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On Dec. 22, President Trump signed the Tax Cuts and Jobs Act (TCJA) into law. This legislation simplified and reduced taxes for job creating corporations and millions of Americans. In addition, one of its key provisions removed the individual mandate penalty of the euphemistically-labeled “Patient Protection and Affordable Care Act” (ACA). ... Many Democrats, health industry interests and policy makers, including, according to a report in yesterday’s issue of USA today, former Health and Human Services (HHS) Secretary Tom Price, have criticized repeal of the individual mandate. This hostility is misplaced. (Roger D. Klein, 5/2)

Thanks to a little-known change made in April by the Trump administration to the exemptions provision of the Affordable Care Act (ACA), millions of Americans will have the opportunity to escape having to pay the ObamaCare penalty imposed on those who are not enrolled in a “qualifying” health insurance plan. (Justin Haskins, 5/2)

“Trump disseminated false medical records to fool the public about his health.” That is a headline you have never seen, though you should have. If you’ve gotten tired of hearing how something President Trump did would have been a major or even career-ending scandal for any other candidate, I sympathize. But that fatigue is exactly the problem, because from the beginning of his run for president, Trump has been treated not just by different rules but by rules that indulge his most dangerous tendencies. (Paul Waldman, 5/2)

For almost 140 years, The Salvation Army has been lifting up Americans in need — the hungry, the homeless, those struggling with addiction, people in every zip code who are challenged by poverty. We have seen firsthand the transformative power of dignified, stable work. Work is increasingly becoming a requirement for many forms of government assistance, from Medicaid to Supplemental Nutrition Assistance Program to Temporary Assistance for Needy Families, among others. Both the Trump administration and Congress are creating new provisions for work requirements across a broad range of means-tested public assistance programs. Also, a new executive order calls for the consolidation or elimination of federal workforce development programs. (David Hudson, 4/2)

Two patients come to my emergency department with identical symptoms. One turns out to have a potentially life-threatening problem and will need immediate surgery. The other has a minor medical condition and will be able to go home. As the patient, you don’t know if you’ll be the one with the life-threatening problem. And it’s not your job to know. It’s my job as an emergency physician. Both patients were prudent to seek emergency care. However, Anthem Blue Cross Blue Shield is trying to make it your job to diagnose yourself by warning you not to go to the emergency room unless you know that it’s a medical emergency. (Paul Kivela, 5/2)

Strong public transit is fundamental to building and maintaining healthy communities in Southeast Michigan. Connecting our communities and removing the barriers that keep patients from accessing regular health care is critical to our region’s future. The evidence is clear. Lack of access to a working regional transit system can have life and death consequences for residents of our community. It is a public health issue and an issue that we have the ability to solve. (John Fox, Jene Meyer, Dr. Anthony J. Tedeschi and Wright L. Lassiter III, 5/2)

Recently, the Centers for Medicare & Medicaid Services issued a rule that, for the first time, allows Medicare Advantage plans to offer home care as a supplemental benefit. This long-awaited decision recognizes the value that professional caregivers have in keeping older adults healthy and will enable many more Americans to access services that can help them stay healthy at home. But given that our 65-and-older population will double to 80 million in the next 30 years, this rule has to be the beginning of larger structural changes to serve this generation. (Seth Sternberg, 5/2)

Every day I wake up thinking about how to get gene therapy to the children who will benefit from this breakthrough treatment. Right after that I start thinking about how we will pay for it. I am not a doctor or a researcher or an employee of a biotech company. I’m just a mom who, through a set of unfortunate circumstances, had a front-row seat to one of the biggest medical breakthroughs in a generation: FDA approval of the first gene therapy to treat an inherited disease. This milestone was rightfully the cause for celebration by the scientists and doctors and patients who have worked for decades to develop treatments for hundreds of disorders caused by a mutation in a single gene. (Maria Kefalas, 5/3)

A decade ago, I used to go on walks. Drunken walks. In those days, gin was my companion, my confidante, my comfort. I would go to a pond near my home, then across the street to a cemetery. There is a place in the cemetery called the “City of Angels.” The baby plots. I would go there often, even though my infant son does not have a grave there, or anywhere for that matter. I would clean up the grave sites and put the toys and flowers and other mementos back to where they belonged after being blown around by the wind. The graveyard was my place to cry and feel my sadness over my son, my challenging career, and the stranglehold alcohol had on me. ...My sadness was so severe that it did not follow the hands on a clock. My problem with alcohol is frighteningly common. (Elizabeth B. Fortescue, 5/2)

Gary Jackson never stood a chance. Gary was 28 and working as a security guard at a taco truck in Oakland, Calif., in 2009 when he saw Dreshawn Lee carrying a sawed-off shotgun and reported it to police. Three months later, Lee took his revenge by shooting and killing Jackson with an AK-47-style semiautomatic assault rifle. I was the prosecutor who persuaded a jury to convict Lee and persuaded a judge to put him away for 65 years to life. But Gary’s autopsy report still haunts me. (Eric Swalwell, 5/3)

A case in point is Assembly Bill 3087, which would regulate the prices that hospitals, physicians and prescription drug makers charge commercial insurers. In turn, insurers would be told how much they could charge policyholders. ...But imposing uniform payment rates is dangerous and misguided. (Erin Trish and Dana Goldman, 5/2)

I often hear the term “able-bodied adult” when talking about KanCare expansion. I was one of those “able-bodieds,” except my body isn’t always so able. I am living with multiple sclerosis. ... Kansas needs KanCare expansion. Expansion would allow chronically ill people who have complex health care needs to continue to work, attend college and contribute to society. (Marcillene Dover, 5/3)

Researchers, police officers, and doctors have long understood the challenge of so-called frequent utilizers — mentally ill or addicted people who cycle in and out of emergency rooms and jailhouses at enormous cost, with little sign of improvement. But while the most extreme cases are easy to identify, there are plenty that go unnoticed. The problem is that individuals’ interactions with the system can be spread out over so many agencies — the police department, the community health center, the homeless shelter.There are records here and records there. But you’d have to look at them in combination — two ambulance calls for overdoses, a police call for an attempted suicide in one town and a second call, in a neighboring town, when she was the victim of an assault — to get the full picture. That’s the idea behind a promising new pilot program bringing together law enforcement, corrections officials, and health care providers in three jurisdictions: Long Beach, Calif., Johnson County, Iowa, and Middlesex County, a sprawling region that includes urban centers like Cambridge and Lowell and smaller towns like Concord and Groton. (5/3)

Homelessness is one of the largest problems facing our community. Despite spending more than $190 million in King County last year on this issue, the Seattle City Council recently decided it must raise an additional $75 million from Seattle businesses through a new tax on jobs. The council proposes no ways to measure the success of this additional spending. The council has made it clear that the new tax will be passed next month regardless of the input they received. If the City Council insists on passing this misguided tax on jobs in order to throw more money at a significant problem without a plan, we propose a compromise: Let businesses deduct donations directly to charities serving the homeless or building low-income housing from their proposed jobs-tax burden, rather than have the money be processed through government bureaucracy with the inevitable waste that entails. (Jasmine Donovan, Howard S. Wright III and Rachel Marshall, 5/2)

In response to the maternal mortality crisis Texas is facing, medical providers have offered that one solution would be expanding the availability of health insurance. Instead, Attorney General Ken Paxton has filed a federal lawsuit with elected officials across 20 states to render the Affordable Care Act unconstitutional. Rather than seeking to improve health care accessibility for Texans, Paxton will make it even more precarious. (Wendell Potter, 5/3)

As director of Santa Clara County’s Social Services Agency, I’ve seen first-hand the commitment of our social workers in Adult Protective Services (APS) to intervene and protect seniors and adults with disabilities from abuse and neglect. However, when the California Elder and Dependent Adult Civil Protection act was passed in 1982, the county and state could not have envisioned the current shortage of affordable housing coupled with the increasing aging population, or the impacts it would have on these vulnerable populations. (Robert Menicocci, 5/2)