Week in Washington

Shutdown

There was no progress this week on ending the shutdown. While there have been some conversations on a compromise, high level leadership discussions have not happened. Nor is there any specific event that could trigger discussions. Two potential sources are that food stamp (SNAP) funding is likely to run out next month as well as further travel delays, especially during the holiday season.

CMS

CMS plans to recall about 3,000 staff that were furloughed on Monday. CMS said these staff members were being brought back to assist with Medicaid and ACA Open Enrollments. The return of staff could also assist in pushing along regulations (e.g., final Medicare payment rules)

Potential Changes to Social Security

Several news outlets reported that the White House is considering reducing eligibility for Social Security disability payments. They are considering eliminating age as a factor in eligibility. Analysis on such a change could reduce Social Security Disability Insurance enrollment by 10% to 20% , with the largest reductions occurring in the South/Appalachia.  The changes would have implications as this would reduce Medicare and Medicaid enrollment

News of Notes

• One potential compromise on extending ePTCs would be to continue ePTCs but require a minimum Marketplace premium. Matt Fiedler estimates that eliminating $0 premiums would reduce enrollment by about a 1 million people.
• ACAsignups has a tracker on issuer exits in the ACA market. Overall issuer exits would affect about 1.6 million enrollees this year.
• Elevance signaled a challenging year for Medicaid businesses. Elevance told investors that rising Medicaid costs driven by higher member acuity and utilization was putting pressure on margins into 2026. Elevance is the first major issuer to report quarterly earnings this cycle.