As the U.S. government shutdown extends into its fourth week, millions of Americans are feeling the pressure across essential services, health programs, and the economy.

The Centers for Medicare & Medicaid Services confirmed that both programs will continue operations, with Medicaid funded through the end of the year. However, experts caution that if the shutdown continues, hospitals and doctors could face delayed reimbursements. Social Security payments, including Supplemental Security Income and retirement benefits, are unaffected since they fall under mandatory spending, though local offices are offering limited services.

Air travel has been severely disrupted. Staffing shortages at the Federal Aviation Administration (FAA), compounded by Hurricane Melissa, caused ground stops and flight delays at major airports including Los Angeles, Atlanta, and Newark. Transportation Secretary Sean Duffy warned that more disruptions are likely as air traffic controllers continue to work without pay.

Small businesses are also bearing the brunt. The Small Business Administration (SBA) reported that more than 320 companies cannot access $170 million in loans needed for hiring and expansion. Meanwhile, energy assistance programs for low-income households and the Women, Infants, and Children (WIC) nutrition program could run out of funds by early November, potentially leaving millions without aid as winter approaches.

Treasury Secretary Scott Bessent said active-duty troops could go without pay starting November 15 if no funding deal is reached. The Senate remains divided, with Democrats demanding the inclusion of Affordable Care Act premium subsidies in the spending bill, while Republicans and President Trump insist on passing a clean funding resolution without additional health policy provisions.

The prolonged deadlock, now on track to become the longest shutdown in U.S. history, continues to test the country’s economic resilience and political patience.