WHITE HOUSE:

The White House focused this week on a series of international trade agreements, including with Australia, Cambodia, Thailand, Malaysia, and Vietnam,  a two-year reprieve on an EPA regulation related to copper mining, and getting started with a renovation of the White House’s East Wing. 

CONGRESS:

A whole lot of nothing going on in Congress as the federal government shutdown nears its fourth week. A Senate bill that would have paid federal workers failed to pass while both sides play the blame game. Federal employees are starting to miss paychecks as the questions also start up about military pay. It’s an unfortunate reminder that real people get hurt during a shutdown. Next up on the list? Food stamps, which the USDA says won’t be funded as of November 1st. While several Democrats have changed their stance, it’s still not enough to end the shutdown. Republicans are exploring a new Continuing Resolution that would take us into 2026, although how they get enough Democrats to support the effort remains the question. For now, we continue the wait. Elsewhere in DC:

• Republicans are in a bind about what to actually do about the end of the ACA subsidies.

• Virginia jumped into the redistricting game as Democrats look to take back a seat, even as North Carolina gave Republicans another pickup. 

• NCSL is keeping their guide to how the federal shutdown affects state programs up to date. 

• Looks like political polling has a new competitor: the betting markets...

• The plan to shrink the federal government during the shutdown is hitting some hiccups.

  
  

AGENCIES:

CMS issued a revised QSO with guidance on which surveys can be conducted during the shutdown, including how to handle those with upcoming DPNA dates. It’s available here (PDF). 

CMS brought back many furloughed employees to shepherd the agency through the Open Enrollment period. 

OPM (the Office of Personnel and Management) wants to modernize the government’s HR system and turn the estimated 119 (!) different systems into one. 

FROM THE NOTEBOOK:

• Ballad Health, one of the largest non-profit systems in Tennessee & West Virginia, is suing United Health for “Medicare Advantage Manipulation”. 

• Meanwhile, MA plans are arguing that providers are being too “aggressive” in their coding practices. 

• Novo Nordisk is lobbying Medicaid programs to keep paying for GLP-1’s. 

• A look at what happens when MA plans withdraw from a market.