
Policy Update – November 18, 2025
This week: We saw the end of the 43-day government shutdown that restored over one million federal workers but excluded ACA subsidy extensions, setting up 25%+ premium increases for millions of enrollees.

This week: We saw the end of the 43-day government shutdown that restored over one million federal workers but excluded ACA subsidy extensions, setting up 25%+ premium increases for millions of enrollees.

This week: the Senate votes to end the historic 36-day government shutdown, though the deal excludes ACA subsidy extensions and leaves millions facing potential premium increases.

This week’s digest: agencies in crisis, providers under pressure, and everyone wondering who’s actually steering the ship.

This week: how federal dysfunction collides with Medicare Advantage’s first enrollment contraction in 20 years, raising fundamental questions about healthcare system stability and access for vulnerable populations.

This week: More shutdown fallout with Congress no closer to finding an end.

A perfect storm: federal shutdown furloughs 32,000+ HHS staff and halts FDA approvals, Medicare Advantage enrollment drops amid premium cuts, Trump’s drug pricing deals draw widespread skepticism, and millions face insurance cost spikes as Congress battles over ACA subsidies.
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Savage Health Policy
csavage@shpconsulting.llc
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