Abigail Kaericher John Williams: Inside DC, What Hospitals Need to Know

In this episode, Jim Burke and Steve Pratt sit down with John Williams and Abigail Kaericher of Hall Render’s Washington, D.C. office to break down what really happened during the recent federal government shutdown—and what it means for health systems. Both guests bring years of federal advocacy experience, including time on Capitol Hill and work with major health care associations, giving them a front-row seat to the political maneuvering behind the scenes.

John explains that the roots of the shutdown stretch back months to tensions around continuing resolutions and backlash within the Democratic base. While healthcare policy was the “official” issue—specifically expiring ACA premium tax credits—political positioning played an even larger role. Abigail notes that Democrats leaned heavily into messaging around healthcare because it resonates strongly with voters, but ultimately the shutdown continued far longer than expected as neither party initially paid a political price.

As the shutdown dragged on, pressure points finally emerged: SNAP complications, upcoming elections in states like Virginia and New Jersey with large federal-employee populations, and even FAA-related flight reductions. These factors created enough urgency for lawmakers to reach a deal—one that, despite all the drama, ultimately resulted in only a promise for a future vote on tax credits rather than a concrete policy change. For hospital leaders watching from the outside, the entire episode can feel like political theater with real operational consequences.

Looking ahead, the panel discusses the uncertainty surrounding January’s funding deadline and the role of the Trump administration in shaping any proposals to extend or modify ACA tax credits. Early signals point to a short-term extension tied to income thresholds, but the final details are still unreleased. For health systems, any continuation of coverage—regardless of the political framing—would help reduce pressure on emergency departments and stabilize access to care. But as John reminds us, Congress operates on last-minute leverage, meaning the health sector should brace for another round of negotiations as the clock runs down.

Chapters

00:00 Introduction and Context of the Conversation

01:23 Understanding the Recent Government Shutdown

11:01 Future Implications of the Shutdown

18:11 The Future of Telehealth and Hospital at Home

19:43 Telehealth and Legislative Challenges

21:27 The Impact of Short-Term Waivers

24:35 Understanding PAYGO and Its Implications

25:46 Election Year Dynamics and Healthcare Legislation

27:14 The Future of Medicaid and Regulatory Changes

31:11 Key Takeaways for Hospital Leaders