Long before she contracted COVID-19 at a Kirkland, Washington, nursing home, Barbara Dreyfuss made sure to document the wishes that would govern how she died.

The medical directive she signed last year at the Life Care Center outside Seattle called for no resuscitation if her heart stopped, no machine to help her breathe. The 75-year-old, who suffered from lung disease and heart problems, had been on a ventilator for two weeks in 2016, a grueling experience she didn’t want to repeat.

“Mom’s form said, ‘Do not resuscitate, allow natural death,’” said son Doug Briggs, 54. “That was her choice.”

So after Dreyfuss fell ill in late February, becoming one of the first U.S. patients sickened by the new coronavirus sweeping the globe, her family reluctantly allowed doctors to halt lifesaving treatment in favor of comfort care.

Dreyfuss, a once-vivacious feminist and activist, died March 1, two days before tests formally confirmed she had COVID-19. But her decision to confirm her wishes in advance could serve as an example for growing numbers of individuals and families feeling new urgency to pin down end-of-life preferences

By Julie Rovner
March 23, 2020

<br /> <span class="byline">Julie Rovner, Kaiser Health News</span><br /> <iframe id="wpcom-iframe-608b44202e505549dae5cba78d07e68a" width="100%" height="250" src="https://embeds.kff.org/protected-iframe/608b44202e505549dae5cba78d07e68a" scrolling="" frameborder="0" class="wpcom-protected-iframe"><br /> </iframe>

On March 23, 2010, President Barack Obama signed the Affordable Care Act into law. Kaiser Health News chief Washington correspondent Julie Rovner talks to NPR’s Ari Shapiro about how the ACA has changed health care in America over the past decade and also how the coronavirus pandemic ultimately may change the still embattled law. Kaiser Family Foundation Executive Vice President Larry Levitt also marked the anniversary of the law, discussing with Noel King, on NPR’s “Morning Edition,” how the law led to 20 million Americans gaining health insurance.

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[UPDATED on March 21]

Rural hospitals may not be able to keep their doors open as the coronavirus pandemic saps their cash, their CEOs warn, just as communities most need them.

As the coronavirus sweeps across the United States, all hospitals are facing cancellations of doctor visits and procedures by a terrified populace — profitable services that usually help fund hospitals. Meanwhile, the institutions also find themselves needing to pay higher prices for personal protective equipment such as face masks and other gear that’s in short supply. Vice President Mike Pence called on hospitals nationwide Wednesday to delay elective surgeries to free up capacity and resources for future coronavirus patients.

The American Hospital Association responded Thursday by asking Congress for $100 billion for all hospitals to offset coronavirus costs, citing rural hospitals’ inability to withstand huge losses for long.

“If we’re not able to address the short-term cash needs of rural hospitals, we’re going to see hundreds of rural hospitals close before this crisis ends,” warned Alan Morgan, the head of the National Rural Health Association, which represents 21,000 health care providers

WEST PALM BEACH, Fla. ― A much-needed drive-thru coronavirus testing site opened here Monday, just a few miles from the Mar-a-Lago Club, home to the country’s most high-profile COVID-19 exposure. A week ago, President Donald Trump and a few top aides hosted a festive dinner with Brazilian officials, some later found to be ill with the novel coronavirus.

Despite repeated assertions from White House officials that tests will soon be available to anyone who wants them, residents here found the reality much different. Of the 6,000 people who called for an appointment and hundreds who drove up on Monday, just 65 were able to get tested. Testing officials said they had 80 test kits left for future patients and announced Tuesday they would not take any more appointments.

What’s more, contrary to experts saying that tests would be restricted to those who need it, among those who managed to get the test was at least one worried well person without symptoms and without an increased risk of exposure.

Jay Wolfson, a professor of public health at the University of South Florida in Tampa, said he sees the “potential irony” of communities close to Trump’s home struggling to meet testing demands

Happy Friday the 13th! Which feels extra appropriate this week. One of the very few silver linings of our current situation is the 368% increase in social media pictures of people’s pets as they work from home. (Shoutout to Brianna Ehley, a health reporter at Politico, whose pup made me gasp out loud from cuteness overload.)

On to my best attempt to get you the most important and interesting news about the COVID-19 outbreak. This is one of those stories that’s changing by the minute, however, so I would highly recommend checking out KHN for our coverage and also signing up for the Morning Briefings to get a comprehensive look at what’s going on.

But here we go:

— As of this morning, the House was barreling toward a coronavirus deal after Speaker Nancy Pelosi (and the lawmakers she tapped to help her) spent yesterday working through partisan complaints together with Treasury Secretary Steven Mnuchin, who has been acting as the administration’s point person on the plan. But I’m