The record-long federal shutdown is over after a small group of Democrats agreed to a deal with most Republicans that funds the government through January — but, notably, does not extend more generous Affordable Care Act tax credits. Plus, new details are emerging about how the Trump administration is using the Medicaid program to advance its policy goals. Anna Edney of Bloomberg News, Shefali Luthra of The 19th, and Sandhya Raman of CQ Roll Call join KFF Health News’ Emmarie Huetteman to discuss these stories and more. Also this week, KFF Health News’ Julie Rovner interviews KFF Health News’ Julie Appleby, who wrote the latest “Bill of the Month” feature.

A standoff in Congress is keeping much of the government shut down as open enrollment begins in most states for Affordable Care Act plans. Democrats are demanding Republicans agree to extend ACA tax credits, but there has been little negotiating — even as customers are learning what they’ll pay for coverage next year. Meanwhile, the Trump administration is telling states they can’t pass their own laws to keep medical debt off consumers’ credit reports. Paige Winfield Cunningham of The Washington Post, Maya Goldman of Axios, and Alice Miranda Ollstein of Politico join KFF Health News’ Julie Rovner to discuss those stories and more.

La ley habría obligado a las aseguradoras a cubrir y a las farmacéuticas a dispensar 12 meses de terapia hormonal de una sola vez a pacientes transgénero y a otras personas.

California Gov. Gavin Newsom vetoed a bill that would have expanded access to hormone therapy, a top priority for the trans community. Advocates say it would have ensured continuity in gender-affirming care amid Trump administration attacks. Analysts say it’s another sign of the Democrat’s move to the center.

Democrats and Republicans remain stalled over funding the federal government as Republicans launch a new attack on the Affordable Care Act. Meanwhile, the Trump administration is taking advantage of the shutdown to lay off workers from programs supported mostly by Democrats. Anna Edney of Bloomberg News, Lauren Weber of The Washington Post, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine join KFF Health News’ Julie Rovner to discuss those stories and more. Also this week, Rovner interviews health insurance analyst Louise Norris about Medicare open enrollment.

In Mississippi, a state with one of the highest obesity rates in the nation, Medicaid covers weight loss drugs, but few enrollees have signed up for the benefit.

Ketamine, long used as an anesthetic or illegal party drug, is being combined with psychotherapy to treat severe depression and post-traumatic stress — a potential tool for those with high trauma rates, like firefighters and police officers. Yet the drug’s stigma and unregulated marketplace leave first responders in uncharted territory.

On the "Today, Explained" podcast, KFF Health News' Julie Rovner recaps the TrumpRx announcement and why the direct-to-consumer initiative may not save you money on prescription drugs if you have insurance through your employer or the government.

Barbara Kingsolver won a Pulitzer Prize for her bestselling novel about Appalachia’s drug crisis. She invested some of the proceeds into a home for women trying to beat substance use disorders.

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