Nov. 14, 2025

Executive and Congressional News

On Nov. 12, 2025, the president signed, H.R. 5371, a continuing resolution to fund the federal government until Jan. 30, 2026. This ends the 42-day shutdown.

Military Health Care News

TRICARE Open Season begins Monday, Nov. 10, and runs through Tuesday, Dec. 9. TRICARE is reminding its beneficiaries that open season is the opportunity to enroll in or make changes to their TRICARE plan for 2026. Changes you make during this time will take effect on Jan. 1, 2026.  Once TRICARE Open Season ends, you’ll only be able to make changes to your plan if you experience a TRICARE Qualifying Life Event—like getting married, having a baby, or moving to a new location. Otherwise, your next opportunity to change plans will be during next year’s open season. On Nov. 12, 2025, TRICARE announced new copays for the TRICARE Pharmacy Program starting Jan. 1, 2026. The National Defense Authorization Act for Fiscal Year 2018 established TRICARE prescription drug costs. The costs will be in effect through Dec. 31, 2027. There are a few things that affect beneficiaries’ costs, as noted in the TRICARE Pharmacy Program Overview Fact Sheet. Beneficiary category: o Active duty service members: Pay nothing for covered drugs from military pharmacies, home delivery, and retail network pharmacies. o Survivors of ADSMs and medically retired service members and their family members: Copayments won’t change in 2026. Go to Pharmacy Costs to learn more. o All other beneficiaries: Most copayments will increase in 2026. TRICARE groups prescription drugs into four categories: o Generic formulary drugs o Brand-name formulary drugs o Non-formulary drugs o Non-covered drugs Generic formulary drugs are the least expensive. This is followed by brand-name formulary drugs and non-formulary drugs. Non-formulary drug can be accessed at the formulary cost if a provider establishes medical necessity and the medical necessity authorization request is approved. Prescription for a non-covered drug are not subsidized at all and TRICARE beneficiaries will be expected to pay the full cost of the drug. Where you get your prescription also affects your costs.   Military pharmacies (up to a 90-day supply): Beneficiaries pay nothing. (Call the pharmacy to confirm they carry your drug.)   Home delivery (up to a 90-day supply): o Generic formulary drugs will increase from $13 to $14. o Brand-name formulary drugs will increase from $38 to $44. o Non-formulary drugs will increase from $76 to $85. Retail network pharmacies (up to a 30-day supply) o Generic formulary drugs will still be $16. o Brand-name formulary drugs will increase from $43 to $48. o Non-formulary drugs will increase from $76 to $85. Non-network pharmacies (Up to a 30-day supply) Individual TRICARE health plans have different non-network pharmacy costs in the U.S. and U.S. territories. (Note: Go to Pharmacy Costs to find cost-shares for overseas pharmacies.) Keep in mind that beneficiaries who use a non-network pharmacy will have to pay full price for their drug up front and them file a claim for reimbursement. Reimbursements are subject to applicable deductibles, cost-shares, and copayments.   Visit to preview TRICARE health plan costs for 2026.

Veterans Affairs News

With the passage of the continuing resolution, the VA wants to let veterans know what to expect over the next few days as things return to normal. Because VA has its own advanced appropriations core services, such as health care and disability compensation, continued during the shutdown and are now fully funded for the rest of the fiscal year.  Health care: VA medical centers and clinics remained open during the government shutdown. However, some appointments may have been postponed due to local staffing or shutdown-related disruptions. VA expects these appointments to be rescheduled as administrators get clear guidance and staffing stabilizes. Disability Claims: Existing benefits continued, but there were some adjustments due to staffing.  Claims processing will now restart, with a risk of backlogs as staff dig out from six weeks of limited operations.

General Healthcare News

The Centers for Medicare & Medicaid Services (CMS) today announced that all 50 states submitted applications for the $50 billion Rural Health Transformation Program—a landmark initiative created under the Working Families Tax Cuts legislation [Public Law 119-21] to strengthen health care across rural America. The application period, open from Sept. 15 through Nov.ember 5, 2025, invited every state to design a plan for transforming its rural health care system. Each proposal must outline how states intend to expand access, enhance quality, and improve outcomes for patients through sustainable, state-driven innovation. The Rural Health Transformation Program is a catalytic investment designed to help states strengthen rural health infrastructure and build enduring systems of care. Guided by five strategic goals, the program aims to: o Support rural health innovations and promote preventive care. o Ensure rural providers can become long-term access points for care by improving efficiency and sustainability. o Build and retain a strong rural health care workforce. o Test new models of care delivery to improve rural health outcomes and lower the cost of care. o Expand use of technologies that promote access and efficiency in rural settings. All submitted applications will now undergo CMS review to ensure completeness and compliance with the requirements outlined in the Notice of Funding Opportunity. States that meet these requirements and have approved applications will receive baseline funding—representing 50% of total available program funds—distributed equally among approved states. Applications that meet baseline criteria will then undergo a rigorous, data-driven merit review for the remaining 50% of available program funds. This in-depth review will assess each state’s proposed initiatives and alignment with program goals to ensure a fair, transparent, and consistent merit review process across all states. CMS will announce approved awardees by Dec.31, 2025, with funding distributed over five years beginning in federal fiscal year 2026. As states begin implementation, program officers from CMS’s Office of Rural Health Transformation will provide technical assistance and ongoing support to help states design, launch, and sustain initiatives that best serve their rural communities. To learn more about the Rural Health Transformation Program, visit: https://www.cms.gov/priorities/rural-health-transformation-rht-program/rural-health-transformation-rht-program

Reports/Policies

The GAO and CBO have not published a report since Oct. 1.

Congressional Hearings

There are no congressional hearings regarding health care scheduled next week.

Proposed Legislation

No health-related legislation was promoted this week.

Conferences/Meetings

The 2026 AMSUS Annual Meeting will be held on March 2-5, 2026, in National Harbor, Md. Annual Meeting – AMSUS – Society of Federal Health Professionals   The 2026 HIMSS Global Health Conference & Exhibition will be held on March 9-12, 2026, in Las Vegas, Nev. HIMSS Global Health Conference & Exhibition The Military Health System has a series of courses and events to help educate its medical personnel. https://www.health.mil/News/Calendar-of-Events

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