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Dear John,

Join Health Affairs on January 21 for an exclusive Insider virtual event exploring the latest drug policies with the University of Utah’s Joey Mattingly.

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At Year’s End Where Are We Now, and Where Are We Going?

It has been an eventful end to an eventful year for both markets and the health care industry. The stock market has swung sharply, driven by trade uncertainty and the promises, along with the potential pitfalls, of AI.

At the time of this writing on Friday December 11, there's been no solution to the looming ACA subsidies expiration date. Without an extension, consumers will face steep increases in costs, putting pressure on industry professionals who could see decreasing profit margins.

At the same time, the labor market has been shaky.

Layoffs were at an annual high in October, while Fed Chair Jerome Powell warned the economy sits in a fragile equilibrium that could quickly tip into recession.

For today’s newsletter, I reflect on these year-end forces rippling through the economy with an eye towards what new challenges may bring in 2026.

Where the Economy Stands Now

Powell has remarked the labor market was in a “curious kind of balance,” referring to unusually low rates of both hiring and quitting ([link removed] ) .

This standoff has led to a low unemployment rate that would normally cause celebration.

What has the fed so spooked?

To Read the Whole Essay, Purchase Health Affairs Insider

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