WHITE HOUSE:

The White House continued its focus on Asia this week with the announcement of new trade agreements with China, Korea, and Japan.

CONGRESS:

As you can tell from the brief White House update, things have really slowed down in Washington DC as the government shutdown drags on. With the shutdown scheduled to hit its 34^th day (as of Wednesday, November 5^th), it will officially become the longest shutdown in history. SNAP benefits lapsed for the first time ever, and while 2 federal judges ordered the government to use emergency funding to continue the payments, it’s not clear when those payments will resume. This is a stark reminder that the shutdown isn’t merely politics; there are real world ramifications for regular Americans. With flight delays piling up, states scrambling to fill in the gaps on SNAP payments, and federal employee not receiving paychecks, the pressure is ramping up to get a deal done. There’s been some optimism that an end could be in sight, but with the President getting frustrated, there’s no telling how this will go. Elsewhere in DC: 

·         A reminder that several big elections are coming up this week: New Jersey’s gubernatorial race and New York City’s mayoral race. If you’re local to NYC or NJ, go vote!

·         The President called for ending the filibuster, which would allow the GOP to pass a bill without any Democratic support. For now, the GOP is resisting the call, with concerns that ending the filibuster will set a terrible precedent for the future. 

·         Ohio settled on a new redistricting map following a bipartisan compromise. The new maps could net 2 more seats for Republicans. The new map has already claimed its first victim: the GOP candidate for one of the seats dropped out. Meanwhile, Democrats are continuing to explore their own options to pick up seats. This is a good look at where we stand with all the efforts.

·        GOP Speaker Mike Johnson has kept the House out of session for nearly six weeks now, a break that has Members anxious about the limited amount of time left whenever they do get back to DC.

·         A look at the  2026 Midterms, one year away.

·         A group of Democratic strategists released a deep dive postmortem on the parties struggles in recent elections, arguing that they’ve lost focus of the real issues that matter to the electorate.

AGENCIES:

CMS released an updated QSO outlining the latest on surveys during the government shutdown. It’s available here (PDF).

The OIG at HHS performed an audit of the SFF program, finding that the program hasn’t led to long-term improvement. The full report is here (PDF) while the summary is here (PDF). As part of the audit, they released a “data snapshot” on the program. You can find the full analysis here (PDF) while the summary is here (PDF).

CMS released the Medicare Physician Fee schedule final rule. The fact sheet is here. The final rule is scheduled for publication to the Federal Register on November 5^th, but if you simply cannot wait to read it, you can download a prepublication copy of the 2,375 page rule here (PDF).  The rule also includes changes to the Shared Savings Program.

The FDA is looking to accelerate the development of biosimilar drugs. A draft guidance is available here (PDF).

FROM THE NOTEBOOK:

·         John Oliver skewered the MA program on the latest episode of his show. It’s well worth the watch.

·         A few early pilot programs testing out new tech to help streamline Medicaid work verification eligibility are off to a rocky start. Meanwhile, a recent survey of state Medicaid directors by KFF laid out the many challenges facing states as the plan to implement work requirements.

·         Cigna announced plans to end rebate pricing for their drugs. Healthcare Dive has a good summary.

·         A new study in JAMA compared post-acute care and usage between MA and traditional Medicare.

·         Modern Healthcare examined the latest for hospitals, now that DSH cuts are here.

·         Another day, another health system dropping a MA network.

·         A new study found that SNF’s are typically reluctant to take residents that are released from prison on compassionate release programs.