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Republican senators are having early discussions about modifying enhanced Affordable Care Act tax credits to allow for an extension of the subsidies before they expire at year's end. ... GOP leaders insist an ACA extension won't be part of any stopgap legislation to keep the government funded into November. (Sullivan, 9/22)

Congress headed out of Washington on Friday after spending legislation stalled in the Senate, leaving only two workdays to resolve a stalemate before a potential government shutdown would begin on Oct. 1. The House passed a Republican-backed measure earlier in the day, largely along party lines, that would push the shutdown deadline to Nov. 21. But then the Senate rejected a Democrat-led proposal that would keep the government open through Oct. 31, as well as implement several Democratic priorities on health care and government spending, and also failed to pass the House bill. (Beggin and Meyer, 9/19)

The legal authorities for telehealth and hospital-at-home programs and funding for community health centers and other priorities remain in limbo after Congress failed to approve a spending bill Friday. These and other healthcare issues are swept up in broader partisan fights about government spending. Fiscal 2025 ends Sept. 30, lending urgency to the Republican majority’s push to send President Donald Trump a stopgap appropriations bill to prevent a federal government shutdown. Numerous healthcare programs and funding streams are set to expire on the same date. (McAuliff, 9/19)

Hospitals in Medicaid expansion states could see double-digit declines in 2027 operating margins as a result of new Medicaid work requirements, according to a study released Thursday. The analysis by the Commonwealth Fund, a nonprofit foundation focused on healthcare policy, found that hospitals in expansion states could see their operating margins decrease by 0.4 to 0.5 percentage point, or a drop of -11.7% to -13.3%. (Broderick, 9/19)

�鶹Ů�� Health News: States Are Cutting Medicaid Provider Payments Long Before Trump Cuts Hit 

Every day for nearly 18 years, Alessandra Fabrello has been a medical caregiver for her son, on top of being his mom. “It is almost impossible to explain what it takes to keep a child alive who should be dead,” said Fabrello, whose son, Ysadore Maklakoff, experienced a rare brain condition called acute necrotizing encephalopathy at 9 months old. ... Now, broad cuts to North Carolina Medicaid will make finding and paying for care even more difficult. (Sable-Smith and Tribble, 9/22)