Any day now, the 5th Circuit Court of Appeals in New Orleans could rule the entire Affordable Care Act unconstitutional. At least it seemed that two of the three appeals court judges were leaning that way during oral arguments in the case, State of Texas v. USA, in July.

Much of what we accept as legal in medical billing would be regarded as fraud in any other sector. I have been circling around this conclusion for the past five years, as I’ve listened to patients’ stories while covering health care as a journalist and author.

It was supposed to be one place President Donald Trump and House Speaker Nancy Pelosi could strike a deal. But Pelosi and House Democrats are going it alone on drug pricing, pushing through sweeping legislation this week to bring down the cost of medicines.

Three years ago, 3.9 million Americans received a plain-looking envelope from the Internal Revenue Service. Inside was a letter stating that they had recently paid a fine for not carrying health insurance and suggesting possible ways to enroll in coverage.

If it pays off, this could be the biggest breakthrough of the year, vis-à-vis medical bills: movers and shakers in both the House and Senate have reached agreement on legislation to tackle surprise medical bills.

More than $12 billion is at stake for the nation’s health insurers Tuesday when the Supreme Court hears another Affordable Care Act case.