to get care. People are motivated, uniquely motivated, and we really squander that opportunity when we turn health care into a place of reporting.” 

U.S. Senate Appropriations Committee Chairwoman Susan Collins, R-Maine, speaks with reporters inside the Capitol building in Washington, D.C., on Monday, Sept. 29, 2025. (Photo by Jennifer Shutt/States Newsroom)

WASHINGTON — The chairwoman of the U.S. Senate Appropriations Committee said Tuesday the Government Accountability Office should sue the Trump administration over its efforts to freeze or unilaterally cancel spending approved by Congress. 

“I believe that GAO, which is empowered under the Impoundment and Budget Control Act of 1974 to sue in cases, should do so,” Sen. Susan Collins said. “The GAO has found seven instances in which the (impoundments) violate the act and it has standing to sue.”

Collins, R-Maine, also told reporters that she doesn’t agree with the Supreme Court’s decision last week on its emergency docket that allows the Trump administration to cancel $4 billion in foreign aid. 

“I disagree with the Supreme Court’s temporary decision, but it was not a decision that delved into the merits of the case,” Collins said. “That’s yet to come.”

Collins, one of the more vocal members of her party over preserving Congress’ constitutional power of the purse, said “Well, let’s see,” when asked if she expects the GAO, a government watchdog agency, would win a lawsuit over the Trump administration impounding funds. 

The GAO and White House budget office did not immediately respond to a request for comment. 

Funds frozen for libraries, medical research, FEMA

Republicans in Congress have been either supportive or relatively quiet about the Trump administration’s efforts to freeze or cancel funding approved by Congress. 

The GAO has cited the Trump administration for illegally impounding funding for electric vehicle charging, museums and libraries, Head Start, energy efficiency upgrades in K-12 schools, funding for medical research at the National Institutes of Health and funding for the Federal Emergency Management Agency. 

Senate Appropriations Committee ranking member Patty Murray, D-Wash., released a statement earlier this week rebuking the Trump administration’s actions after the GAO released its seventh impoundment decision. 

“Today, we have another stark reminder of how President Trump’s lawless assault on our spending laws is hurting real people in every part of the country—as funding is held up to address homelessness, prepare for disasters, and much more,” Murray wrote. “It is time for Republicans to join us in insisting that every last penny that is owed to the American people gets out to the American people.”