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It may already be too late to implement certain changes Republicans are insisting on as a condition for renewing Affordable Care Act subsidies, further casting doubt on any congressional deal to extend the financial aid.

Why it matters: GOP lawmakers have made clear that they need to see changes to the enhanced ACA tax credits at the center of the government shutdown fight in order to extend them.

• But insurers, states and other experts say some changes could already be impossible for next year, with ACA enrollment due to begin in less than two weeks, on Nov. 1. The subsidies are due to expire at year's end, absent further action.

What we're hearing: Extending the credits after Nov. 1 is still possible, experts say, but gets much harder if there are significant changes, such as capping eligibility at a certain income level or requiring recipients to make a minimum premium payment.

What they're saying: "I have zero confidence that there's enough operational time for systems and issuers to be able to implement changes, significant changes," said Jeanne Lambrew, a former key health adviser in the Obama White House and later a top health official in Maine.

• "There's no way to prepare for a compromise that nobody knows about," added Lambrew, now a senior fellow at The Century Foundation.
• Sen. Mike Rounds (R-S.D.), one of the GOP senators more open to some form of subsidy extension, acknowledged that the implementation timeline poses a problem.
• "That's why a lot of us started talking about it in July," Rounds told Axios, blaming Democrats for triggering the shutdown on Oct. 1.

Between the lines: One possible workaround would be for Congress to extend the enhanced subsidies unchanged for one year and then have GOP changes take effect in 2027. It's not clear if that would pass muster in the House and Senate.

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The Trump administration may move to impose new regulations on food companies that don't follow through on promises to remove artificial colorants from their products, White House adviser Calley Means said at a health industry conference yesterday.

Why it matters: Health Secretary Robert F. Kennedy has so far focused on getting voluntary commitments from companies like Kraft Heinz and Walmart on varying timelines.

• While major food makers have sent cooperative signals, they've by and large stopped short of endorsing outright bans.

What they're saying: "There absolutely is an appetite to use the regulatory lever to protect kids when necessary," Means told Maya during an onstage interview at the HLTH 2025 conference in Las Vegas.

• Still, Means said it's a "big victory" that major food and beverage companies have voluntarily agreed to remove artificial dyes.
• "We told the food companies, we can do this the hard way or the easy way," he said.

State of play: The FDA in April announced it would work with industry to eliminate six widely used synthetic food dyes by the end of the year. But the agency didn't specify consequences for noncompliance.

• A tracker on the FDA website lists 20 company commitments to stop using food dyes. Only one company, In-N-Out Burger, is listed as having completed its initiative.

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Novo Nordisk was shaken yesterday when the drug giant's entire board stepped down after its top shareholder moved to take control amid declining profits.

Why it matters: It's the latest sign of turmoil for the Danish behemoth behind Wegovy and Ozempic, which saw its shares slide and pursued thousands of layoffs after losing traction in the U.S. market for obesity treatments.

Details: The Novo Nordisk Foundation led by Lars Rebien Sørensen, a former CEO of the company, owns more than 25% of shares and controls over 70% of the voting rights.

• The departed directors and the foundation disagreed on changes to make, with the foundation seeking "a more extensive reconfiguration," the company said in a statement.
• The foundation in May pushed out CEO Lars Fruergaard Jørgensen due to "market challenges" and its falling share price, per the BBC.
• Novo announced it would hold an election for a new board on Nov. 14.

Behind every medicine is a team of skilled American workers and a distribution network helping to make care possible.

Their impact: Distributors move medicines to every corner of the country, ranging from common medicines to complex treatments.

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Some U.S. states have maternal mortality rates similar to those of countries with relatively high numbers, a new analysis finds.

Why it matters: Comparing states with foreign nations can put health outcomes into a global — not just national — context.

By the numbers: Louisiana (41.9 deaths per 100,000 live births), Tennessee (31.3) and Arkansas (31.2) had the highest maternal mortality rates in 2023, per a new report from the Commonwealth Fund, a health care foundation.

• Those figures are similar to countries such as El Salvador (39), Belize (31.6) and Azerbaijan (29.3).

California (9.5) and Washington (9.7) had the lowest rates in the U.S., similar to countries like Canada (9.4).

• The overall U.S. maternal mortality rate was 18.6 in 2023, down from 22.3 a year prior. The leading causes were obstetric, maternal disorders and postpartum complications. Black mothers in the U.S. die at a rate nearly three times the national average.

✍️ More than 420 bills attacking long-standing public health protections — vaccines, milk safety and fluoride — have been introduced in statehouses across the U.S. this year. (PBS News)