The Government Shutdown—and the ripple effects on student health and well-being

A federal government shutdown may seem like a distant policy battle, but its impacts ripple into campus health systems in very real ways. When agencies like the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) scale back operations, the public health safety net weakens. At the same time, the recent budget debate has included whether to extend enhanced Affordable Care Act (ACA) marketplace subsidies—a decision that sharply affects students who rely on these plans for health coverage. Despite the unknowns that lie ahead, for campus health leaders, the confluence of these threats requires urgent attention.

A weakened public health backbone

Former CDC officials have warned the agency is “not prepared for daily public health emergencies” when shutdown-related funding gaps lead to staffing cuts and delayed guidance. In a shutdown, the CDC may lose a significant portion of its workforce, interrupting laboratory work, surveillance, and communication with local health departments.¹

Without this backbone of public health support, local health systems and university health centers face delayed guidance, reduced coordination, and increased risk.

How public health disruptions surface on campus

Colleges may not be directly run and supported by federal programs, but they are embedded in a network of public health dependencies.

1. Campus & community health services

Many university health centers have services supplemented by nearby community clinics which rely on federal funding streams or technical support from federal health agencies. When those agencies slow or pause, partner clinics may face cash-flow constraints, delayed reimbursements, and fewer resources for disease outbreaks or behavioral health surges. For students, particularly those who are uninsured, low-income, or rely on campus/partner clinics, the risk includes delayed appointments, medication gaps, or reduced access to care.²

2. Communication & outbreak readiness

When the CDC halts non-essential communications, campus health officials may lose access to timely updates or regional epidemiologic data. As observed during the 2018–19 shutdown, these pauses can result in delayed flu-season guidance and inconsistent local messaging.³

Without reliable upstream guidance, campus health teams must fill the gap, often with less information, more stress, and higher risk.

3. Research, training, and readiness

Many institutions host public health training programs, student researcher roles, and federal-agency-partnered studies. A shutdown or funding delay stalls projects, affects student researchers, and erodes future public health workforce development.

This is especially concerning for campuses that see themselves as health-innovation hubs or regional public health supports.

The insurance subsidy threat & student coverage

Here’s where the issue of insurance subsidies becomes directly relevant to student health and well-being.

1. The subsidy landscape

Under the ACA marketplace, premium tax-credit subsidies help make private coverage accessible for millions. Analysts estimate that if the enhanced subsidies (introduced during the COVID period) expire at the end of 2025, about 7.3 million people could lose subsidized coverage, 4.8 million could become uninsured, and premiums would rise sharply, with average out-of-pocket costs more than doubling in some cases.^{4, 5}

2. Why students are vulnerable

According to a 2020 report, college students benefited significantly from the ACA as coverage among students increased by about ten percentage points from 2010 to 2018; the law narrowed racial coverage gaps; and Medicaid expansion played a key role.⁶

The cutting of subsidies would mean students who purchase marketplace plans (or rely on dependent coverage until age 26) may suddenly face much higher premiums or coverage loss.⁷ This threatens their access to preventive and behavioral health services just when other campus health pressures are heightened.

3. The combined impact

Imagine a scenario in which:

• The CDC’s surveillance and local health coordination are delayed because of shutdown impacts.
• Simultaneously, students’ marketplace insurance premiums jump, causing coverage dropouts or financial strain.

The result? Uninsured or underinsured students, fewer campus referrals to community clinics, higher untreated illness, more demand for campus services, and more risk of student attrition or crisis cases.

Student well-being & equity: The downstream cost

When the public health ecosystem weakens and coverage becomes unstable, student well-being suffers in multiple ways:

• Health anxiety and financial stress escalate when students fear losing insurance or access to care.
• Preventive care and chronic-condition management may lapse if premiums rise or coverage is lost.
• Behavioral health demand spikes just as resource constraints grow in campus clinics and partner networks.

Students from low-income, first-generation, or marginalized backgrounds face the largest risk, especially if their insurance options hinge on subsidies or campus-partner arrangements. When students’ health is unstable, academic engagement, persistence, and retention risk are all elevated.⁸

Institutional ripple effects

The impacts extend beyond individual student health to institutional mission and operations:

• Outbreak management: Risk increases when federal public health systems and local partner networks are not fully functional.¹
• Resource strain: Campus health centers may absorb more demand, costing budget, staffing and referral capacity.⁹
• Coverage-related financial pressure: Students with higher premiums may delay care, leading to later and more expensive interventions—or higher crisis counseling loads on campus.⁸
• Research/training slowdown: Reduced subsidies and delayed federal grants affect institutional competitiveness and campus-health innovation programs.⁹
• Equity and retention pressure: Coverage loss is an equity issue; vulnerable students may be most at risk of health-related dropout.⁸

Together, these create a multi-faceted threat: weaker public health, stretched campus health services, unstable student coverage, and higher institutional risk.

Key action for health & well-being leaders

Due to the tense political climate, the over 40-day shutdown has been the longest in the nation’s history. As we work to pick up the pieces, now is the time for proactive planning. Institutions of higher education should coordinate among those on campus including student health, counseling, financial aid, admissions (for international students), and community health to create plans that mitigate the health impacts of the government shutdown. 

Leadership should:

1. Map dependencies: Identify all campus and partner services reliant on federal health agencies, public health grants, marketplace subsidies, and referral networks.
2. Secure bridge partnerships: Sign MOUs with local hospitals, tele-behavioral health vendors, community clinics, and plan for surge capacity if federal/partner support falters.
3. Pre-prepare communication templates: Have ready-to-send messages for students about insurance subsidy changes, premium increases, coverage options, and health-service access during disruptions.
4. Set up emergency health-access funds: Allocate institutional with philanthropic reserves to assist students facing coverage loss or premium hikes, ensuring access to preventive care, medication, counseling.
5. Conduct scenario drills: Simulate two concurrent events: (a) partial shutdown of a federal health agency (e.g., CDC outreach delayed), and (b) marketplace subsidy termination shock. Test roles, communication, referral pathways, and response capacity.

Preparedness isn’t just about crisis response—it’s about structured continuity when policy disruptions hit.

Bottom line

A government shutdown and the potential loss of federal health insurance subsidies aren’t simply “Washington problems”—they translate directly into campus vulnerabilities. When public health systems pause, the campus becomes not only the first, but a last line of defense for student well-being. If insurance subsidies disappear or premiums surge, students’ access to care and financial security wobbles.⁸ For health and well-being leaders in higher education, bridging these gaps now is critical to protecting students, preserving institutional stability, and ensuring continuity of care in an era of policy uncertainty.

References

1. Moniuszko, S. (2025, October 15). After CDC cuts, former officials say “we’re not prepared” for daily public health or emergencies. Accessed on October 27, 2025. https://www.cbsnews.com/news/cdc-cuts-former-officials-not-prepared-daily-public-health-emergencies/
2. Regenstein, M., Rosenbaum, S., et al. (2025, March 31). An Enduring Commitment to Health and Health Care: Community Health Centers at Sixty. Accessed on October 29, 2025. https://geigergibson.publichealth.gwu.edu/enduring-commitment-health-and-health-care-community-health-centers-sixty
3. Japsen, B. (2018, January 22). How The Government Shutdown Makes A Bad Flu Season Worse. Accessed on October 29, 2025. https://www.forbes.com/sites/brucejapsen/2018/01/21/how-the-government-shutdown-makes-a-bad-flu-season-worse/
4. Ku, L., Gorak, T., et al. (2025, October 16). Expiring ACA Premium Tax Credits Could Lead to Nearly 340,000 Jobs Lost Across the U.S. in 2026. Accessed on October 29, 2025. https://www.commonwealthfund.org/publications/issue-briefs/2025/oct/expiring-premium-tax-credits-lead-340000-jobs-lost-2026
5. Lo, J., Levitt, L., et al. (2025, September 30). ACA Marketplace Premium Payments Would More Than Double on Average Next Year if Enhanced Premium-Tax Credits Expire. Accessed on October 27, 2025. https://www.kff.org/affordable-care-act/aca-marketplace-premium-payments-would-more-than-double-on-average-next-year-if-enhanced-premium-tax-credits-expire/
6. Mishory, J., Chan, O., Granville, P. (2020, July 8). The ACA’s Impact on College Students. Accessed on October 27, 2025. https://tcf.org/content/report/the-acas-impact-on-college-students/
7. Harvard Kennedy School. (2025, October 20). The health insurance subsidies behind the government shutdown. Accessed on October 27, 2025. https://www.hks.harvard.edu/faculty-research/policy-topics/health/health-insurance-subsidies-behind-government-shutdown?
8. Lau, J. (2025, September 29). If health insurance subsidies end, people could see higher prices, coverage loss. Accessed on October 27, 2025. https://hsph.harvard.edu/news/if-health-insurance-subsidies-end-people-could-see-higher-prices-coverage-loss/
9. Parker, E. (2025, October 2). How A Government Shutdown Could Disrupt Universities, Student Aid, And Research. Accessed on October 29, 2025. https://www.universityherald.com/articles/79853/20251002/how-government-shutdown-could-disrupt-universities-student-aid-research.htm
10. Michel, A. N. (2025, October 7). Six Reasons to Not Extend the Enhanced Obamacare Subsidies. Accessed on October 27, 2025. https://www.cato.org/blog/six-reasons-not-extend-enhanced-obamacare-subsidies

Wellfleet, Wellfleet Student, Wellfleet Special Risk, and Wellfleet Workplace are marketing names used to refer to the insurance and administrative operations of Wellfleet Insurance Company, Wellfleet New York Insurance Company, and Wellfleet Group, LLC (known in California only as Wellfleet Group, LLC dba Wellfleet Administrators, LLC). All insurance products are administered or managed by Wellfleet Group, LLC. Product availability is based upon business and/or regulatory approval and may differ among states.

WFSTU-251001