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WHITE HOUSE:

The White House focused this week on a new plan to counter domestic terrorism, an address to the UN, and a new Executive Order seeking a solution to the TikTok sale. Three items of interest:

• • The formal announcement hasn’t yet come, but the President posted to his Truth Social account that tariffs are coming for pharmaceuticals. It’s unclear what exemptions will be available, but this will complicate pharma pricing.

• • Continuing their recent efforts to streamline and deregulate federal contracting, they released a new set of regulatory guidelines for small business contracting. The full guidance at the GSA’s central resource page for the overhaul. For those who do business with the federal government, it’s a very useful trend to monitor.

• • Following up on a campaign promise, they announced a potential link between Acetaminophen and the rise in autism diagnoses. While not universally accepted, they will be taking several new regulatory actions based on the possible linkage. More below in the Agency section.

CONGRESS:

The rhetoric in DC continues to escalate as we get closer to a shutdown. After the President canceled his scheduled sit-down with Democratic leadership, it looks like he will meet with Congressional leaders prior to the government shutdown this Wednesday. Adding fuel to the fire was a memo from the White House’s Office of Management and Budget that in the event of a shutdown agencies need to prepare for mass layoffs, with no plans to bring back furloughed employees following the eventual resolution of the shutdown, part of OMB Director Russ Vought’s long-held plans to shrink the federal government. Most of the targeted employees would be from programs that are no longer being funded and are not “consistent with the President’s priorities”. Despite the added pressure, Democrats have dug in their heels, holding firm in their resolve, while House Speaker Mike Johnson cancelled votes on Monday & Tuesday, upping the chances that we end up with a shutdown. The political blame game is in full view as we get closer to a shutdown. Elsewhere in DC:

• • A new bipartisan bill, introduced by Senators Cortez Masto (D – NV) and Marsha Blackburn (R – TN), would mandate that MA plans pay promptly. A companion bipartisan House bill was introduced by House Budget Chair Jodey Arrington (R – TX) and Linda Sanchez (D – CA). The full text of the bill is here (PDF).

• • Senate Democratic Leader Chuck Schumer is losing support of many Democratic candidates running for office, as well as current Senators.

• • Another name has joined the crowded race for Wisconsin Governor: former state rep, and current Congressman, Tom Tiffany.

• • Following the opening of applications by HHS last week for the Rural Hospital Transformation Fund, Congressional figures are getting involved on behalf of their states.

• • Utah’s entering the redistricting fight.

• • Two notable CRS reports from the week:

• • R48290: We mentioned that a big part of the shutdown discussion is how to navigate the federal subsidies for the Affordable Care Act. The CRS prepared a guide to Congressional offices on ACA subsidies and what their expiration would mean.

• • R48724: This is unrelated to healthcare, but many of you have a real interest in this. As part of the OBBBA, a new tax credit was created for scholarship programs. The CRS prepared a guide to the credit for Congressional offices.

AGENCIES:

On Friday, CMS released the 2026 MA and Medicare Part D pricing premiums, with the expectation that pricing will remain stable next year. A state-by-state fact sheet is available here (PDF). A spreadsheet with the pharmaceutical pricing can be found on their central page in the zip file titled CY2026 Landscape.

As mentioned above, HHS announced several regulatory actions related to the announcement of the link between acetaminophen and autism. The fact sheet is here.

SAMHSA announced the award of more than $45 million to state opioid response programs to assist with youth soberness and homelessness programs.

Following up on the President’s directive to crack down on misleading pharma advertising, the FDA sent out letters to drugmakers warning them to cease and desist the misleading advertising. The Wall Street Journal has a good summary of the effort.

CMS has a good section of explainers on federal concepts related to federal health programs. They updated the section on CMMI’s different programs.

The White House’s Council of Economic Advisors released a report on the expanded eligibility of HSA programs under the OBBBA. The full report is here (PDF).

The GAO released a report on Georgia’s work requirements program, finding that the state spent more on administrative requirements for the program then the healthcare they provided. A good summary of the findings is here.

FROM THE NOTEBOOK:

• • A deep dive from KFF on special needs plans in MA.

• • A good look from the Kaiser Family Foundation on what the expiration of the ACA subsidies would mean and why it has even Republicans thinking about supporting their extension.

• • Speaking of the end of ACA subsidies, it’s causing havocin the insurance markets, especially in California.

• • Facing significant budget challenges, Colorado held a sit-down with their Senator to talk through the issues.

• • North Carolina is getting closer to Medicaid cuts to providers.

• • AI healthcare tools are the hottest investment in health tech right now, but it’s causing problems for some of the big players.

• • All the uncertainty coming out of HHS is leading states and private healthcare entities to start their own advisory bodies.

• • Aetna is expanding a program that rewards hospitals for reduced rehospitalizations. Healthcare Dive has a good summary.

• • The Minnesota Star Tribune went deep into United Healthcare and the issues with Medicare Advantage.