From Washington, DC,

• Roll Call reports,
  • “Amid tough talk from both sides of the aisle about who’s to blame for the partial government shutdown, bipartisan talks began to take shape as the rank-and-file sought a way out of the impasse.
  • “Various groups of senators were seen huddling on the floor Wednesday during a vote series, even as Democrats again mostly rejected the House-passed stopgap funding bill that would reopen the government through Nov. 21.
  • “The 55-45 margin on the procedural vote was the same tally as the night before, with the same three Democratic caucus members crossing the aisle to support it: Nevada’s Catherine Cortez Masto, Pennsylvania’s John Fetterman and Maine’s Angus King, an independent who caucuses with the party.
  • “That’s two more Democratic caucus members than voted for the measure 10 days ago, which Republicans believe demonstrates fissures in the ranks that will only grow as the shutdown’s impacts build. But it’s five votes short of the 60 needed to overcome a filibuster.”

• The Wall Street Journal adds,
  • “During a huddle with a bipartisan group of senators on the floor Wednesday, Sen. Ruben Gallego (D., Ariz.) floated the idea of voting to reopen the government with a commitment from Republicans to negotiate on the healthcare subsidies by Nov. 1. Republicans reiterated they didn’t want to negotiate while the government was shut down, according to a person familiar with the conversation.
  • “This is us, just senators randomly getting together and spit balling, and then see if we can get to some kind of consensus,” Gallego said. “And then I think a lot of us would then go back to our leadership and then go from there.”

• Federal News Network informs us,
  • “After congressional appropriations lapsed and a government shutdown began at midnight on Oct. 1, the Trump administration now warns that further federal employee layoffs are imminent.
  • “It’s unclear which agencies will move forward with potential layoffs, beyond at least one agency — the U.S. Patent and Trademark Office — that on Wednesday issued layoff notices. Vice President JD Vance doubled down on the Office of Management and Budget’s last week’s directive to terminate more federal employees in the case of a government shutdown.
  • “If this thing drags on for another few days, or, God forbid, another few weeks, we are going to have to lay people off,” Vance told reporters during a White House press conference Wednesday afternoon. “We’re going to have to save money in some places so that essential services don’t get turned off in other places.”
  • “OMB Director Russell Vought took a more immediate stance on how quickly he expected RIFs to take place. In a private call with House Republicans on Wednesday, Vought said agency RIFs would begin “in a day or two,” according to reporting from Politico.”

• Fierce Healthcare offers a look at the major insurers’ 2026 Medicare Advantage plans and adds,
  • “On day one of the government shutdown, the Centers for Medicare and Medicaid Services (CMS) sent out a Medicare Learning Network Connects Newsletter offering guidance on Medicare billing and telehealth services during the lapse in appropriations. 
  • “CMS reaffirmed in the guidance that pandemic-era expanded telehealth flexibilities have ended for Medicare beneficiaries. Per standard course of action, CMS has directed Medicare Administrative Contractors (MACs) to implement temporary claims hold for 10 business days on telehealth claims. 
  • “Assuming the hold starts Oct. 1, claims will begin to be processed on Oct. 15. The guidance says that providers can still submit claims during the temporary hold, but they will not receive payment. 
  • “The claims hold is meant to avoid the reprocessing of claims in the event that Congress re-ups the flexibilities.” 

• The White House posted a fact sheet about “the first agreement with a major pharmaceutical company, Pfizer, to bring American drug prices in line with the lowest paid by other developed nations (known as the most-favored-nation, or MFN, price).”

• The Wall Street Journal explains “How Trump’s Drug-Buying Site ‘TrumpRx’ Will Work. If you are among the 90% of Americans who have health insurance, it’s unlikely to save you much money.”
  • “President Trump announced a deal with Pfizer to sell drugs at reduced prices via TrumpRx.gov and to Medicaid at Most Favored Nation prices.
  • “TrumpRx.gov, launching in early 2026, will offer Pfizer drugs, including Eucrisa and Xeljanz, with average savings of 50%.
  • “The initiative primarily benefits the 27 million uninsured Americans, as 90% with insurance likely save more using their plans.”

From the public health and medical / Rx research front,

• The New York Times reports,
  • “Children and teenagers are twice as likely to develop long Covid after a second coronavirus infection as after an initial infection, a large new study has found.
  • “The study, of nearly a half-million people under 21, published Tuesday in Lancet Infectious Diseases, provides evidence that Covid reinfections can increase the risk of long-term health consequences and contradicts the idea that being infected a second time might lead to a milder outcome, medical experts said.
  • “Dr. Laura Malone, director of the Pediatric Post-Covid-19 Rehabilitation Clinic at Kennedy Krieger Institute in Baltimore, who was not involved in the study, said the findings echo the experience of patients in her clinic.
  • “Just because you got through your first infection and didn’t develop long Covid, it’s not that you are completely out of the woods,” she said.”

• STAT News tells us “Leucovorin has a place in autism treatment, researcher says, but he tamps down parents’ expectations. ‘I haven’t seen a remarkable response,’ says Robert Hendron, who studied its use in kids with ASD.”

• The Washington Post calls attention to “what you should know before buying folate and folinic acid supplements. Medical experts warn against treating over-the-counter supplements the same as leucovorin, the drug the Trump administration has touted as an autism treatment.”

• Cigna, writing in LinkedIn, discusses the unique health needs of women.

• Medscape lets us know that “A prospective cohort study found that a high intake of ultraprocessed foods (UPFs) was associated with an increased risk for overall colorectal cancer (CRC) and right-sided colon cancer.”

• The Washington Post relates,
  • “Walmart will stop using synthetic dyes and certain preservatives, artificial sweeteners and fat substitutes in its private-label offerings, adding the world’s largest retailer to the growing contingent of brands moving to banish food additives amid questions about their health risks.
  • “The announcement Wednesday comes as consumers are pressing for healthier options, and as state and federal officials crack down on the use of petroleum-based dyes in cereals, condiments and a variety of other foods. Health and Human Services Secretary Robert F. Kennedy Jr. — who has likened such additives to “poisonous compounds” — said in April that the administration had reached an “understanding” with the food industry to phase out several colorings over the next few years. General Mills, Kraft Heinz and other foodmakers have since issued statements to that effect.”
  • “Walmart said it will excise nearly 30 additives from its private-label food portfolio by January 2027, including its Great Value, Freshness Guaranteed, Bettergoods and Marketside brands.”

• Medscape points out what scientists are learning about laser tattoo removal.

From the U.S. healthcare business front,

• Modern Healthcare reports,
  • “CommonSpirit is betting on ambulatory care expansion to shore up operations and putting hospital deals on ice.
  • “The Chicago-based system has added 90 ambulatory care sites to its footprint in its last two fiscal years, 34 of which opened across nine states in fiscal 2025, which ended June 30.
  • “At this point, we’re not focused on hospital acquisitions. We’re primarily looking at ambulatory growth to meet the needs of our consumers,” said CommonSpirit CEO Wright Lassiter III on a Wednesday earnings call. “We are very intentional about where we’re headed and what we believe we need to do to create the kind of success we want as a ministry.”
• and
  • “Health insurance companies and health systems are familiar with heated contract battles, but the scramble to lock down favorable terms is rising.
  • “Hospitals, under pressure to operate within tight margins, are wrestling with the financial ramifications of looming federal healthcare cuts and coping with sustained labor shortages Insurers seek to clamp down on rising utilization and appease dissatisfied investors.
  • “Those dynamics have fostered an environment that’s led to more messy public contract fights than usual. “We’ve just never seen anything like it,” said Brandon Edwards, CEO of Unlock Health, a marketing agency for providers.
  • “There were 79 confirmed contract disputes between insurers and providers this year as of Sept. 1, according to an FTI Consulting analysis of publicly reported negotiations. Half related to Medicare Advantage, and 20% were unresolved at the beginning of September. The trend has been rising since last year, the analysis shows.”

• Per Fierce Healthcare,
  • “General Catalyst’s Health Assurance Transformation Company (HATCo) has wrapped its acquisition of Summa Health, shifting the Akron, Ohio-based healthcare system from a nonprofit to a taxed subsidiary.
  • “The deal was first announced in early 2024 and underwent a lengthy regulatory review amid pushback from local residents. Ohio Attorney General Dave Yost gave the transaction a green light during the summer with certain conditions, including an increase in the sale price from $485 million to $500 million.
  • “Today is the culmination of months of collaboration between our organizations and marks the start of a new chapter for Summa Health and those we serve,” Cliff Deveny, M.D., Summa Health President and CEO, said in Wednesday morning’s announcement. “With HATCo, we can preserve our community roots, invest in our team and take bold steps to modernize and expand access to ensure Summa remains strong for decades to come.”
  • “Summa Health is among Ohio’s larger health systems. It employs more than 8,500 people across two acute care hospital campuses, 15 community medical centers, a rehab hospital, a health insurance arm, a multispecialty group practice and a research and medical education program. It reported about $2 billion in total revenue, but a narrow operating loss of $8 million in fiscal year 2024.”
• and
  • “With $10 billion earmarked to grow its U.S. operations through 2035, AbbVie continues to lay out the particulars on its decade-long domestic investment strategy.
  • “The Chicago-area Big Pharma has kicked off work on a $70 million expansion of its bioresearch center in Worcester, Massachusetts, where the company conducts both manufacturing and R&D for biologic medicines.
  • “The project, which falls under the banner of AbbVie’s broader U.S. investment announced in April, will beef up capacity at the Worcester site that AbbVie plans to use for local production of current and upcoming drugs in cancer and immunology, according to a Sept. 30 press release.
  • “AbbVie is specifically building out additional biologics manufacturing areas at the site, as well as a new three-story building that will contain a laboratory, warehouse and office space. The company said it expects the project to hasten the production transfer of certain oncology meds from Europe to the U.S.”

• The Wall Street Journal notes,
  • “Patients are increasingly managing their own healthcare due to doctor shortages and chronic diseases.
  • “Direct-to-consumer lab tests are expanding, with Quest Diagnostics, for instance, offering more than 150 tests.
  • “AI chatbots and wearable devices are emerging tools, but concerns exist regarding data privacy, misinformation and clinical validation.”