TL/DR –
The US government shutdown continues, with the ACA exchange open enrollment launching Nov 1, federal SNAP funding running out, and an order from the FAA to reduce daily domestic flights at 40 airports. Several health-related policies and deals are being negotiated, including a Senate deal that could involve a vote on the enhanced ACA subsidies, a new longer CR, and the passage of the Military Construction-Veterans Affairs appropriations package. Other developments include a letter from Senate Democrats arguing that the administration has failed to address rising healthcare costs, the CMS issuing their CY 2026 Medicare Physician Fee Schedule Final Rule, and the Trump administration announcing Most Favored Nations deals with Eli Lilly and Novo Nordisk to lower the cost of their products and increase their investment in US manufacturing.
Health Policy Highlights for the week of November 10, 2025
Developments Amidst the U.S. Government Shutdown
The ongoing U.S. government shutdown has been a focal point this week due to a variety of factors including the ACA exchange open enrollment starting on November 1, depletion of federal SNAP funding, off-year elections on November 4, and an FAA mandate to reduce daily domestic flights at 40 airports. Senate Majority Leader John Thune (R-SD) hinted at a potential agreement that includes:
- Vote on enhanced ACA subsidies or a promise of a vote by a specified date
- A new extended CR until late 2025 or early 2026 (the current House-passed CR expires on November 21)
- Approval of the Military Construction-Veterans Affairs, Agriculture (including the FDA), and Legislative Branch minibus appropriations package
Despite the Democrats’ success in Tuesday’s elections, they are insisting on attaching a one-year extension of the enhanced ACA subsidies to the CR. The Senate is expected to vote on Friday, with the precise details and probable outcome still uncertain. To reopen the government, Republicans would require the votes of approximately five Democrats.
President Trump has largely remained on the sidelines of shutdown discussions, but has frequently urged Republicans to override the filibuster for appropriations, allowing the CR to pass with a simple majority vote.
Democrats Express Concern Over Rising Healthcare Costs
On November 4, a group of 28 Senate Democrats sent a letter to HHS Secretary Robert F. Kennedy Jr., criticizing the administration’s failure to address increasing healthcare costs.
Final Rule for CY 2026 MPFS Issued by CMS
The Centers for Medicare & Medicaid Services (CMS) released their Calendar Year (CY) 2026 Medicare Physician Fee Schedule (MPFS) Final Rule on October 31. This rule includes updates to Medicare Part B payments and policies, Medicare Shared Savings Program (MSSP), the Inflation Reduction Act (IRA) rebate models, and more. It finalizes conversion factor increases of 3.77% and 3.26% for qualifying participants and non-qualifying participants, respectively. However, it also features numerous updates to the methodology for determining the physician fee schedule that will limit the positive update for some specialties.
FDA Grants New National Priority Review Vouchers
On November 6, the FDA announced six new products from Boehringer Ingelheim, Johnson & Johnson, GSK, Vertex, Novo Nordisk, and Eli Lilly that received national priority review vouchers.
Federal Government Ordered to Pay Full SNAP Benefits for November
A federal court judge in Rhode Island recently issued a ruling requiring the federal government to fully pay SNAP benefits for November. The USDA has appealed the decision, stating they only have sufficient funding to cover about 65% of November’s benefits.
Supreme Court Examines Tariffs under the International Emergency Economic Powers Act (IEEPA)
On November 5, the Supreme Court heard oral arguments in three cases examining whether the International Emergency Economic Powers Act (IEEPA) permits the President to impose tariffs to address a national emergency. During the arguments, a majority of the Justices expressed skepticism of the Government’s claim that the statutory authority under IEEPA to “regulate importation” includes tariff imposition. The timing of a decision remains uncertain, but the expedited process for the case could lead the Court to issue a decision before the end of 2025.
Most Favored Nations Deals Announced by the Trump Administration
The Trump administration announced Most Favored Nations (MFN) deals with Eli Lilly and Novo Nordisk on November 6. The deals aim to lower the cost of their products, including GLP-1s, and boost their investments in U.S. manufacturing and R&D in exchange for expanded market access for GLP-1’s, protection from future tariffs, and priority review of their new GLP-1 products.
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