Table of Contents
As the cool weather ushers in November, the end of October marks one month since the government was last open. After another week out of session for the House, with the last votes occurring on September 19, a Senate resolution appears to be nowhere in sight. As a deal stalls, the shutdown threatens to become the longest in US history—35 days.
With Affordable Care Act (ACA) subsidies having expired on November 1, systems worry about the rise in uninsured, a spike estimated to be 4.8 million in newly uninsured. Several states have already posted already posted increases in 2026 ACA premiums, with the average threatening to rise up to 93%. Additionally, roughly 30% of hospitals have halted Medicare telehealth services, while others report discharging or transferring hospital-at-home patients to traditional facilities following the expiration of COVID-era flexibilities.
Key Takeaways
The government shutdown has stretched over a month, with no Senate resolution in sight, marking one of the longest in U.S. history.
Expiration of ACA subsidies on November 1 could leave an estimated 4.8 million newly uninsured Americans.
ACA premiums are projected to surge by as much as 93% in 2026 as systems brace for increased financial strain.
Hospitals are scaling back services, with about 30% halting Medicare telehealth and others ending hospital-at-home programs after COVID-era flexibilities expired.