We are 20 days into the government shutdown, making this the longest full shutdown in US history (the 35-day shutdown in 2018 – 2019 was partial). Pressure to end the shutdown grows as more federal employees and programs remain uncompensated; however, there is no resolution in sight.
November 1, 2025, could be a flashpoint that increases pressure to open the government. The date marks the beginning of open enrollment for health insurance purchased through the Affordable Care Act Marketplace . Millions of people who get coverage from the Marketplace will face monthly premiums that are likely hundreds of dollars more than they were last year. Democrats continue to advocate for an extension of the Marketplace’s advanced premium tax credits (APTCs) that expire December 31, 2025, as part of any deal to reopen the government, while Republicans maintain that they will not negotiate on APTCs until the government reopens. Both sides are balancing the policy considerations with political messaging and who gets to take credit or blame. States have also received notice from the US Department of Agriculture (USDA) that Supplemental Nutrition Assistance Program funding will become insufficient after October 31, 2025. USDA encouraged states to develop contingency plans to fulfill those needs. That will also add pressure for federal action.
The House is in recess again this week and has not voted since passing a “clean” continuing resolution (CR) on September 19, 2025, to extend government funding until November 21, 2025.
The Senate is in town and in session. Health-related committee action includes reviewing shoppable services in the Committee on Aging and reviewing the 340B Program in the Committee on Health, Education, Labor, and Pensions.
Senators will also vote on the House-passed CR for the 11th time, and the vote is expected to fail. Later this week, Majority Leader John Thune (R-SD) plans to introduce a bill to pay military and essential federal employees during the shutdown. If the bill passes the Senate, the House might be forced to come back from recess to vote. Returning from recess presents the opportunity for more debate, and it would also mean that Representative-elect Adelita Grijalva (D-AZ) would be sworn in.
President Trump, who has historically been a significant motivating force in the Republican party, has been largely uninvolved in the shutdown negotiations. He is hosting a White House luncheon for congressional Republicans tomorrow to thank them for sticking together during the shutdown. We must wait and see what determining factors will finally get us out of this shutdown.
In this week’s Healthcare Preview podcast, Debbie Curtis and Rodney Whitlock join Erin Fuller to discuss the ongoing government shutdown and the upcoming Senate HELP Committee hearing on the 340B program.
