Government shutdown becomes the longest in history

The ongoing government shutdown entered its 36th day on Wednesday, officially making it the longest shutdown in U.S. history, surpassing the shutdown that occurred from December 2018 to January 2019 during President Donald Trump's first administration.

The federal government shut down at 12:01 AM on October 1 after lawmakers failed to reach a deal to pass a short-term funding bill, which would have financed government operations for fiscal year 2026. The disagreement has been mainly focused on subsidies for the Affordable Care Act (ACA), which were originally implemented during the COVID-19 pandemic.

Democratic lawmakers have been pushing to make the subsidies permanent. Republican lawmakers excluded extra subsidies in the short-term government funding bill but said they may consider legislation at the end of the year to extend them. Democrats have also been pushing for substantial Medicaid cuts under the One Big Beautiful Bill Act to be reversed.

Since then, both sides have remained at an impasse. However, around a dozen Senate Democrats have privately signaled they're willing to support a stopgap funding deal to reopen the government in exchange for a future vote on healthcare, according to two sources familiar with the discussions who spoke to CNN.

The group of Senate Democrats have discussed a deal that would include a short-term funding plan, most likely through January, as well as a package of three bipartisan full-year bills and a commitment from Republicans to a future vote on extending ACA subsidies, CNN reports.

Following a two-hour lunch on Tuesday with Senate Democrats, Senate Minority Leader Chuck Schumer (D-N.Y.) said the party isn't planning on backing down.

"Families are opening their healthcare bills and wondering how they'll pay them. That's the reality," he said. "So we're going to keep fighting day after day, vote after vote, until Republicans put working families ahead of the wealthy few."

Schumer added that informal talks between Senate Democrats and Republicans are underway, but said that President Donald Trump has not been involved.

(Treisman, NPR, 11/5; Broadwater, New York Times, 11/5; CNN, 11/5; Carney et al., POLITICO, 11/4)

Trump administration nearing a deal with Novo Nordisk, Eli Lilly for cheaper weight loss drugs

The Trump administration is nearing deals with Eli Lilly and Novo Nordisk to lower the prices of their weight loss drugs and expand access to them, including having Medicare cover them for weight loss, according to people familiar with the matter who spoke to STAT.

The deals have not officially been announced. However, one lobbyist with knowledge of the negotiations told STAT they believe both parties are closing in on an agreement and that the companies have been close to a deal for weeks.

According to the people who spoke with STAT, the agreement is expected to include Medicare coverage of the drugs for weight loss. People familiar with the matter who spoke to the Wall Street Journal said the deal would also include Medicaid coverage for weight loss. Currently, Medicare covers GLP-1s to treat diabetes and some other conditions, but not for weight loss.

The deal would also lower the price of the drugs. Currently, Eli Lilly sells its GLP-1, Zepbound, for $349 a month at the lowest dose and $499 for all other doses, while Novo Nordisk sells Wegovy for $499 a month for all doses.

According to the people who spoke with the Journal, the lowest dose of Wegovy would be sold through TrumpRx at $149 while the starting dose of Zepbound would be sold for $299. One person who spoke to the Journal said that Novo Nordisk's diabetes drug, Ozempic, may also be offered on TrumpRx but the person didn't specify a price.

"Discussion about deals that have not been officially announced by the Administration should be regarded as speculation," said White House spokesperson Kush Desai in a statement. Meanwhile, a spokesperson for Eli Lilly said the company is "in discussions with the administration to further expand patient access, preserve innovation, and promote affordability of our medicines." A spokesperson for Novo Nordisk said the company "is engaged in constructive discussions with the Administration."

(Payne, et al., STAT+ [subscription required], 11/4; Whyte/Loftus, Wall Street Journal, 11/4)

At a press conference, White House press secretary Karoline Leavitt said the Trump administration is fully complying with the court orders but added that SNAP recipients need to understand it will take time to receive money.

"The President does not want to have to tap into this fund in the future, and that's what he was referring to in his Truth Social post," she said.

The U.S. Department of Agriculture (USDA), which oversees SNAP, announced that the program will be partially funded for November.

SNAP serves around 1 in 8 Americans and costs more than $8 billion per month nationally. USDA said the emergency fund it will use has $4.65 billion, which is enough to cover around half the normal benefits. It's unclear exactly how much beneficiaries will receive or how quickly they'll see the value show up on the debit cards they use to purchase groceries, but in a supplementary declaration, USDA said that the changes states have to implement to roll out the reduced benefits could "take anywhere from a few weeks to up to several months."

The administration also provided an additional $450 million in funding to the Special Supplemental Nutrition Program for Women, Infants, and Children.

(Mulvihill/Kruesi, Associated Press, 11/3; Casey, et al., Associated Press, 10/31; Walker, Axios, 11/3; Peck, Axios, 11/4)

RFK Jr. says there's no 'sufficient' evidence Tylenol causes autism

HHS Secretary Robert F. Kennedy Jr. in a press conference last week said there isn't "sufficient" evidence that Tylenol causes autism, walking back warnings that he and President Donald Trump have made discouraging the medicine's use by pregnant women and young children. Kennedy also directed FDA in September to change the safety label for Tylenol and its generic equivalents.

Kennedy reiterated during the press conference that pregnant women should only use Tylenol when "absolutely necessary."

"We've all said from the beginning that the causative association between Tylenol given in pregnancy … is not sufficient to say it definitely caused autism, but it is very suggestive," Kennedy said.

"And so there should be a cautious approach to it, and that's why our message to patients, to mothers, to people who are pregnant, the mothers of young children, is consult your physician, and we have asked physicians to minimize the use to one that’s absolutely necessary," he added.

Kennedy's comments come after Texas Attorney General Ken Paxton last month filed a lawsuit against the makers of Tylenol, claiming the companies hid the drug's risks for childhood brain development, including autism and attention deficit hyperactivity disorder.

(Weixel, The Hill, 10/30)

Trump administration aims to overrule state laws that protect credit reports from medical debt

The Consumer Financial Protection Bureau (CFPB) last month issued new guidance interpreting the Fair Credit Reporting Act (FCRA) in a way that says the law should preempt any state laws or regulations when it comes to how debt should be reported to credit bureaus.

Over a dozen states, including California, Colorado, Maryland, and Washington, have enacted laws in recent years keeping medical debt from affecting a person's credit. Nationwide, around 100 million people have some form of healthcare debt and in 2023, the three credit bureaus — Experian, Equifax, and Trans Union — said they would no longer track any medical debts below $500.

In the new guidance, CFPB argues that FCRA bars states from restricting medical debts from credit reports and that only the federal government holds that authority.

"Congress meant to occupy the field of consumer reporting and displace state laws," CFPB said in its rule, which was signed by Russell Vought, White House budget director and acting head of CFPB.

The new rule repeals previous rules and regulations issued by the Biden administration that allowed states to implement their own credit reporting bans.

Lucy Culp, who oversees state lobbying efforts for Blood Cancer United, warned that the new guidance "will have a chilling effect on states' willingness to pass these critical patient protections."

"This isn't just a health care issue," said Allison Sesso, president and CEO of Undue Medical Debt. "It's an economic crisis that's keeping families from building wealth and fully participating in the economy. When credit scores are dinged by medical bills, everyone loses."

(Sweet, Associated Press, 10/28; Levey, KFF Health News, 10/30)