Passing budget

As Congress faces a Jan. 30 deadline to pass the FY2026 budget, one imperative must guide its work: we cannot allow a repeat of last year’s disorder.

The Trump Administration’s illegal impoundments and partisan rescissions were not technical skirmishes over process. They were a direct affront to Congress’ constitutional authority. When an administration defies the law and withholds funds that Congress has lawfully appropriated, it strikes at the core of our constitutional system.

Our democracy endures only when each branch honors its defined role. When that balance is breached, public trust erodes, government grinds toward dysfunction, and the rule of law is weakened.

As lawmakers finalize the budget, I urge them to defend the Constitution by embedding clear, enforceable safeguards that prevent any administration from nullifying the will of Congress. Passing a budget is not enough; it must be one that cannot be ignored. The stability of our democracy depends on it.

William Deignan

Medford

Rural patients

As a practicing rheumatologist in Boston, I know firsthand that convenient access to quality healthcare is essential for Bay Staters living with rheumatic diseases. Affecting the joints, muscles, and bones, more than a quarter of adults in Massachusetts suffer from arthritis — the most common form of rheumatic disease — making it difficult and painful just to leave the house, let alone to travel long distances for care.

Thankfully, rural healthcare funding was included in the One Big Beautiful Bill Act (OBBBA) earlier this year. When deciding where to allocate our portion of the funding, Massachusetts’ state legislators must remember the importance of improving rheumatology care to make necessary care for vulnerable patients more accessible. Specifically, these funds should be used to recruit more specialty providers and incentivize specialists to practice in rural settings.

Additionally, funding should support expanded telehealth reimbursement and strengthen community-based interventions so rural patients can manage their conditions locally – or even from their own homes. This is especially important for New England patients who must travel long distances for care in medical hubs like Boston. It’s time for not just telehealth, but also interstate telehealth to be a priority.

Nothing is more important for rheumatology patients than ensuring access to care while also prioritizing their safety and comfort. I urge our lawmakers to use OBBBA resources to enhance rural healthcare and preserve the independence of Massachusetts’ most vulnerable patients.

Gerald B Miley, MD, FACR

Boston