Health care attorneys and their clients are less worried about a government shutdown than any changes to the Affordable Care Act that might come out of budget negotiations.
"In large part, most of the clients are proceeding with business as usual," said Jason Caron, a health care partner at McDermott Will & Emery. "People are definitely keeping an eye on what will be the likely compromise, given that I don't think either side of the aisle wants to have the government shut down for a long time."
Republicans have demanded to defund or delay parts of the Affordable Care Act as part of the ongoing federal budget negotiations. Congress has until midnight to reach a deal, otherwise "nonessential" federal employees would be furloughed.
Besides stripping money from the health care reforms. Republicans have pushed to repeal a medical device tax. President Barack Obama has threatened to veto any bill that does either, but if they somehow passed into law lawyers would have to advise clients accordingly.
But after repeated fights in Congress over raising the debt ceiling and passing a continuing resolution to fund the government, clients and attorneys are immune to the prospect of a shutdown.
"The multimillion dollar question is: Is it going to happen and for how long?" said Stuart Langbein, a partner at Hogan Lovells.
At the U.S. Department of Health and Human Services, a little more than half of all employees – 52 percent – would be furloughed, according to the agency's contingency plan. Bruce Fried, the Washington managing partner of Dentons, said that despite the furloughs, the health care exchanges were prefunded and would continue to operate as normal. And a large part of the health care system is run by outside contractors unaffected by the budget battle.
"People often overlook the fact that so much of what the government does in health care has been outsourced," Caron said. Take, for example, a Medicare claim by a doctor for services rendered—contractors, not the federal government itself, makes reimbursement payments. But if Congress allows the government to shut down for longer than a few days, then clients and attorneys would have to adjust.
"There is a little part of me that says this could go on for a while," Fried said. "If that happens, then I think people will start to get anxious."