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   DealBook: The showdown behind the shutdown
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             October 20, 2025
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         <span style="font-style:italic">
          Good morning. Andrew here. We’ve got some news this morning on the government shutdown. But I want to focus for a moment on a different kind of outage: Amazon Web Services, which went down for hours overnight, though it’s coming back now. Its failure temporarily shuttered or slowed sites including Venmo, Robinhood, Facebook and even those of some airlines.
         </span>
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        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span style="font-style:italic">
          It is a rare occurrence — but one that demonstrates just how critical these services have become. They are the equivalent of electricity for much of our economy. And the truth is that they are too big to fail. (Was this newsletter forwarded to you?
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         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline;font-style:italic">
          Sign up here.
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          )
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            <span style="color:#666;font:normal 14px georgia,serif">
             The government shutdown has thrust the cost of health care back into the spotlight.
            </span>
            <span style="margin:0;font:11px/11px georgia,serif;color:#888;letter-spacing:.01em">
             Haiyun Jiang/The New York Times
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        <h2 class="css-10nzuqq" style="color:#000;font:700 25px/32px arial,sans-serif;margin:0 0 10px">
         <span>
          The bitter shutdown pill
         </span>
        </h2>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          The U.S. government shutdown has entered Day 20 — with little progress in sight.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          So far, investors have shrugged off the impasse. But the crisis is carrying a growing economic and political cost.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          The biggest consequences of the shutdown are perhaps in health care.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span style="font-weight:700;font-family:arial,sans-serif;color:#000">
          Affordable Care Act subsidies have become a battleground.
         </span>
         <span>
          Democrats are demanding that the support, which is set to expire at the end of the year and benefits more than 20 million Americans, be extended as a condition of ending the shutdown. Failing to do so, they say, would increase health care costs for families.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          The enhanced subsidies are popular,
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          especially in red states
         </a>
         <span>
          . And the prospect of higher health care costs alongside rising food and housing prices is
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          weighing on Americans
         </a>
         <span>
          , according to an Associated Press-NORC Center for Public Affairs Research poll.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span style="font-weight:700;font-family:arial,sans-serif;color:#000">
          But keeping the tax credit carries a big price tag.
         </span>
         <span>
          Permanently expanding the most generous benefits would
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          increase the deficit by $350 billion
         </a>
         <span>
          from 2026 to 2035, the Congressional Budget Office has estimated.
         </span>
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         <span style="font-weight:700;font-family:arial,sans-serif;color:#000">
          Fiscal hawks want to let the assistance lapse.
         </span>
         <span>
          Killing Obamacare remains a core objective of some Republican hard-liners: Senator
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          Mike Lee
         </a>
         <span>
          , Republican of Utah, wrote on X this month that his party “ran on this for a decade. We shouldn’t run from it now.”
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          But actually scrapping the Affordable Care Act has grown politically risky. Perhaps sensing that, Republican leadership in Congress seems intent to change the topic away from the health care fight. (That said, the White House argues that Democrats want to lock in health care subsidies to spend on “
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          illegal immigrants and other noncitizens
         </a>
         <span>
          ” — a claim that has been
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          labeled misleading
         </a>
         <span>
          .)
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          Senator John Thune, the majority leader, has said that Republicans would be open to negotiating an extension, but only after the government reopens. In an interview with “Face the Nation” yesterday,
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          Senator Mark Kelly
         </a>
         <span>
          , Democrat of Arizona, said the shutdown could be swiftly resolved, if the Republicans would “sit down and have a negotiation with us.”
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span style="font-weight:700;font-family:arial,sans-serif;color:#000">
          Lawmakers don’t have much time.
         </span>
         <span>
          About a dozen states so far have published A.C.A. health
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          insurance prices for 2026
         </a>
         <span>
          , showing many premiums skyrocketing absent action by Congress. By the end of next week, dozens more states will reveal pricing for next year.
         </span>
        </p>
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             <ul class="css-1dtd48z" style="color:#000;font:20px georgia,serif;text-align:left;padding-left:50px;list-style-type:square;margin-bottom:10px">
              <li style="margin:0 0 10px 0;line-height:27.5px">
               <span style="font:normal 17px/25px georgia,serif;vertical-align:middle">
                In related news, here’s why President Trump’s promise to
               </span>
               <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline;font:normal 17px/25px georgia,serif;vertical-align:middle">
                tap billions in tariff revenue
               </a>
               <span style="font:normal 17px/25px georgia,serif;vertical-align:middle">
                for purposes like paying troops at risk of missing a paycheck isn’t exactly straightforward.
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           <h3 style="color:#000;font:700 17px/25px arial,sans-serif;margin:5px 0 30px 0;letter-spacing:.2px">
            <span>
             HERE’S WHAT’S HAPPENING
            </span>
           </h3>
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        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span style="font-weight:700;font-family:arial,sans-serif;color:#000">
          China’s economy holds steady during the trade fight with the U.S.
         </span>
         <span>
          During the third quarter, it
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          expanded 1.1 percent
         </a>
         <span>
          over the previous quarter, maintaining about the same pace as during the spring. It’s a sign that the country has managed to maintain strong exports and continued investment despite falling retail sales and other pressures from the tariff battle with the Trump administration.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span style="font-weight:700;font-family:arial,sans-serif;color:#000">
          An Amazon Web Services outage eases after hours of online disruptions.
         </span>
         <span>
          The cloud computing giant said that it was seeing “significant signs of recovery” after a problem at an Amazon cloud computing division in the U.S. caused
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          interrupted service at hundreds of websites
         </a>
         <span>
          and apps. The outage underscored for some the fragility of internet infrastructure, with many apps and other services dependent on a few major tech companies.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span style="font-weight:700;font-family:arial,sans-serif;color:#000">
          President Trump says he will withdraw aid to Colombia.
         </span>
         <span>
          Trump issued his threat after President Gustavo Petro of Colombia
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          accused the U.S. of killing a fisherman
         </a>
         <span>
          in a strike on a boat in the Caribbean; the U.S. leader accused his counterpart of doing “nothing” to stop what he says is illegal drug production in his country. The U.S. gave
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          more than $200 million in foreign aid
         </a>
         <span>
          to Colombia in the 2025 fiscal year.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span style="font-weight:700;font-family:arial,sans-serif;color:#000">
          A hunt is on for suspects in the Louvre Museum daylight robbery.
         </span>
         <span>
          Burglars used an electric ladder and grinders to break into the Paris museum yesterday morning, stealing
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          eight precious objects
         </a>
         <span>
          , including a diadem worn by Empress Eugénie, the wife of Napoleon III. It is the latest in a line of recent robberies at French museums, including the theft of raw gold worth about $700,000 from the National Museum of Natural History.
         </span>
        </p>
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            <img alt="A user holding an iPhone with the OpenEvidence app on its screen." class="css-xsf469" height="333" src="https://inboxflows.com/_/image/https%253A%252F%252Fstatic01.nyt.com%252Fimages%252F2025%252F10%252F20%252Fbusiness%252F20db-openevidence%252F20db-openevidence-jumbo.jpg/?inbox_flows_img_sig=eyJwYXRoIjoiaHR0cHMlM0ElMkYlMkZzdGF0aWMwMS5ueSIsInRpbWUiOjE3NjA5NjE5OTIuMDA0NjgxNn0:1vAoem:OXANKj8GEpgRHNYyRD2qn3IEs1BJwZsrKjyTnDg6OiM" style="display:inline-block;width:83%;max-width:500px;height:auto;padding-top:10px;padding-bottom:0;line-height:0" width="500"/>
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           <td style="text-align:center;width:100%;padding-top:6px;padding-bottom:20px;line-height:12px">
            <span class="css-1wuwhda" style="width:83%;max-width:500px;display:inline-block;text-align:left">
             <span class="css-1hnedf7" style="color:#666;font:normal 12px georgia,serif">
              OpenEvidence, a medicine-focused chatbot, now supports 15 million clinical consultations a month, according to the company.
             </span>
             <span style="margin:0;font:11px/11px georgia,serif;color:#888;letter-spacing:.01em;padding-left:5px">
              OpenEvidence
             </span>
            </span>
           </td>
          </tr>
         </tbody>
        </table>
        <h2 class="css-10nzuqq" style="color:#000;font:700 25px/32px arial,sans-serif;margin:0 0 10px">
         <span>
          Exclusive: An A.I. tool for doctors raises a big new round
         </span>
        </h2>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          Mega-chatbots like ChatGPT and Anthropic that are trained on giant stores of information have captured most of the world’s attention around artificial intelligence. But investors see value in smaller, more specialized applications as well.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          One of them, the medicine-focused OpenEvidence,
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          has raised new money
         </a>
         <span>
          just a few months after its last fund-raising round, Michael de la Merced is the first to report.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span style="font-weight:700;font-family:arial,sans-serif;color:#000">
          OpenEvidence has raised $200 million at a $6 billion valuation,
         </span>
         <span>
          Daniel Nadler, the start-up’s co-founder and C.E.O., told DealBook. The new round came after it
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          raised $210 million
         </a>
         <span>
          in July at a $3.5 billion valuation.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          The latest round was led by Google Ventures, an existing backer, and also included Sequoia Capital, Kleiner Perkins, Blackstone, Thrive Capital, Coatue Management, BOND and Craft.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span style="font-weight:700;font-family:arial,sans-serif;color:#000">
          The company aims to be an A.I.-driven tool for medical providers.
         </span>
         <span>
          OpenEvidence draws on journals from JAMA and the New England Journal of Medicine — “blue-chip stuff,” Nadler said — to help answer queries by doctors, nurses and other professionals.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          To Nadler, the app helps practitioners treat patients faster and more precisely, increasingly important when time is tight and medical workloads are higher than ever.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span style="font-weight:700;font-family:arial,sans-serif;color:#000">
          A key to the app’s growth:
         </span>
         <span>
          It charges no fees for its use, though full access requires users to enter their National Provider Identifier, and instead runs ads. Nadler said that the setup had helped it expand to more than 10,000 medical centers since the company was founded in 2022, supporting 15 million clinical consultations a month. (That’s up from
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          8.5 million consultations a month
         </a>
         <span>
          in July.)
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          The rapid growth helped persuade Google Ventures to invest — and so soon after helping lead its last round, said Sangeen Zeb, a partner at Google Ventures. OpenEvidence, Zeb told DealBook, had achieved “verb-like status.”
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          Zeb added that the investment round came together quickly: His colleagues took Nadler out to dinner on a Thursday over the summer after a joint presentation to ad buyers, pitched him on raising another round, and ironed out many of the details by Sunday.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span style="font-weight:700;font-family:arial,sans-serif;color:#000">
          Up next:
         </span>
         <span>
          The fund-raising round comes as investors increasingly question whether the A.I. boom — and the vast amounts of money being spent at soaring valuations —
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          has become overheated
         </a>
         <span>
          .
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          But Nadler expects OpenEvidence to keep growing rapidly. The company has forecast that it would hit $100 million in ad revenue next year, and it is already halfway there after having started to commercialize its app about 90 days ago.
         </span>
        </p>
        <table width="100%">
         <tbody>
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           </td>
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           <td style="border-top:1px solid #dcdcdc;padding-bottom:15px">
           </td>
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         </tbody>
        </table>
        <h2 class="css-10nzuqq" style="color:#000;font:700 25px/32px arial,sans-serif;margin:0 0 10px">
         <span>
          “I thought it was a big mistake to not invite Elon Musk when we did a big E.V. event. I mean, here he is, the major American manufacturer of extraordinary innovation in this space.”
         </span>
        </h2>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span style="font-style:italic">
          —
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline;font-style:italic">
          Kamala Harris
         </a>
         <span style="font-style:italic">
          , on the Biden administration excluding Tesla from an electric vehicle event at the White House in 2021. The omission of the prominent E.V. maker from this event was seen as one of several factors that helped push Musk more overtly to the political right; he eventually
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline;font-style:italic">
          donated nearly $300 million
         </a>
         <span style="font-style:italic">
          to President Trump and Republicans.
         </span>
        </p>
        <table width="100%">
         <tbody>
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           </td>
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           <td style="border-top:1px solid #dcdcdc;padding-bottom:15px">
           </td>
          </tr>
         </tbody>
        </table>
        <h2 class="css-10nzuqq" style="color:#000;font:700 25px/32px arial,sans-serif;margin:0 0 10px">
         <span>
          Inside Jeffrey Epstein’s bond with Leon Black
         </span>
        </h2>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          Ongoing revelations about Jeffrey Epstein and his relationships with global elites have continued to have severe consequences, including for
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          the British royal family
         </a>
         <span>
          .
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          Now a Times investigation has further uncovered how deeply the convicted sex offender
         </span>
         <a class="css-sdwaa1" style="color:#286ed0;-webkit-text-decoration:underline;text-decoration:underline">
          was tied to Leon Black
         </a>
         <span>
          , the billionaire co-founder of Apollo Global Management who relied on Epstein for advice on areas like taxes and art collecting. (Black was pushed out of Apollo in 2021 over his ties to Epstein.)
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          The Times report confirmed that Black retained Epstein for a number of services, and paid Epstein, a college dropout, far more than what prestigious traditional firms would have charged. It also revealed the sometimes cruel approach Epstein took toward his biggest client, including insult-laced emails, boasts about his value as a financial adviser and steep demands for payment.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:0 0 15px">
         <span>
          From The Times’s report:
         </span>
        </p>
        <p class="css-14jlz04" style="font:17px/25px georgia,serif;margin:0 50px 15px;color:#666">
         <span>
          While Mr. Epstein repeatedly rattled off the projects he said he was undertaking for Mr. Black, the actual role that he played — as well as the true value derived from that work — is unclear.
         </span>
        </p>
        <p class="css-14jlz04" style="font:17px/25px georgia,serif;margin:0 50px 15px;color:#666">
         <span>
          Yet Mr. Epstein told Mr. Black that the work was highly valuable. Mr. Black generally coughed up the fees Mr. Epstein requested. The total would ultimately reach $170 million. By a wide margin, Mr. Black was Mr. Epstein’s greatest source of income after 2012. (The apparent runner-up: the French banker Ariane de Rothschild, who paid Mr. Epstein at least $15 million in 2015.)
         </span>
        </p>
        <p class="css-14jlz04" style="font:17px/25px georgia,serif;margin:0 50px 15px;color:#666">
         <span>
          Mr. Epstein also gave Mr. Black access to his Rolodex. Over the years, he connected him with Bill Gates and Stephen K. Bannon. He introduced one of Mr. Black’s sons to Woody Allen to learn about film editing, according to court records. Mr. Black, meanwhile, donated millions to one of Mr. Epstein’s charities.
         </span>
        </p>
        <p class="css-14jlz04" style="font:17px/25px georgia,serif;margin:0 50px 15px;color:#666">
         <span>
          Some work that Mr. Epstein performed for Mr. Black required the utmost discretion. For instance, he helped him keep a long-running extramarital affair under wraps.
         </span>
        </p>
        <p style="font:normal 17px/25px georgia,serif;color:#333;margin:20px 0 15px">
         <span>
          Black continued to rely on Epstein even after he served jail time for soliciting prostitution from a minor. But Black eventually “fired Epstein because he was disruptive and believed the fees for his services were excessive,” one of Black’s lawyers told The Times.
         </span>
        </p>
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           <h3 style="color:#000;font:700 17px/25px arial,sans-serif;margin:5px 0 30px 0;letter-spacing:.2px">
            <span>
             THE SPEED READ
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          Deals
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