On Jan. 30, the Senate approved a revised funding package in a 71–29 vote, but the House of Representatives did not return in time to meet the midnight deadline. As a result, a partial government shutdown began on Jan. 31 and is expected to last through the weekend.
Key points:
- The Senate has passed a funding package that now awaits action in the House.
- The House is scheduled to return Feb. 2, with a vote anticipated early next week.
- Once approved by the House, the package must be signed by President Donald Trump.
- The funding lapse affects several federal agencies, including the Department of Health and Human Services (HHS).
From an immigration law and healthcare staffing perspective, any shutdown even a partial one creates uncertainty, especially where federal agencies and health-related programs intersect.
What’s in the Funding Package?
The legislative package now under consideration includes:
- Full-year appropriations through Sept. 30 for five agencies, including HHS.
- A two-week stopgap funding measure for the Department of Homeland Security (DHS), which has been at the center of negotiations due to immigration enforcement issues.
For healthcare organizations and international nurses, this package is particularly important because it contains key healthcare provisions that indirectly support a stable clinical environment for foreign-trained nurses working in the United States.
1. Shutdown Disrupts Hospital-at-Home Programs
One of the most immediate healthcare impacts of the partial shutdown involves hospital-at-home services, which have been supported by pandemic-era waivers and flexibilities.
The revised package includes:
- An extension of pandemic-era telehealth flexibilities through 2027.
- An extension of the CMS hospital-at-home waiver through 2023.
However, the temporary lapse caused by the shutdown has already disrupted hospital-at-home programs nationwide. Because federal waivers are highly regulated, even a short interruption can force hospitals to pause services to remain compliant with CMS and Medicare rules.
As Constantinos “Taki” Michaelidis, MD, medical director of UMass Memorial Health’s Hospital at Home program, explained to Becker’s:
> “It takes weeks to plan for a shutdown and weeks to turn the program back on. With Hospital at Home, when we lose the waiver, if we still have patients with us, it becomes a compliance issue. We would be in violation of Medicare Conditions of Participation if a patient is still on service at 12:01 a.m. Saturday morning [Jan. 31].”
Why this matters for international nurses and healthcare employers
- Workload and staffing pressures: When hospital-at-home programs shut down, patients often shift back to inpatient settings, increasing demand for bedside nurses including international nurses already in the U.S. on immigrant or nonimmigrant visas.
- Care continuity: Hospitals that employ foreign-trained nurses in acute care roles may need to reassign or reprioritize staff as services transition from home-based to hospital-based.
- Planning for future recruitment: Healthcare organizations relying on international nurse recruitment should be aware that program disruptions like this can alter staffing models and timelines, affecting when and where internationally educated nurses are needed most.
2. HHS Braces for Furloughs and Service Reductions
HHS has prepared a fiscal 2026 contingency plan for a full government shutdown, outlining how it would reduce operations. While this current situation is only a partial shutdown, the plan reveals how sensitive federal healthcare operations are to funding lapses.
Under a full shutdown scenario, HHS would:
- Furlough approximately 41% of staff, or 32,460 employees.
- Maintain “essential” services, but suspend many supporting functions.
According to HHS, services that would remain operational in any shutdown include:
- Medicare and Medicaid benefit payments and essential operations
- Healthcare fraud investigations
- CDC disease surveillance and pandemic response
- NIH clinical care and critical research activities
- FDA drug and medical product reviews (with some limitations)
Services that would be halted or scaled back include:
- Research grant oversight
- Certain data collection activities
- Responses to public records (FOIA) requests
- Some CDC communications and outreach
- Most NIH patient admissions, except when medically necessary
- Various CMS contractor oversight functions
Implications for immigration and international nurses
Even though core health programs continue, reduced staffing and oversight can create secondary delays and uncertainty:
- Data and policy delays: Slower release of health policy data can affect how hospitals plan long-term staffing, including international nurse hiring.
- Grant and research slowdowns: Academic medical centers that host international nurses or sponsor J-1 or H-1B professionals could see research projects and funding oversight delayed.
- Operational strain: Any reduction in administrative capacity may indirectly impact programs that rely on federal guidance, which hospitals use to determine staffing ratios, care models, and recruitment needs.
While HHS is not the main immigration agency for nurse visas, its stability is crucial to the healthcare environment in which international nurses practice. A reliable healthcare system makes it easier for employers to sponsor and retain foreign-trained nurses over the long term.
3. DHS Funding Faces Political Holdup
The other major piece of the funding story centers on the Department of Homeland Security the agency that oversees many critical immigration functions, including some that affect international nurses and their families.
What happened with DHS funding?
- The House passed a six-bill funding package on Jan. 22, initially expected to move smoothly through the Senate.
- Momentum stalled after federal immigration agents fatally shot 37-year-old registered nurse Alex Pretti in Minneapolis on Jan. 24.
- In response, Senate Democrats indicated they would advance DHS funding without certain immigration enforcement reforms, prompting a political standoff.
- This dispute led Democrats to push for *separating DHS funding* from the broader package.
- Lawmakers ultimately agreed to a revised deal: fund five agencies (including HHS) through Sept. 30 and grant a two-week extension for DHS funding.
Why DHS funding matters for international nurses
DHS oversees key components of the U.S. immigration system that directly affect international healthcare workers:
- U.S. Citizenship and Immigration Services (USCIS), which adjudicates:
- Immigrant visa petitions (e.g., I-140 for EB-3 nurses)
- Certain nonimmigrant petitions (e.g., H-1B for some advanced practice roles)
- Employment authorization documents (EADs) and adjustment of status applications
- Immigration enforcement and border operations, which have become politically sensitive and central to current funding debates.
Although many USCIS operations are fee-funded and may continue even during a shutdown, political battles over DHS funding can:
- Slow decision-making on immigration policy and guidance
- Create uncertainty about adjudication timelines
- Increase the risk of sudden policy shifts affecting work authorization, status, or processing priorities
For U.S. hospitals and healthcare systems recruiting international nurses, this uncertainty reinforces the need to:
- File immigration petitions as early as possible
- Maintain clear documentation for all nurse immigration cases
- Work with experienced immigration counsel to navigate any policy or processing changes that may arise from DHS funding fights and enforcement debates
What Healthcare Organizations Should Do Now
While this partial government shutdown may be relatively short-lived, it underscores how vulnerable healthcare and immigration systems are to political and budgetary disputes. Healthcare organizations that rely on international nursing staff can take several steps to protect themselves:
1. Evaluate staffing plans and contingency strategies
- Review how program disruptions (e.g., hospital-at-home) might affect inpatient staffing needs.
- Assess how many international nurses are currently in the pipeline and whether timelines need adjustment.
2. Monitor federal agency operations closely
- Stay updated on USCIS, DHS, and HHS announcements.
- Track any changes that might affect visa processing, work authorization, or healthcare program compliance.
3. Prioritize critical immigration filings
- Ensure I-140 petitions, consular processing steps, and adjustment of status filings for international nurses are not delayed unnecessarily.
- Plan ahead for potential slowdowns, including longer lead times for onboarding foreign-trained nurses.
4. Partner with a specialized immigration law firm
- Work with counsel that understands both immigration law and healthcare operations.
- Align immigration strategy with staffing, accreditation, and service-line planning.
How VisaMadeEZ Supports Healthcare Employers and International Nurses
At VisaMadeEZ, we focus exclusively on helping healthcare organizations hire and retain international nurses. Our team understands how changes in federal funding, shutdowns, and agency operations intersect with real-world staffing needs.
We assist with:
- Recruitment-focused immigration strategy for hospitals, health systems, long-term care facilities, and home health agencies
- Immigrant and nonimmigrant visa petitions for nurses and advanced practitioners
- Compliance guidance to help organizations maintain lawful employment practices and avoid immigration-related penalties
- Ongoing monitoring of DHS, USCIS, and HHS developments that may affect international nurse hiring
Even during periods of uncertainty, a proactive, informed approach can help healthcare organizations maintain a reliable pipeline of international nursing talent while ensuring compliance with complex immigration and healthcare regulations.
If your organization is planning to hire international nurses or is concerned about how the current government funding situation could affect your immigration processes, VisaMadeEZ is here to help you navigate each step with clarity and confidence.
