Congressional:

Government Shutdown Enters Third Week

The government shutdown, which began on October 1, is on its 17th day. At the heart of the shutdown is a disagreement between Congressional Republicans and President Trump, who have pushed for a clean continuing resolution (CR) to fund the government on a short-term basis, and Democratic leaders who have demanded that any funding deal include the permanent extension of Affordable Care Act (ACA) enhanced advanced premium tax credits (APTCs), which are set to expire at the end of this year, along with a repeal of the Medicaid and ACA savings provisions included in Republican-passed H.R. 1. So far, the Senate has voted and failed to pass the House-passed CR (H.R. 5371) ten times.

On Tuesday, Senate Majority Leader John Thune (R-SD) made some preliminary moves to gauge Democratic support for taking up full-year appropriations bills. The Senate then took a procedural vote on H.R.4016 (FY26 Department of Defense Appropriations Act) on Thursday, which failed by a vote of 50-44. Leader Thune also told MSNBC on Thursday that he has privately told Democratic leaders that, if they need a vote on extending APTCs in exchange for opening the government, he is willing to make that deal. 

Late last week, House Majority Leader Steve Scalise (R-LA) told reporters on Capitol Hill that the APTCs should not be extended, stating that “You don’t answer that by propping it up with hundreds of billions of dollars of insurance company subsidies. Why would you keep pouring billions more tax dollars into a sinkhole when you can find a better way?” On Wednesday, Ways and Means Republicans criticized the APTCs for increasing costs and reducing coverage options, further deepening the shutdown divide.

Notable Bills Introduced:

Senators Shaheen, Collins Reintroduce Bipartisan Bill to Lower Cost of Prescription Drugs

On Thursday, Senators Jeanne Shaheen (D-NH) and Susan Collins (R-ME), co-chairs of the Senate Diabetes Caucus, are reintroduced the Ensuring Timely Access to Generics Act to help lower the cost of prescription drugs. The legislation would increase competition for generic drugs by providing better oversight of the Food and Drug Administration (FDA) citizen petition process. Read the press release here and the bill here. 

Executive Branch:

CMS Changes Direction on Paused Medicare Payments During Shutdown

The Trump administration is reversing course on a plan that it had originally announced earlier this week to hold Medicare payments to providers during the ongoing government shutdown. In an updated claims hold notice, the Centers for Medicare and Medicaid Services (CMS) said the hold would only apply to claims for services for which authorization had expired on September 30, including claims for many telehealth services. CMS, as of Wednesday, had previously said its hold would apply to all Medicare claims from federally qualified health centers, providers paid under the physician fee schedule, as well as claims for ground ambulance services, with a date of service of October 1 or later. Read the update here.

President Trump Announces Actions to Lower Costs and Expand Access to In Vitro Fertilization (IVF)

On Thursday, President Trump announced a new approach by the administration to boost in vitro fertilization and other fertility treatments, along with a most-favored-nation (MFN) agreement with the manufacturer EMD Serono to lower the price of a common fertility drug, Gonal-F. The medication will be available on the forthcoming TrumpRx direct-purchasing website early next year, and its price will drop by anywhere between 42 and 79 percent, depending on the patient’s income. As part of the agreement with EMD Serono, the Trump administration agreed to offer a national priority review voucher from the FDA to bring Pergoveris, another fertility drug available abroad, to the U.S. market. Additionally, Trump announced the creation of a New Benefit Option for fertility benefits, allowing employers to offer stand-alone coverage of IVF benefits to employees similar to dental or vision packages. Read the fact sheet here.

President Trump Announces Second Deal to Bring Most-Favored-Nation Pricing to American Patients

Late last week, on Friday, President Trump announced the second most-favored-nation (MFN) agreement with AstraZeneca to lower prescription drug costs by aligning prices with those paid in other developed nations through an MFN pricing model. The deal gives state Medicaid programs access to MFN prices on existing AstraZeneca products and guarantees MFN prices on all new medicines AstraZeneca brings to market. It also requires AstraZeneca to repatriate increased foreign revenue on existing products that AstraZeneca realizes as a result of new trade policies to American Patients. In addition, AstraZeneca will offer certain drugs directly to consumers through a new direct purchasing platform, TrumpRx.gov. Read the White House Fact Sheet here.

HHS Reduction in Force Continues During Shutdown

Late last week, on Friday, the Department of Health and Human Services (HHS) sent reduction-in-force (RIF) notices to 1,762 workers, with about half of the employees being reinstated by Monday. Of those RFIs, 1300 were from the Centers for Disease Control and Prevention (CDC). An additional 100 and 150 RFIs were from the Substance Abuse and Mental Health Services Administration (SAMHSA), which already lost about half its staff during HHS Secretary Robert F. Kennedy Jr’s April reorganization. On Wednesday, federal Judge Susan Illston issued a temporary restraining order on the HHS RFIs pending further arguments.