Monthly Washington Update November 2025
We want to begin this update by sending our warmest wishes to you and your loved ones this holiday season. We recognize that this time of year can be challenging for some, and for those experiencing difficulty, we sincerely hope the new year brings brighter days. For those able to enjoy the season, we wish you all the joy and celebration it has to offer.
There is important information below regarding Medicare, Social Security, and, believe it or not, another government shutdown.
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Is Another Government Shutdown Just Around the Corner?
Although the longest federal government shutdown in history ended less than a month ago on November 12th, signs in Washington point to another shutdown starting on February 1, 2026.
That’s the gloomy assessment of many in Washington as Congress continues to be unable to do the country’s business in an orderly fashion.
The Senate is scheduled to be in session for only three more weeks before it adjourns for the year-end recess, and Majority Leader John Thune (South Dakota) has acknowledged that the Senate might not have time this month to pass another package of government funding bills.
Even if the Senate passes another spending package in the coming weeks, most federal agencies won’t be funded past January if Senate leaders don’t reach a compromise that can pass the House.
Even though Congress passed three of the dozen annual appropriations measures as part of the short-term spending bill last month, it still needs to set spending levels for most of the federal government, including the Pentagon, education programs, and health agencies.
One of the major sticking points to passing the remaining spending bills will be extending the Affordable Care Act subsidies, which are set to expire at the end of this year. Those subsidies, passed during the COVID-19 epidemic, have helped millions of Americans get health care they otherwise couldn’t afford.
As part of last month’s agreement to end the shutdown, Senate leaders committed to holding a vote by mid-December on extending health care tax credits. However, the political dynamics remain unchanged. It is still unlikely that the extension will pass the Senate, move through the House, or reach the President’s desk. And, even if it did, there is no certainty it would be signed into law.
Senate Health Committee Chair Bill Cassidy (Louisiana) is working to identify a compromise for extending the credits. He has proposed converting the expiring tax credits into pre-funded ACA health savings accounts, but this approach does not have unanimous support within his caucus.
At this point, it is difficult to determine how many senators would support an extension, as no unified plan has been introduced, and the level of support will depend on the specific details of any proposal.
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Big Medicare Advantage Companies Don’t Want You If You Are Old or Sick
If you’ve noticed that you have fewer choices when it comes to picking a Medicare Advantage plan this year, there’s a reason that’s happening.
A new report says major health insurers are taking drastic steps to discourage older adults from signing up for their private Medicare plans, as the companies seek to boost profits.
Humana, UnitedHealthcare, Anthem, Centene, and regional insurers like SummaCare are among the firms halting or cutting commissions on Medicare plans.
Some are even cutting off access to online enrollment portals, according to company notices obtained by a medical reporter. Many of those decisions occurred after Oct. 15th, when Medicare’s annual enrollment period started. It ends Dec. 7.
Companies have overhauled their 2026 Medicare Advantage and Medicare prescription drug plans in an attempt to boost profits and adapt to the Inflation Reduction Act.
An estimated 3 million people are in soon-to-be-terminated Medicare Advantage plans and have to choose new coverage. Over the past few years, the Medicare markets have become an increasingly feverish game of hot potato — with Humana, CVS Health’s Aetna, and now UnitedHealthcare altering benefits and drug formularies to push their sicker, costlier customers to choose a competitor’s plan.
TSCL strongly believes Congress needs to investigate this issue and take whatever action is necessary to ensure that seniors can get the coverage they need.
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New Drug Price Reductions are Announced
The Centers for Medicare & Medicaid Services have announced lower prices for 15 Medicare Part D drugs selected for the second cycle of negotiations under the Inflation Reduction Act’s Medicare Drug Price Negotiation Program, which was passed during the Biden Administration.
The selected drugs are used to treat cancer, diabetes, asthma, and other chronic conditions. CMS said the new pricing will take effect Jan. 1, 2027, and that Medicare Part D beneficiaries are expected to save $685 million in out-of-pocket costs.
Headlining the list of 15 treatments that will undergo price reductions in 2027 are Novo Nordisk’s semaglutide products, Ozempic and Wegovy. Also included are the inhaler Trelegy Ellipta and cancer drugs Xtandi, Pomalyst, and Ibrance.
The negotiated price for Ozempic is $274 per month compared to the current list price of $959. Meanwhile, the new price for higher doses of Wegovy will be $385 per month, according to a CMS document. The adjusted prices are what Medicare will pay drugmakers for the medicines.
Prices for drugs on the list have been slashed by between 38% and 85%, according to CMS. The discounts will cut Medicare’s costs for the 15 drugs by 44% and save taxpayers roughly $12 billion per year from prior spending levels, the agency said.
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Some will Receive Two Social Security Checks this Month
According to a report on Fox Business News, some recipients of Social Security benefits will receive two checks in December because a calendar quirk will move the payment timeline to an adjacent month.
The Social Security Administration (SSA) ordinarily disburses payments for Supplemental Security Income (SSI) on the first day of a given month. The SSI program provides monthly payments to eligible older adults with little or no income, as well as to disabled individuals, which differ from Social Security’s standard retirement benefits.
Due to the way the 2025 calendar falls, two SSI payments will go out in December – one on December 1st, which will provide benefits for December, and the second on Wednesday, December 31st, which will deliver benefits for January.
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If You want to go to a Social Security Office, You’d Better Hurry
Earlier this year, the Trump administration carried out the largest staffing cut in the history of the Social Security Administration, cutting the agency’s workforce by around 7,000. The cut left one SSA worker for every 1,480 beneficiaries, resulting in understaffed field offices and overwhelmed phone operations.
Beneficiaries have also repeatedly faced issues this year in accessing the Social Security website, problems that SSA’s plan to curb field office visits could exacerbate.
The administration is reportedly considering a significant reduction in the number of visitors to Social Security field offices nationwide. Some lawmakers have expressed concern that this approach could lead to service disruptions and potentially affect access to benefits.
According to one source that has reviewed internal Social Security Administration (SSA) planning documents, the documents show that the agency is aiming for “no more than 15 million total” in-person visits to field offices in fiscal year 2026—half the level of the prior fiscal year.
Instead, the agency is aiming to push people to interact with Social Security online instead of going to a field office or calling the agency.
As these plans continue to develop, individuals who rely on Social Security services may face an evolving landscape for accessing assistance. Whether through reduced in-person availability or a greater shift toward online platforms, the coming years are likely to bring significant changes to the way the agency interacts with the public. Staying informed about these developments and preparing for potential adjustments in service delivery will be essential for beneficiaries who want to ensure uninterrupted access to the support they need.
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