View on our site, with interactive table of contents. Not a subscriber? Sign UpTuesday, October 28, 2025
Visit KFF Health News for the latest headlines
Morning Briefing
In This Edition:
- KFF HEALTH NEWS ORIGINAL STORIES
- 1. A Ticking Clock: How States Are Preparing for a Last-Minute Obamacare Deal
- 2. Many Fear Federal Loan Caps Will Deter Aspiring Doctors and Worsen MD Shortage
- 3. A Listener’s DIY Project Helps Others Deal With High Medical Bills
- 4. Political Cartoon: ‘Trick or Treatment?’
- SPENDING AND FISCAL BATTLES
- 5. In Pivot, Federal Workers’ Union Calls For Immediate End To Shutdown
- 6. As States Prep To Sue Over Food Aid, Some In GOP Seek Separate SNAP Vote
- EDITORIALS AND OPINIONS
- 11. Viewpoints: Fast-Tracking Leucovorin Sets Unsettling Precedent; Debt Pushes Med Students Away From Primary Care
From KFF Health News:
KFF HEALTH NEWS ORIGINAL STORIES
1. A Ticking Clock: How States Are Preparing for a Last-Minute Obamacare Deal
Even if Congress strikes a deal soon to extend more generous Affordable Care Act subsidies, the prices and types of ACA plans available could change dramatically. Unprecedented uncertainty and upheaval could cloud this year’s open enrollment season, which begins in most states on Saturday. (Amanda Seitz and Julie Appleby, 10/28)
2. Many Fear Federal Loan Caps Will Deter Aspiring Doctors and Worsen MD Shortage
Health care professionals fear that new caps on federal student lending, set to start in July, will put medical school out of reach for many who want to become doctors and exacerbate physician shortages. Others say unlimited federal lending has fed a rise in academic costs, saddling families and, ultimately, taxpayers with debt. (Bernard J. Wolfson, 10/28)
3. An Arm and a Leg: A Listener’s DIY Project Helps Others Deal With High Medical Bills
A medical student’s DIY project brings “An Arm and a Leg” listeners together with new tools to fight medical debt. (Dan Weissmann, 10/28)
4. Political Cartoon: ‘Trick or Treatment?’
KFF Health News provides a fresh take on health policy developments with “Political Cartoon: ‘Trick or Treatment?'” by Genevieve Shapiro.
Here’s today’s health policy haiku:
HURDLES TO HEALTH CARE
Doctor, please see me.
I want to be healthy now.
“You’re out of network.”
– Alyssa Reyes
If you have a health policy haiku to share, please Contact Usand let us know if we can include your name. Haikus follow the format of 5-7-5 syllables. We give extra brownie points if you link back to an original story.
Opinions expressed in haikus and cartoons are solely the author’s and do not reflect the opinions of KFF Health News or KFF.
Summaries Of The News:
5. In Pivot, Federal Workers’ Union Calls For Immediate End To Shutdown
The president of the American Federation of Government Employees suggested that negotiations over Democrats’ health care demands should continue only after the government is reopened. Separately, news outlets cover the Obamacare price hikes headed for residents in New Jersey, Illinois, Arizona, and Colorado.
The New York Times: Top Federal Workers’ Union Breaks With Democrats on Shutdown
The largest union of federal workers called on Monday for Congress to pass a spending bill to immediately end the government shutdown, effectively siding with President Trump and Republicans who have opposed Democratic efforts to restore health care spending. “Both political parties have made their point, and still there is no clear end in sight,” Everett Kelley, the president of the American Federation of Government Employees, said in the statement. He added, “It’s time to pass a clean continuing resolution and end this shutdown today. No half measures, and no gamesmanship.” (Cameron, 0/27)
The Hill: Speaker Mike Johnson: GOP Working On Republican Health Care Plan Amid Shutdown
Speaker Mike Johnson (R-La.) on Monday said House Majority Leader Steve Scalise (R-La.) is working with the chairs of three House committees to compile a Republican health care plan as the government shutdown nears the one-month mark and Democrats demand action on expiring ObamaCare subsidies. “Republicans have been working on a fix for health care, we’ve been doing this for years,” Johnson said in a press conference on Monday when asked about the coming “health care cliff.” (Brooks, 10/27)
Politico: Here’s Where The 7 Most Vulnerable House Republicans Stand On An ACA Extension
House Republicans in the toughest races in the country aren’t on board to extend expiring Obamacare subsidies yet. The Cook Political Report, a nonpartisan election handicapper, detailed seven House Republican races in the “toss up” category ahead of the 2026 midterms. The races are likely to be close next year and even a small shift could decide the House majority. Republicans currently hold a six-seat margin that’s slated to shrink to five when a newly elected Democrat is sworn in. (King, 10/27)
States brace for higher ACA costs —
Politico: New Jerseyans Expected To Pay Nearly 175 Percent More For Health Insurance On Exchange
New Jerseyans who purchase health insurance through the state’s exchange will see an average increase of nearly 175 percent in their premiums next year, the Murphy administration announced Monday. The state’s Department of Banking and Insurance said the sticker shock is attributed to the expiration of enhanced federal health insurance subsidies — which have been the key sticking point of the federal government shutdown. (Han, 10/27)
Chicago Tribune: Illinoisans May See 78% Average Hike For ACA Health Insurance
Illinois residents will pay an average of 78% more across the state for health insurance through the Affordable Care Act exchange if Congress does not extend enhanced premium tax credits — the issue at the heart of the current government shutdown — state regulators said Monday. (Schencker, 10/27)
KJZZ Phoenix: What To Expect If Obamacare Premiums Hit As Much As $2,000 A Month In Arizona
“I do think that people are either going to forego care, or we’re going to see a huge rise in uncompensated care. And the system at this point really cannot take the additional burden of more uncompensated care,” said Jen Longdon, chief external affairs officer with the Arizona Alliance for Community Health Centers. (Brodie, 10/27)
The Colorado Sun: Colorado Health Insurance Prices Set For Significant Increase In 2026
The average person in Colorado who buys health insurance without help from an employer will see what they pay more than double next year, as the state released final prices before open enrollment begins next week. (Ingold, 10/28)
KFF Health News: A Ticking Clock: How States Are Preparing For A Last-Minute Obamacare Deal
One family in Virginia Beach, Virginia, just found out their health plan’s deductible will jump from $800 to $20,000 next year. About 200 miles north, in Maryland, another household learned they’ll pay $500 more monthly to insure their brood in 2026. And thousands of people in Idaho were greeted with insurance rates that’ll cost, on average, $100 more every month. As shopping season opens for Affordable Care Act plans in some states, customers are confronting staggering costs for their health insurance next year. The extra federal subsidies put in place in 2021 that made coverage more affordable for millions of people will expire at the end of this year unless a gridlocked and idle Congress acts. (Seitz and Appleby, 10/28)
6. As States Prep To Sue Over Food Aid, Some In GOP Seek Separate SNAP Vote
Democrat-led states are petitioning for the government to tap an emergency fund to keep food aid flowing amid the shutdown — after the Trump administration said it would not do that. Meanwhile, a Texas grocer has a plan to help families in need; Connecticut issues emergency relief; and more.
Politico: Democrats Plan To Sue Over Food Aid As GOP Splits On Legislative Patch
Dozens of Democratic attorneys general and governors are planning to sue President Donald Trump’s administration Tuesday over its decision to not tap emergency funds amid the government shutdown to keep food aid flowing to 42 million Americans next month, according to three people granted anonymity to discuss the matter ahead of a public announcement. (Hill, 10/27)
NBC 5 Dallas-Fort Worth: H-E-B Donates Millions As SNAP Benefits Risk Disruption
H-E-B is donating $5 million to Texas food banks and $1 million to Meals on Wheels programs statewide. The San Antonio-based grocer announced the donations on Friday, days before federal SNAP programs were expected to go unfunded due to the ongoing government shutdown. WIC, TANF, Medicaid and CHIP are not currently affected by the shutdown, but the Texas Health and Human Services Commission said they are monitoring those programs for any changes. Approximately 3.5 million Texans relying on monthly SNAP benefits to help pay for groceries will not receive any assistance in November. (10/27)
The CT Mirror: Facing Loss Of SNAP, CT Increases Funding For Foodshare
Connecticut’s first steps to mitigate the fast-approaching suspension of a federally funded food assistance program will be a $3 million emergency grant to nonprofit Connecticut Foodshare and an outreach campaign informing recipients of their nearest food pantry, Gov. Ned Lamont said Monday. (Pazniokas, 10/27)
Stat: SNAP Benefit Cut-Off Dangerous For People With Chronic Illness
Millions of Americans are set to lose access to food benefits starting Saturday because of the government shutdown, with at least 25 states telling recipients they won’t receive checks for the Supplemental Nutrition Assistance Program (SNAP) in November. Health care experts warn that families will be forced to go hungry or make impossible choices between groceries and other basic needs like rent and medication, with potentially dire consequences. (Todd, 10/27)
ABC News: Some Americans Prepare For Halt In SNAP Benefits: ‘I’m Going To Have Hungry Kids’
About 42 million Americans are poised to lose their Supplemental Nutrition Assistance Program (SNAP) benefits when federal funding comes to a halt on Nov. 1 amid the government shutdown. The U.S. Department of Agriculture (USDA) said it would not use emergency funds to help cover benefits and posted a message on its website over the weekend that “the well has run dry.” (Kekatos, 10/27)
The Washington Post: Beans And Rice, Foods That Won’t Go Bad: Creators Give Advice On Staying Fed If SNAP Benefits Stop
With a possible pause in SNAP benefits this weekend, content creators are giving advice on how to keep from going hungry by using pantry staples. (Kelly, 10/28)
7. Mental Health Grants For Schools Must Be Restored, Judge Rules
The Trump administration had canceled the grants, claiming they were not awarded based on merit. The judge said the states made a case for real harm from the cuts to the grants meant to help with a shortage of mental health workers in schools. Also, more than 1 million people show suicidal intent each week while talking to chatbots.
AP: Trump’s Education Dept. Must Restore Mental Health Grants, Judge Rules
The Trump administration must release millions of dollars in grants meant to address the shortage of mental health workers in schools, a federal judge ruled Monday. Congress funded the mental health program after the 2022 school shooting in Uvalde, Texas. The grants were intended to help schools hire more counselors, psychologists and social workers, with a focus on rural and underserved areas of the country. But President Donald Trump’s administration opposed diversity considerations used to award the grants and told recipients they wouldn’t receive funding past December 2025. (10/28)
In related news about mental health —
The Guardian: More Than A Million People Every Week Show Suicidal Intent When Chatting With ChatGPT, OpenAI Estimates
The finding, part of an update on how the chatbot handles sensitive conversations, is one of the most direct statements from the artificial intelligence giant on the scale of how AI can exacerbate mental health issues. (Robins-Early, 10/27)
More health news from the Trump administration —
CNN: Trump Administration Delays Release Of New Dietary Guidelines Amid Shutdown
The Trump administration is delaying the release of new national dietary guidelines after the government shutdown disrupted efforts to finalize the overhaul by the end of October, officials said. (Cancryn and Owermohle, 10/27)
Axios: Pepsi, Kraft Team With Strategists To Fight Kennedy’s Food Dye Plan
Big food companies are working with conservative strategists to build support for national standards that would preempt the state bans on dyes and additives that Health Secretary Robert F. Kennedy Jr. is promoting. (Goldman, 10/28)
KFF Health News: Many Fear Federal Loan Caps Will Deter Aspiring Doctors And Worsen MD Shortage
Medical educators and health professionals warn that new federal student loan caps in President Donald Trump’s tax cut law could make it more expensive for many people to become doctors and could exacerbate physician shortages nationwide. And, they warn, the economic burden will steer many medical students to lucrative specialties in more affluent, urban areas rather than lower-paying primary care jobs in underserved and rural communities, where doctors are in shortest supply. (Wolfson, 10/28)
On the immigration crisis —
Politico: Another Shutdown Consequence: Democrats Can’t Visit ICE Detention Facilities
Federal immigration authorities say they no longer have to provide on-demand access to detention facilities for members of Congress. The reason? The government shutdown. Immigration and Customs Enforcement officials, who have been fighting a lawsuit brought by Democratic lawmakers over prior denied visit attempts, have informed lawmakers that they simply don’t have the staff or funding to support those visits. Lawmakers have previously been legally allowed to demand them as part of their oversight duties, which includes monitoring conditions and communicating with detainees facing deportation. (Cheney and Ward, 10/27)
The New York Times: Tear Gas Can Be Dangerous. The Rules On How To Use It Vary.
The repeated use of tear gas by federal immigration officers in Chicago has renewed a debate about how chemical irritants should be used by law enforcement personnel. (Smith, 10/28)
Also —
Politico: House Republicans Urge Caution As HUD Proceeds With Homeless Housing Program Cuts
Congressional Republicans are pushing the Trump administration to renew grants for a program the White House has targeted for dramatic cuts that helps provide permanent housing to people experiencing homelessness, according to a draft letter obtained by POLITICO. The lawmakers warn that the substantive changes to the Department of Housing and Urban Development program “should be implemented carefully to avoid destabilizing programs that serve individuals with severe disabilities related to mental illness, chronic health conditions, or substance use disorders, as well as seniors with disabilities.” (Hapgood, 10/27)
The Washington Post: House Biden Autopen Report Released, Finds Biden Actions ‘Illegitimate’
The House Oversight Committee released a report on Tuesday that questions the legitimacy of former president Joe Biden’s executive actions, and calls on the Department of Justice to open a new investigation into the Biden administration. The report is the result of a five-month-long investigation into accusations made by President Donald Trump and his allies, that aides covered up a decline in Biden’s cognitive ability, and that the Biden administration misused the presidential autopen to issue executive actions without Biden’s direct involvement. (Goba and Abutaleb, 10/28)
8. Cigna Will Scrub Drug Rebate Models From Some Plans Starting In 2027
As Bloomberg explains, pharmaceutical companies pay the rebates in order to get favorable placement on pharmacy benefit managers’ lists of covered drugs, a practice some have likened to kickbacks. All of Cigna’s Evernorth customers will have access to upfront discounts starting in 2028.
Bloomberg: Cigna Will End Drug Rebates In Many Private Health Plans
Cigna Group will eliminate prescription drug rebates in many of its commercial health plans in 2027, upending an opaque, controversial practice that’s drawn the ire of President Donald Trump. The insurer will expand the rebate-free model to clients of its pharmacy benefits business starting in 2028. The plan to eventually phase out rebates more broadly portends a seismic shift in the flow of billions of dollars among drugmakers, insurers and employers. (Tozzi, 10/27)
More on the high cost of health care —
MedPage Today: Medicare To Spend $15B On Treatment Linked To Fraud, Patient Harm
Medicare is expected to spend more than $15 billion by year’s end on pricey wound care products linked to waste, fraud, and abuse, according to an analysis of data by the National Association of ACOs (NAACOS) and the Institute for Accountable Care. Spending on skin substitutes climbed to $7.7 billion through July, and is projected to reach as much as $15.4 billion by the end of 2025 — 55% more than was spent in 2024, the groups said. (Firth, 10/27)
Modern Healthcare: CVS Health To Close 16 Oak Street Health Clinics
CVS Health plans to close 16 Oak Street Health sites by the end of February due to financial challenges, including higher medical costs. The company, which is in the midst of a $2 billion cost-cutting strategy, said Monday it will continue to operate 230 centers across 27 states following the closures. “The move positions Oak Street Health for sustainable, long-term growth as we continue to navigate external challenges, such as elevated medical costs, [Centers for Medicare and Medicaid Services] risk adjustment model changes, and health plan payer dynamics,” CVS Health said in a statement. (DeSilva, 10/27)
Mississippi Today: Leader Of Greenwood Hospital Says Dispute With Mississippi Medicaid Could Lead To Reduced Services
Greenwood Leflore Hospital, plagued by financial hardship for years, saw a bright spot this spring when it was selected for a new federal payment status. But a dispute with Mississippi Medicaid could jeopardize the Greenwood public hospital’s ability to keep services open if a resolution is not reached, its leader says. “Access to services will be reduced for residents of the central Delta region,” Interim CEO Gary Marchand told Mississippi Today. He said no decisions about service changes have been made yet. (Dilworth, 10/27)
The Hill: Many Voters Say Health Care Unaffordable, Are Open To New Insurance System: Poll
New polling has found that the majority of voters say health care in the U.S. is unaffordable and are open to a health insurance system that doesn’t tie coverage to employment. Undue Medical Debt, a nonprofit that works to eliminate medical debt and supports policies to prevent new debt, sponsored the poll, which was led by the nonpartisan research firm PerryUndem. Along with a national survey, focus groups were also asked for their opinions on health care. (Choi, 10/27)
Fierce Healthcare: Patients Are Blaming Insurers For Medical Debt: Survey
U.S. consumers across the political spectrum are largely in favor of new legal protections against medical debt, and the majority are laying blame at the feet of the insurance industry rather than other healthcare players like hospitals or drugmakers, according to a new national survey. The poll of 1,319 2024 general election voters, fielded between Aug. 21 and Sept. 2, 2025, found about 35% currently owed money or have debts due to medical and dental expenses. Eighty-four percent said they believed having health insurance should protect people from medical debt, and 74% said the country’s current health insurance system is “mostly failing” in protecting from medical debt. (Muoio, 10/27)
KFF Health News: KFF Health News’ ‘An Arm and a Leg’: A Listener’s DIY Project Helps Others Deal With High Medical Bills
In April, Thomas Sanford, a medical student who regularly listens to “An Arm and a Leg,” set