Many of the October health headlines that captivated SmartBrief readers centered on fears about costs and access challenges. The federal government shutdown that started at the top of the month proved to be a major factor underlying many of the trends, from disrupted public health functions to staffing and service cuts.
Health services on the line
What happened: An Oct. 1 KFF Health News analysis noted that while programs such as Medicare, Medicaid and the Indian Health Service would continue during the shutdown, some public health services were likely to be affected. The report examined conflicts between Republican and Democrat lawmakers over Affordable Care Act subsidies and Medicaid cuts. Democrats had expressed an interest in extending ACA premium subsidies for Americans, while Republicans tended to oppose it.
What’s next: The longest government shutdown on record lasted until Nov. 12. Other effects were projected, such as reduced disease surveillance programs, huge numbers of federal employee furloughs, interrupted CDC funding for local and state health departments, and potential closure of community health centers that depend on federal funds.
A recent NPR report with former Rep. Charlie Dent, D-Pa., examined fallout since the shutdown’s end, including rising health care costs.
Costs and concerns
What happened: An AP-NORC survey found that a majority of US adults are concerned about health care expenses continuing to rise. About 60% of respondents said they were “extremely” or “very” concerned about costs going up in the coming year, a trend that cut across age groups and includes people who do and do not carry health insurance.
About 40% of respondents said they were “extremely” or “very” concerned about not being able to pay for care or necessary medications, not having access to care when they need it, and either not having coverage or losing it altogether. Federal cuts aimed at reducing fraud and abuse could expose millions of people to spiraling premiums and a very real threat of coverage loss.
What’s next: A November NBC analysis looked at similar trends, based on a West Health-Gallup survey. Thirty-seven percent of respondents said they were worried about prescription drug costs, up from 30% four years ago, and the proportion of adults claiming health care costs add “a lot of stress” to their lives has nearly doubled since 2022. About one-third of respondents said they had either skipped or delayed medical care in the previous year because of costs. “The urgency around this is real,” said West Health President Timothy Lash. “When you look at the economic strain that is on families right now, even if health care prices didn’t rise, the costs are rising elsewhere, which only exacerbates the problem.”
A premium on coverage
What happened: An Oct. 17 New York Times report outlined how 2026 plan pricing under the Affordable Care Act had already been published for about a dozen states, giving a glimpse of the tough premium hikes many people are likely to see if Congress doesn’t extend existing subsidies. Insurance company filings showed that plan prices will rise by 18% on average nationwide in 2026. Some consumers also will have fewer plan options, as some markets will lose insurers next year.
What’s next: The ACA marketplace open enrollment period began Nov. 1 and ends Dec. 15. A HealthCare Dive article in mid-November outlined WTW research on how next year’s increases will stack up against those of recent years. Worldwide, the cost of health benefits is expected to grow 10.3% in 2026, up from 10% this year and 9.5% last year. “Despite variations in health care provision in different countries and regions around the world, rising medical costs are a consistent trend for all,” said WTW’s Linda Pham.
Jobs in jeopardy
What happened: Chief Healthcare Executive reported in early October that US hospitals had laid off thousands of employees since the beginning of June, some due to NIH grant terminations and others because of growing financial struggles. Major systems announcing layoffs over the period included Adventist Health, Providence, Kaiser Permanente and Banner Health, and individual facilities such as Vanderbilt University Medical Center and Children’s Hospital Los Angeles experienced staff reductions as well. Northern Light Health executive Dr. Jay Reynolds noted that “these challenges are especially acute in rural areas, where small hospitals and clinics struggle to remain viable and meet the needs of our aging, remote populations.”
What’s next: A Nov. 14 Becker’s Hospital Review article offered additional details on US hospital staff reductions this year. Among the largest are Crozer Health’s 2,651 layoffs, Mass General Brigham’s 1,500, New York-Presbyterian’s 1,000, Orlando Health’s 940, Jefferson Health’s 650 and the Duke University system’s 599.