At the time of this writing, and in lieu of completing the federal budget in the proscribed set of rules and procedures, the US House of Representatives is attempting to pass various appropriations bills to fund different areas of the government, such as defense, education, health care, and transportation. Of important note, Congress has enacted 1 or more continuing resolutions in all but 3 of the 47 fiscal years since the start of the fiscal year was changed to October 1 beginning in fiscal year 1977. Fiscal year 1997 was the last fiscal year for which no continuing resolutions were enacted. 1 It now appears that Congress will again not be able to agree on a full budget before the start of the fiscal year. They will need to pass continuing resolutions to keep the government funded temporarily at the previous year's levels until a new budget is agreed on. If Congress is unable to agree to continuing resolutions, a government shutdown may occur and, if so, there will be a temporary closure of government agencies. Government shutdowns have occurred in the past, most notably from 1995 to 1996 and in 2013, 2018, and 2019. This uncertainty about the federal government budget creates financial market uncertainty, pressure to increase interest rates, erosion of consumer and business confidence, and concern about the country's creditworthiness.The total federal budget deficit for fiscal year 2023, which ends September 30, will be $1.5 trillion, and the national debt is $32.9 trillion, or $98 083 per citizen. 2,3 As a result of the inability to pass balanced budgets and the increasing national debt, Fitch Ratings, an international credit-rating agency based in New York City and London, recently downgraded the US government's credit rating. 4 It is reasonable to believe that federal dollars will be redirected from public health and biomedical research to other parts of the federal budget, including paying interest on the debt. Currently, interest payment alone on the national debt is $663 billion, the fourth-largest single item behind Medicare and Medicaid, Social Security, and defense/war. 2 The combination of the failure of the federal government to address persistent budget deficits and the growing national debt will have dramatic and predictable consequences on the US economy. These effects include economic crises, reduction in global competitiveness of US products and purchasing power, unsustainable debt, and "crowding out" of important government functions such as public health and biomedical research, higher interest rates, and reduced economic growth.It is already widely agreed that the US underinvests in public health. It has been estimated that there is a $4.5 billion