The nation’s prolonged government shutdown edged closer to resolution Monday night as the U.S. Senate passed a short-term funding package that would reopen federal agencies and extend government operations through January 30, 2026. The 60–40 vote came after eight Democrats joined all 52 Republicans to break a weeks-long impasse that had shuttered federal services and left hundreds of thousands of workers without pay.

The measure now heads to the House of Representatives, where Speaker Mike Johnson has directed members to return to Washington within 48 hours. House consideration is expected later this week, though the timing and outcome remain uncertain.

Health Programs and Physician Payment Relief

The Senate’s continuing-resolution package maintains government funding at current levels and renews several expiring health programs that were jeopardized by the shutdown—retroactive to October 1, 2025. It extends the National Health Service Corps, the Teaching Health Center Graduate Medical Education program, community health centers, the Hospital-at-Home initiative and $8 billion for Disproportionate Share Hospitals. It also restores Medicare’s pandemic-era telehealth flexibilities retroactive to October 1, 2025, ensuring continuity of care for patients who depend on virtual visits.

Importantly for physicians, the bill waives the statutory budget-neutral “PAY-AS-YOU-GO” requirement to prevent an across-the-board 2% federal budget sequestration cut in 2026. Without that waiver, physician payments could have faced an additional 2% sequestration reduction in 2026, compounding the ongoing financial strain on medical practices.

ACA Premium Tax Credits Left Out

However, the agreement leaves one major health care issue unresolved: the fate of the enhanced Affordable Care Act premium tax credits that make marketplace coverage affordable for millions of Californians. The credits—first expanded under the American Rescue Plan and extended once under the Inflation Reduction Act—are set to expire unless Congress acts before the end of the year. Senate Republican Leader John Thune has pledged to hold a stand-alone vote to extend the subsidies in mid-December, but House leaders have so far resisted bringing the measure forward.

Without an extension, as many as 5 million Americans—including nearly 500,000 Californians—could lose ACA coverage entirely. Nearly 2 million Californians are facing premium hikes of up to 66%, making coverage unaffordable for many middle-income families. Covered California estimates that average marketplace premiums could rise by nearly 97% for some regions, with rural counties hit hardest.

What’s Next

For physicians and patients, the Senate vote leaves long-term uncertainty. Federal agencies are poised to resume full operations once the House acts, and vital programs will be protected—but only through January. And the absence of an ACA fix means millions could see premium hikes or lose coverage in 2026, threatening access to care and straining an already burdened safety net of hospitals and physicians.

"Ending the shutdown and restoring telehealth services is a necessary first step, but the real test will come next month," said CMA President René Bravo, M.D. "Congress cannot claim victory while millions of Americans stand to lose their health coverage. Extending the ACA premium tax credits isn’t optional—it’s essential to protecting access to care and preventing the destabilization of our health system."

CMA will continue to urge the California Republican delegation to preserve access to affordable ACA health care coverage as the December vote approaches.