Kao Kalia Yang has been called the foremost chronicler of Hmong life in the United States, and though this isn’t wrong, it’s the kind of tempered acclaim with which immigrant authors are especially familiar. Let’s retire the qualified praise. Her immensely powerful new book confirms Yang as one of America’s sharpest nonfiction writers.

“Where Rivers Part: A Story of My Mother” is about Tswb (pronounced “Chew”) Muas. Yang fans know her by another name. She was “Chue” in Yang’s “The Latehomecomer,” and excellent follow-up, “The Song Poet: A Memoir of My Father,” which Esquire named one of the 50 best biographies ever published.

Tswb gave birth to Yang in a Thai refugee camp, where her family lived for eight years before moving to Minnesota in 1987. Because her life has been a study in resilience, this book could’ve been too reverent for its own good. But, sticking to the approach that worked so well in “Poet,” Yang foregoes third-person narration in favor of her mother’s first-person voice. This gives the book immediacy, authenticity and humor (Yang also has an autobiographical picture book, “The Rock in My Throat,” out this month).

Born in Dej Tshuam, Laos — known locally as the Village Where the Rivers Meet — Tswb’s youth was distressing and brief. Her mother was widowed three times. Seeking stability amid chaos — North Vietnamese and Lao troops stalked members of the Hmong ethnic group, some of whom aided America during the Vietnam War — Tswb wed at 16.

Tswb consulted her mother about such decisions. “Young men who smell bad will only smell worse with age,” her mother said. Nineteen-year-old Npis — “Bee” in Yang’s previous books — must’ve smelled just fine.

Hiding in Laotian jungles, Tswb’s family survived by fishing, bartering and gathering vegetables. They made toothpaste from cooked banana peels.

In 1979, Tswb, Npis and their first child, Dawb, nearly died crossing the Mekong River, yet made it safely to a refugee camp in Thailand. There, the growing family lived near an open sewage canal and trembled as wind blew the roof off their communal house. “Pressures of this transient life” caused marital arguments.

Tswb glimpsed a different life when a letter arrived from her nephew. His family was thriving since they “resettled in a place called St. Paul.” Tswb’s family made the same journey.

In the Twin Cities, Tswb worked in factories and earned her high school diploma. More challenges awaited: Repetitive-stress injuries, depression. One of her toddlers ate lead paint.

The book is stronger for Yang’s decision to include fraught, not necessarily flattering, scenes. In one, Npis, having learned Tswb was pregnant, says he’s too old to raise another child. To Tswb, this is cowardice, the words suggesting she “kill the child inside me.”

For all its harrowing detail, “Where Rivers Part” lets the reader see the world afresh. As young Tswb washes bowls in a stream, “little minnows emerge out of the rocks to grab the bits of rice swimming down the current.” Years later, Minnesota snowdrifts assume “shapes like sheet-clad American ghosts in the orange glow of the streetlamps.”

After marrying, Tswb was known to relatives as “Npis’ wife.” In her daughter’s exceptional book, Tswb shines in the lead role.

Where Rivers Part: A Story of My Mother’s Life

By: Kao Kalia Yang.

Publisher: Atria, 310 pages, $28.99.

©2024 StarTribune. Visit at startribune.com. Distributed by Tribune Content Agency, LLC.

A captain flying on a commercial airline’s largest aircraft can bring home an average of $348,252 a year, based on recent pilot contracts that passed over the last year.

That’s just the best of the best when it comes to being a commercial airline pilot — a career that comes with years of high-earning salaries and benefits. But to get there, pilots need to invest into training and flying hours, which can often come with mounds of debt. ATP Flight School estimates it costs $108,995 to become a pilot when starting with no previous experience or $86,995 when starting with a private pilot certificate.

So what are the top commercial airlines for pilots to earn the big bucks? Here’s a list of a few.

American Airlines

At American, first-year pilots are at a flat rate, Tajer said. A first-year, first officer at American would be paid $116 an hour in 2024 under the new contract. Depending on how often that new commercial airline pilot would fly, that could mean an average $114,180 annual salary starting out, Darby said.

On average a major airline first officer in their first year flying the smallest aircraft may bring home $98,616, according to Darby.

Pay scales are based on a variety of factors, including each year of service, the type of aircraft the pilot flies and the rank of the pilot.

“It’s a good job,” Tajer said. “Each year you’ll get a pay raise because of the length of service and that goes out to 12 years. If you stay as a first officer, you’ll get an annual increase for your longevity up to 12 years and then you’ll cap out your pay per flight hour.”

Southwest Airlines

At Southwest, it is the only airline that pays per trip and a formula is used to calculate how much the pilot makes.

Southwest also only flies Boeing 737 airplanes — a difference in how other airlines get paid. First officers or captains at other major airlines, like American, can see pay bumps if they upgrade to larger airplanes.

A first-year, first officer would make approximately $133.76 an hour at Southwest, under the union’s calculations. Darby estimates that to be about $11,370 a month on average.

Top-of-scale captains at Southwest make $364.52 an hour, but Southwest believes this to be closer to $368.01. That would mean about $371,808 on average per year, Darby said.

Pilots are not paid during boarding or getting to their flight. Pilots sometimes work 10 to 12 hours a day but are only paid for when they are flying.

“What it boils down to is everybody’s competing for the best pilots, the most experienced pilots and that experience translates to safety,” Southwest Airlines Pilot Association president Casey Murray said. “When customers purchase tickets, that’s what they’re buying.”

Delta Air Lines

At Delta Air Lines, the Atlanta-based airline which nailed down its contract before all other airlines early last year, a first officer flying its smallest aircraft can make an average of $109,212 annually, according to Darby.

Pilots at Delta are represented by the Air Line Pilots Association. The deal raised their pay by more than 30% over four years. The union of about 15,000 pilots voted in the contract in March.

Flying their largest aircraft, a captain can make $420,876 a year on average.

United Airlines

United’s pilots who are first officers in their first year on the smallest aircraft can bring home a similar salary — $114,696, according to Darby’s estimate.

In July, United Airlines pilots reached an agreement for a new four-year contract, providing a cumulative increase in total compensation of as much as 40.2% over the life of the agreement.

On the other side of the scale, senior-most captains flying United’s largest aircraft can make a salary of $424,920.

Other commercial airlines

At JetBlue Airways, a first-year pilot can make $99,000. Top of the line, a captain at JetBlue flying its largest planes will make $303,840 on average.

At Allegiant Air, a first-year pilot might make around $55,356. A senior captain on average makes $222,696 flying its largest airplanes.

Spirit Airlines’ first officers starting out on the smallest aircraft make $92,868 a year. For captains flying the largest aircraft, that’s an average of $297,876 a year on average at Spirit.

Alaska Airlines pilots flying the smallest aircraft in their first year make $107,844 in the first year. As a senior captain, they can bring home $326,640 on average flying the largest airplanes at Alaska.

©2024 The Dallas Morning News. Distributed by Tribune Content Agency, LLC.

Deviled eggs — the darlings of church suppers and potlucks — may sound retro, but when served at a fancy cocktail soiree, those eggs disappear long before the canapés. You’ll be hard-pressed to see a leftover deviled egg.

The culinary term “deviled” was first used in the 18th century to refer to spicy foods. But the details of what to fill the eggs with is up to the devil who makes them. Those humble eggs are neutral and accommodate a range of flavors — smoked, pickled, herbaceous and, of course, spicy. A good deviled egg is more than the sum of its parts.

If you’re left with too many Easter eggs, try experimenting with a range of fillings. The eggs are already cooked and easy to fill. I like to make a big batch of a relatively simple stuffing, then tweak small amounts with different flavors to fill different eggs.

Theories of the best way to hard boil eggs abound. Here’s my basic method: Place the eggs in a pot with enough water to cover them by at least four inches. Set the pot over high heat, bring to a low boil, cook the eggs for 10 minutes; then with a slotted spoon, remove the eggs to an ice bath to cool for at least 5 minutes. Instant Pot users swear by the “5-5-5″ method: 5 minutes on high pressure, 5 minutes of natural release, and 5 minutes in an ice bath.

Removing the shells can be tricky. It helps to gently crack the shell all over, then run cold water over the egg while peeling it. This seems to help the shell more easily loosen up. Once the eggs are peeled, use a sharp knife to slice them horizontally. Use a teaspoon to gently remove the yolks, and pile them into a bowl for the base.

The jury is out about what fat is best to enrich the filling and enhance the flavor. Mayonnaise is a must, and some cooks add a little cream cheese or yogurt, too. Some cooks prefer a smooth, velvety filling and opt for the food processor. But if you like a few lumps, use a fork to mash the yolks with the mayonnaise.

The fun is deciding what comes next. Here you’ll find a range of options — from smoked salmon to salsa, pickled beets to pickled okra — for different fillings that can be salty, tangy, salty or hot. Taste, adjust, taste again. You won’t go wrong. The only mistake is not making enough.

Classic Deviled Eggs

Makes 24 halves.

Here is my go-to classic deviled egg recipe. Be sure to use a good mayonnaise (i.e. Duke’s) for the filling. These are great on their own, but also can be the base for a range of different options. Just season to taste and use whatever you have on hand.

• 12 hard-cooked eggs
• 1/3 c. mayonnaise
• 2 tsp. Dijon mustard, to taste
• Salt and freshly ground black pepper, to taste
• Dusting of paprika for garnish

Directions

Cut the eggs in half horizontally; carefully remove the yolks and place in a bowl. Set the whites aside.

Using a fork, mash the egg yolks with the mayonnaise until the mixture is creamy but a few lumps remain. Stir in the mustard. Season to taste with salt and freshly ground black pepper. For the most classic deviled eggs, simply scoop the filling back into the egg whites and garnish with the paprika. Or, create your own variations. Here are a few ideas.

Deviled egg variations

Mexican: Season with a splash of fresh lime juice and a little Tajin seasoning, to taste. Garnish with a sprinkle of Tajin.

Moroccan: Season with Za’atar and ground cumin; garnish with chopped parsley and grated lemon zest.

Miso Sriracha: Season with miso to taste and garnish with a drizzle of Sriracha.

Pickled: Stir in chopped pickled okra or chopped dill pickles and garnish with sliced pickle or pickled okra.

Smoked Salmon: Stir in flaked smoked salmon and prepared horseradish and garnish with capers.

Prosciutto: Stir in chopped prosciutto and garnish with more prosciutto.

Pickled Beet: In a covered container, soak the hard boiled, peeled eggs in pickled beet juice in the refrigerator overnight. Remove and discard the beet juice and garnish with chopped pickled beets.

Spicy and Corny: Stir in corn salsa and garnish with chopped cherry tomato.

Tex-Mex: Stir in chopped avocado, chili powder, a little lime juice and garnish with chili powder.

Asian Peanut: Stir in spicy peanut sauce and garnish with chopped peanuts and chopped cilantro.

Roasted Pepper: Stir in chopped roasted red peppers, a shot of hot sauce and garnish with chopped mint.

Beth Dooley is the author of “The Perennial Kitchen.” Find her at bethdooleyskitchen.com.

©2024 StarTribune. Visit at startribune.com. Distributed by Tribune Content Agency, LLC.

One January morning in 2021, Carol Rosen took a standard treatment for metastatic breast cancer. Three gruesome weeks later, she died in excruciating pain from the very drug meant to prolong her life.

Rosen, a 70-year-old retired schoolteacher, passed her final days in anguish, enduring severe diarrhea and nausea and terrible sores in her mouth that kept her from eating, drinking, and, eventually, speaking. Skin peeled off her body. Her kidneys and liver failed. “Your body burns from the inside out,” said Rosen’s daughter, Lindsay Murray, of Andover, Massachusetts.

Rosen was one of more than 275,000 cancer patients in the United States who are infused each year with fluorouracil, known as 5-FU, or, as in Rosen’s case, take a nearly identical drug in pill form called capecitabine. These common types of chemotherapy are no picnic for anyone, but for patients who are deficient in an enzyme that metabolizes the drugs, they can be torturous or deadly.

Those patients essentially overdose because the drugs stay in the body for hours rather than being quickly metabolized and excreted. The drugs kill an estimated 1 in 1,000 patients who take them — hundreds each year — and severely sicken or hospitalize 1 in 50. Doctors can test for the deficiency and get results within a week — and then either switch drugs or lower the dosage if patients have a genetic variant that carries risk.

Yet a recent survey found that only 3% of U.S. oncologists routinely order the tests before dosing patients with 5-FU or capecitabine. That’s because the most widely followed U.S. cancer treatment guidelines — issued by the National Comprehensive Cancer Network — don’t recommend preemptive testing.

The FDA added new warnings about the lethal risks of 5-FU to the drug’s label on March 21 following queries from KFF Health News about its policy. However, it did not require doctors to administer the test before prescribing the chemotherapy.

The agency, whose plan to expand its oversight of laboratory testing was the subject of a House hearing, also March 21, has said it could not endorse the 5-FU toxicity tests because it’s never reviewed them.

But the FDA at present does not review most diagnostic tests, said Daniel Hertz, an associate professor at the University of Michigan College of Pharmacy. For years, with other doctors and pharmacists, he has petitioned the FDA to put a black box warning on the drug’s label urging prescribers to test for the deficiency.

“FDA has responsibility to assure that drugs are used safely and effectively,” he said. The failure to warn, he said, “is an abdication of their responsibility.”

The update is “a small step in the right direction, but not the sea change we need,” he said.

Europe Ahead on Safety

British and European Union drug authorities have recommended the testing since 2020. A small but growing number of U.S. hospital systems, professional groups, and health advocates, including the American Cancer Society, also endorse routine testing. Most U.S. insurers, private and public, will cover the tests, which Medicare reimburses for $175, although tests may cost more depending on how many variants they screen for.

In its latest guidelines on colon cancer, the Cancer Network panel noted that not everyone with a risky gene variant gets sick from the drug, and that lower dosing for patients carrying such a variant could rob them of a cure or remission. Many doctors on the panel, including the University of Colorado oncologist Wells Messersmith, have said they have never witnessed a 5-FU death.

In European hospitals, the practice is to start patients with a half- or quarter-dose of 5-FU if tests show a patient is a poor metabolizer, then raise the dose if the patient responds well to the drug. Advocates for the approach say American oncology leaders are dragging their feet unnecessarily, and harming people in the process.

“I think it’s the intransigence of people sitting on these panels, the mindset of ‘We are oncologists, drugs are our tools, we don’t want to go looking for reasons not to use our tools,’” said Gabriel Brooks, an oncologist and researcher at the Dartmouth Cancer Center.

Oncologists are accustomed to chemotherapy’s toxicity and tend to have a “no pain, no gain” attitude, he said. 5-FU has been in use since the 1950s.

Yet “anybody who’s had a patient die like this will want to test everyone,” said Robert Diasio of the Mayo Clinic, who helped carry out major studies of the genetic deficiency in 1988.

Oncologists often deploy genetic tests to match tumors in cancer patients with the expensive drugs used to shrink them. But the same can’t always be said for gene tests aimed at improving safety, said Mark Fleury, policy director at the American Cancer Society’s Cancer Action Network.

When a test can show whether a new drug is appropriate, “there are a lot more forces aligned to ensure that testing is done,” he said. “The same stakeholders and forces are not involved” with a generic like 5-FU, first approved in 1962, and costing roughly $17 for a month’s treatment.

Oncology is not the only area in medicine in which scientific advances, many of them taxpayer-funded, lag in implementation. For instance, few cardiologists test patients before they go on Plavix, a brand name for the anti-blood-clotting agent clopidogrel, although it doesn’t prevent blood clots as it’s supposed to in a quarter of the 4 million Americans prescribed it each year. In 2021, the state of Hawaii won an $834 million judgment from drugmakers it accused of falsely advertising the drug as safe and effective for Native Hawaiians, more than half of whom lack the main enzyme to process clopidogrel.

The fluoropyrimidine enzyme deficiency numbers are smaller — and people with the deficiency aren’t at severe risk if they use topical cream forms of the drug for skin cancers. Yet even a single miserable, medically caused death was meaningful to the Dana-Farber Cancer Institute, where Carol Rosen was among more than 1,000 patients treated with fluoropyrimidine in 2021.

Her daughter was grief-stricken and furious after Rosen’s death. “I wanted to sue the hospital. I wanted to sue the oncologist,” Murray said. “But I realized that wasn’t what my mom would want.”

Instead, she wrote Dana-Farber’s chief quality officer, Joe Jacobson, urging routine testing. He responded the same day, and the hospital quickly adopted a testing system that now covers more than 90% of prospective fluoropyrimidine patients. About 50 patients with risky variants were detected in the first 10 months, Jacobson said.

Dana-Farber uses a Mayo Clinic test that searches for eight potentially dangerous variants of the relevant gene. Veterans Affairs hospitals use a 11-variant test, while most others check for only four variants.

Different Tests May Be Needed for Different Ancestries

The more variants a test screens for, the better the chance of finding rarer gene forms in ethnically diverse populations. For example, different variants are responsible for the worst deficiencies in people of African and European ancestry, respectively. There are tests that scan for hundreds of variants that might slow metabolism of the drug, but they take longer and cost more.

These are bitter facts for Scott Kapoor, a Toronto-area emergency room physician whose brother, Anil Kapoor, died in February 2023 of 5-FU poisoning.

Anil Kapoor was a well-known urologist and surgeon, an outgoing speaker, researcher, clinician, and irreverent friend whose funeral drew hundreds. His death at age 58, only weeks after he was diagnosed with stage 4 colon cancer, stunned and infuriated his family.

In Ontario, where Kapoor was treated, the health system had just begun testing for four gene variants discovered in studies of mostly European populations. Anil Kapoor and his siblings, the Canadian-born children of Indian immigrants, carry a gene form that’s apparently associated with South Asian ancestry.

Scott Kapoor supports broader testing for the defect — only about half of Toronto’s inhabitants are of European descent — and argues that an antidote to fluoropyrimidine poisoning, approved by the FDA in 2015, should be on hand. However, it works only for a few days after ingestion of the drug and definitive symptoms often take longer to emerge.

Most importantly, he said, patients must be aware of the risk. “You tell them, ‘I am going to give you a drug with a 1 in 1,000 chance of killing you. You can take this test. Most patients would be, ‘I want to get that test and I’ll pay for it,’ or they’d just say, ‘Cut the dose in half.’”

Alan Venook, the University of California-San Francisco oncologist who co-chairs the National Comprehensive Cancer Network, has led resistance to mandatory testing because the answers provided by the test, in his view, are often murky and could lead to undertreatment.

“If one patient is not cured, then you giveth and you taketh away,” he said. “Maybe you took it away by not giving adequate treatment.”

Instead of testing and potentially cutting a first dose of curative therapy, “I err on the latter, acknowledging they will get sick,” he said. About 25 years ago, one of his patients died of 5-FU toxicity and “I regret that dearly,” he said. “But unhelpful information may lead us in the wrong direction.”

In September, seven months after his brother’s death, Kapoor was boarding a cruise ship on the Tyrrhenian Sea near Rome when he happened to meet a woman whose husband, Atlanta municipal judge Gary Markwell, had died the year before after taking a single 5-FU dose at age 77.

“I was like … that’s exactly what happened to my brother.”

Murray senses momentum toward mandatory testing. In 2022, the Oregon Health & Science University paid $1 million to settle a suit after an overdose death.

“What’s going to break that barrier is the lawsuits, and the big institutions like Dana-Farber who are implementing programs and seeing them succeed,” she said. “I think providers are going to feel kind of bullied into a corner. They’re going to continue to hear from families and they are going to have to do something about it.”

(KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF — the independent source for health policy research, polling and journalism.)

©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

Elizabeth Bauer was working out at the gym one morning last August when she got a phone call from her fertility nurse. It was a call that Bauer and her wife, Rebecca, had long been waiting for.

Elizabeth dialed in Rebecca so they could listen together: They were pregnant.

The Washington, D.C., couple decided before they got married three years ago that they wanted to have a child. Both wanted to play a biological part in the pregnancy. So, they used a process called reciprocal in vitro fertilization, through which eggs were retrieved from Rebecca and fertilized with donor sperm to create embryos. Then one of the embryos was implanted in Elizabeth’s uterus.

Elizabeth, a 35-year-old elementary school teacher, and Rebecca, a 31-year-old nonprofit consultant, had health insurance, but it wouldn’t cover the roughly $20,000 procedure, so they had to pay out of pocket.

But beginning next year, insurers providing coverage in D.C. will have to pay for IVF for beneficiaries, including same-sex couples, who can’t conceive on their own. Only seven states (Colorado, Delaware, Illinois, Maine, Maryland, New Jersey and New York) have similar mandates. However, a new definition of “infertility” could prompt other states to follow suit.

The American Society for Reproductive Medicine in October expanded the definition of infertility to include all patients who require medical intervention, such as use of donor gametes or embryos, to conceive as a single parent or with a partner. Previously, the organization defined infertility as a condition in which heterosexual couples couldn’t conceive after a year of unprotected intercourse.

The group emphasized the new definition should not “be used to deny or delay treatment to any individual, regardless of relationship status or sexual orientation.”

Dr. Mark Leondires, a reproductive endocrinologist and founder and medical director at Illume Fertility and Gay Parents To Be, said the new definition could make a huge difference.

“It gives us extra ammunition to say, ‘Listen, everybody who meets the definition of infertility, whether it’s an opposite-sex couple or same-sex couple or single person, who wants to have a child should have access to fertility services,’” he said.

At least four states (California, Connecticut, Massachusetts and Rhode Island) are currently weighing broader IVF coverage mandates that would explicitly include same-sex couples, according to RESOLVE: The National Infertility Association. Bills were introduced but failed to advance in Oregon, Washington and Wisconsin.

A recent policy shift at the federal level also might add to the momentum. Earlier this month, the departments of Defense and Veterans Affairs announced expanded IVF service benefits to patients regardless of marital status, sexual orientation or whether they are using donor eggs or sperm. The new policy follows a lawsuit filed in federal court last year.

“The federal government is the largest employer in the country, so if they’re providing these type of benefits, it definitely adds pressure on other employers and states to do the same,” said Betsy Campbell, RESOLVE’s chief engagement officer.

A total of 21 states have laws mandating that private insurers cover fertility treatments, but only 15 include at least one cycle of IVF in that mandate. Only New York and Illinois provide some fertility coverage for people who are insured through Medicaid, the state-federal program for people with low incomes and disabilities. Neither state covers IVF for Medicaid recipients.

100,000 babies

IVF involves collecting mature eggs from ovaries, using donated sperm to fertilize them in a lab, and then placing one or more of the fertilized eggs, or embryos, in a uterus. One full cycle of IVF can take up to six weeks and can cost between $20,000 and $30,000. Many patients need multiple cycles before getting pregnant.

Nearly 100,000 babies in the U.S. were born in 2021 through IVF and other forms of assisted reproductive technology, such as intrauterine insemination, according to federal data.

IVF continues to garner nationwide attention in the wake of the Alabama Supreme Court’s ruling last month that under state law, frozen IVF embryos are children, meaning patients or IVF facilities can be criminally charged for destroying them. The decision caused an uproar, and three weeks later Alabama Republican Gov. Kay Ivey signed a bill into law that provides criminal and civil immunity for IVF clinicians and patients.

Polly Crozier, director of family advocacy at GLBTQ Legal Advocates & Defenders, or GLAD, described the Alabama decision as “a shock to the system.” But Crozier said the reaction to it sparked a “bipartisan realization that family-building health care is important to so many people.”

Crozier praised the insurance mandates in Colorado, Illinois, Maine and Washington, D.C., for more explicitly including LGBTQ+ people. Maine’s law, for example, states that a fertility patient includes an “individual unable to conceive as an individual or with a partner because the individual or couple does not have the necessary gametes for conception,” and says that health insurers can’t “impose any limitations on coverage for any fertility services based on an enrollee’s use of donor gametes, donor embryos or surrogacy.”

Christine Guarda, financial services representative at the Center for Advanced Reproductive Services at the University of Connecticut School of Medicine, said more same-sex couples are seeking help starting families. One reason, she said, is that more large employers that provide insurance directly to their employees, such as Amazon, are including broad IVF coverage.

‘Elective procedure’?

But some lawmakers are skeptical of expanding the definition of infertility to include same-sex couples. That was evident at a hearing on the Connecticut bill earlier this month, where Republican state Rep. Cara Pavalock-D’Amato noted that “infertility isn’t necessarily elective, but having a baby is.”

“Now, we are changing definitions to cover elective procedures,” Pavalock-D’Amato said. “If we’re changing the definition for this elective procedure, then why not others as well?”

She added: “Infertility, whether you are straight or gay, up to this point has been a requirement. Now, is it through this bill that we are no longer requiring people to be sick? They no longer have to be infertile?”

But proponents of the change argue that extending IVF mandates to cover same-sex couples is a question of fairness.

“I don’t think anybody in the LGBTQ community is asking for more. They’re just asking for the same benefit, and it is discriminatory to say, ‘You don’t get the same benefit as your colleague simply because you have a same-sex partner,’” Leondires said in an interview.

“If you’re paying to the same health care system as the person sitting next to you, then you should have the same benefit,” he said.

Elizabeth and Rebecca Bauer, who are busy decorating a nursery and buying baby clothes, recognize that they were fortunate to have the money to pursue IVF even without insurance coverage, and that “there are plenty of people who don’t have the time or the ability.”

“There are so many ways that people who want to build a family might struggle,” Elizabeth said, adding that the previous infertility definition felt like a “pretty impossible barrier” for non-straight couples. “Insurance should make building a family possible for any person or persons who want to.”

Stateline is part of States Newsroom, a national nonprofit news organization focused on state policy.

©2024 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

In a real estate transaction, there’s always some level of negotiation. If you’re the seller, you face haggling not only with prospective buyers, but also with the person you’re working with to seal the deal: your real estate agent.

Thanks to a federal lawsuit that was recently settled, the way real estate commissions work will change in July 2024 (pending court approval). If you’re looking to save some money, here’s what you need to know about how commissions work, and how to agree on a rate that both you and your agent can feel good about.

How real estate commission works, and who pays for it

A generation ago, real estate commission rates were typically around 6% of a home’s sale price. But the average real estate commission rate has gone down in recent years to just under 5% of a home’s sale price, according to Real Trends, a real estate research and consulting firm, and to Anywhere Real Estate, the parent of Century 21, Coldwell Banker and other brokerage brands.

Under the current system, the fee is typically paid by the seller at closing, and it’s customarily split down the middle between the seller’s agent and the buyer’s agent. (So, for a 5% commission, each agent would earn 2.5%.) On a $400,000 transaction, which is around the median sale price nationwide, the 5% fee amounts to $20,000.

Agents and brokerages can offer a variety of commission structures, though, with some marketing flat fees or other incentives. So there may be opportunity to negotiate the rate if you’re looking to save on the cost of selling your home.

“There are agents and brokerages that reduce, discount or coupon their services,” says Kevin Van Eck, an executive with @properties, a brokerage in Chicago. “Each agent, along with their brokerage, can determine where they set commissions based on the value and success created.”

Can you negotiate Realtor fees?

Often, yes, there is room for bargaining. And as of July, there may be even more room. As a result of a lawsuit involving the National Association of Realtors (NAR) and several major brokerages, new commission rules will take effect that month that will mean sellers no longer have to cover the cost of the buyer’s agent’s fee, which may lead to more aggressive price competition among buyer’s-side agents. In addition, listing agents will no longer be permitted to state the buyer’s agent commission in the MLS (multiple listing service), as has been common practice.

Your success at negotiating often depends on an individual agent’s circumstances, says Dave Liniger, chairman and co-founder of RE/MAX Real Estate. “Some agents are dead-set,” he says. “Other agents need the business so bad they’ll readily negotiate.”

As you prepare to list your home for sale, you may want to meet with a few listing agents to find the right one for the job. Ask each agent about their commission rate and what exactly you’ll be getting for that price. Consider not only how the agent plans to market your home, but also their skill in pricing it, experience, resources and track record.

“It’s OK for a seller to ask about the commission, but the best time is after talking with the agent and understanding their experience, how they will create exposure for the home and the value they bring to the table,” says Van Eck.

Liniger suggests that sellers invite three to five listing agents to their homes to make their pitches. The competing proposals will let you see how much agents charge, and give you leverage to bargain for a better deal. “You don’t get if you don’t ask,” he says.

You might also consider weighing what you learn from full-service agents against the services of a discount broker. Just keep in mind that the discounter’s offerings may be limited compared to those of a traditional agent.

How to negotiate real estate commissions

Once you understand exactly what you’re paying for, you will be in a better position to ask for a discount. Here are some tips:

• If you’re able to offer the agent more than one listing opportunity, that might be a compelling argument for a reduced commission. “If [you’re] a real estate investor who is looking to offload several properties, I would definitely talk about the commission,” says Dana Bull, an agent with Compass in the Boston area. Most agents welcome repeat business, she says.
• If you don’t have another listing opportunity of your own to offer, try leveraging your ability recommend the agent to others in your neighborhood or network. This might be especially impactful if you know they are looking to build their business. “I can’t just slash my commission, but I might be willing to give a slight discount if the client offered some sort of other strategy to get more business after the sale,” Bull says.
• If you have a home in a sought-after area, or a buyer already interested, or an unusually high sale price, your agent may not need to do as much to earn their fee. If neither party can foresee the need for additional services — “if an agent is coming in to basically just do some hand-holding, keeping the transaction on schedule and assisting with paperwork,” Bull says — that might be another good reason to propose a slightly lower rate.
• If you plan to buy a new home while selling your current one, use that in your favor. Liniger says an agent who can represent you on both the sale and the subsequent purchase will likely be willing to cut their fee.

You may be considering skipping the commission conversation entirely and selling your home yourself. If so, be aware: While an experienced house flipper might be skilled enough to list a home without an agent, for most homeowners, the for-sale-by-owner route can be more challenging, more costly and more time-consuming in the long run.

Bottom line

In any negotiation, both parties must be willing to give and take. Negotiating your agent’s commission can work in your favor, but an agent can walk away if they don’t necessarily need your business. Keep in mind, too, that it can make sense for sellers to pay more for additional services instead of negotiating the commission down, Bull says. These might include higher-end marketing, home staging or additional mailers, for instance. And if you’re not in a rush, consider waiting until after the July rule change to see how things shake out. Ultimately, it’s important to find an agent you can speak with openly about cost, and who you trust to do the best job to sell your home.

(Visit Bankrate online at bankrate.com.)

©2024 Bankrate.com. Distributed by Tribune Content Agency, LLC.

Noise is my nemesis, quiet being one of my cherished but most elusive of holy grails.

So when deciding where to go for a much-needed vacation at the beginning of March, I decided to spend it at a luxury resort, The Somerset on Grace Bay in Providenciales, Turks and Caicos. Fingers crossed that I would find a modicum of peace and serenity.

I had viewed online photos and videos of the property. It certainly looked beautiful, but would it achieve my high standards for low decibels?

This was my third trip to T&C, my first to The Somerset.

It’s not the newest “kid on the block” (it was built in 2006). Shinier “kids” have arrived on the scene — a few of which I have visited — but there is something more genteel, relaxed and intimate about this property. It immediately felt like home. The Somerset oozed charm, without the noisy bells and whistles that many resorts display, mistaking intense activity and helicoptering attention for thoughtful but unobtrusive service.

Part of the charm resided in the configuration of the Spanish Mediterranean style of architecture of yellow stucco capped by the red clay roof. The four-story residences, housing one- to five-bedroom suites, formed a horseshoe shape allowing each unit to have an unobstructed view of Grace Bay Beach. With its miles-long shoreline of silky white sand, Grace Bay is listed among Tripadvisor’s “Best of the Best” beaches for 2024.

I arrived at night after a 90-minute flight from Fort Lauderdale, Florida, so I didn’t see the crowning centerpiece of the property until early the next morning. I opened the floor-to-ceiling drapes in my one-bedroom suite, stood out on the terrace and gaped in amazement at the stunning lap and infinity pools that seemed to flow straight into the ocean. An employee was carefully cleaning the pools while another was setting up the chaise lounges with pristine white covers and rolled towels.

Key to a great resort vacation is the staff. It turns out that many of the employees have been there since The Somerset opened — a good sign. They understand understated hospitality but deliver it with ease and a kind of natural friendliness, as if you’ve known them all your life.

There’s a gym onsite, which I didn’t use because I wanted as much sun and sand and water as I could possibly squeeze into my short stay. But I did avail myself of a sublime massage on my suite terrace. Yuli, a therapist all the way from Bali, knew exactly how to knead those stressed muscles into submission. While working her wonders, the sound of birds and the ever-present warm island breeze kept us company.

Each of the 53 accommodations is uniquely decorated. My 1,500-square-foot suite was airy, modern and immaculate. The kitchen offered every imaginable culinary gadget, Viking and Bosch appliances, and a separate glass wine refrigerator. The king-size bed was mercifully comfy in a massive bedroom bracketed on one side by a Juliet balcony and on the other by the ensuite bathroom and separate closet room.

I may have been the solo traveler there, but had the pleasure of meeting a host of couples young and senior, many with their children or grandchildren. The resort is known for its Caicos Kids Club designed for children ages 3 to 12. While parents grab a bit of free time, an array of supervised activities such as arts and crafts, treasure hunts and beach games occupy the little ones.

For bigger kids like myself, the sea offers endless adventures. Although I was almost enticed into parasailing, I opted for less height and more splash on one of the Hobie Cats that the resort provides. I even let out a few hoots when I first straddled what felt like a trampoline on wings with a sail attached. It was a particularly windy day, and the youthful Navigator steered the craft out into the wild blue yonder. It was thrilling, and a bit scary, when a huge wave danced all over me. But I survived to tell the tale.

Then as my reward for being so brave, I plunked myself down on a beach chaise lounge strategically placed near the water’s edge and munched on a grilled shrimp salad washed down by an intoxicating coconut rum punch served by a waiter from The Somerset’s poolside restaurant. Watching the swimmers, kayakers, parasailers, sailboats and sunbathers was entertainment enough.

Once the headiness of the drink wore off, the sunny beach beckoned me for a long, leisurely stroll.

Grace Bay itself stretches about three miles, but it connects seamlessly with two other beaches so one could conceivably walk for about 12 miles. I didn’t count my steps, but I viewed various properties along the way — some very modern, others a bit worse for the wear — and I liked that the area was not overcrowded and the resorts were spread out so a sense of privacy prevailed. But for me, my Somerset “home” was where I wanted to cocoon. So back I went for my last evening meal at Barbetta. Grilled mahi mahi with asparagus, saffron infused potatoes followed by crackling creme brûlée.

While checking out the last morning of my stay, a couple was just arriving. The woman asked me, “Is it quiet here?”

“Yes,” I said truthfully, “and peaceful.” She turned to her husband with a big smile and said, “That’s exactly what we need.”

A fitting end to my holy grail pursuit and a positive introduction to theirs. Maybe on my next trip I’ll try the parasailing. Fingers crossed.

(For more information, visit thesomerset.com.)

©2024 Tribune Content Agency, LLC.

A trip across the pond has many amazing things to offer, like landmarks, history, food, art and museums — the experience alone can benefit the entire family. However, the No. 1 reason people don’t go on vacation is the cost.

Being strapped for cash shouldn’t deny you the luxuries of experiencing European culture. Whether you need a passport or have to update one, can’t find the time to take off more than a week from work, or the cost isn’t appealing, you can still visit European-inspired sights right here in the United States.

Here are five cities that have a European feel without the long flight.

New Orleans

Highly influenced by French and Spanish ways of life, New Orleans is a melting pot of cultures with a rich history. It was settled by the French and turned over to the Spaniards to settle a war debt. Spain ruled from 1763 to 1803. The city has boisterous music, authentic cuisine, art and museums to explore.

Tarpon Springs, Florida

Tarpon Springs has the look and feel of Greece; according to Tarpon Arts, it has the highest concentration of Greek Americans in the country. These residents contribute their culture, food, clothing, experiences and more to the city.

Montpelier, Vermont

Montpelier is the smallest state capital in the U.S., with a population of just more than 7,000 people. The connection between America and France is on display, giving the quaint town the feel of a French countryside village with shops, green hills, farmers markets, European architecture and more.

Holland, Michigan

When given a name like Holland, you have to live up to your namesake. That is exactly what this little city in Michigan does. It’s dressed with cobblestone streets much like the ones in Europe and nostalgic countryside architecture. The city has authentic Dutch windmills, beaches, food and art — giving the perfect balance of a European, beach and small-town feel.

Solvang, California

After being settled by the Spanish, a small population of Danish people came to Solvang for new beginnings. The city which is not far from Santa Barbra, has transformed into a Danish haven. Nestled in the Santa Ynez Valley, Solvang is happily cultured in its European roots and proudly brings its residents and visitors authentic bakeries, eateries, museums, art and more.

Experiencing European culture doesn’t have to break the bank. Until you can accumulate the necessary funds to afford a trip overseas, taking a small vacation in the U.S. is the perfect substitute.

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©2024 The Atlanta Journal-Constitution. Visit at ajc.com. Distributed by Tribune Content Agency, LLC.

The cozy mystery makes for perfect escapism.

Sometimes we want to set aside stories of grisly violence, gritty reality and dysfunctional cops to reach for soft-boiled, soft-focused tales of crime and detection comprising quaint villages, quirky characters and ample wit, charm and twists.

Kristen Perrin, originally from Seattle and now based in the U.K., has turned her hand to cozy crime for her adult debut. The enticingly titled “How to Solve Your Own Murder” incorporates key components of the genre. Its plot pivots on a decades-old prediction. In 1965, 17-year-old Frances visited a fair and learned from a fortune-teller that she would be murdered. Instead of dismissing the prophecy, Frances believed it and spends her life trying to prevent her early demise by gathering information on everyone she knows —ruffling many feathers in the process.

In the present day, Annie, an aspiring crime writer living in London, receives a letter out of the blue from Frances’ solicitor. Frances has named her great-niece sole benefactor of her estate and would like her to attend a meeting. Annie is baffled; she has never met her relative. Her confusion turns into shock when she arrives at Gravesdown Hall in the village of Castle Knoll and finds Frances dead.

Foul play is suspected, and at the reading of the will Frances issues a challenge from beyond the grave: In order to claim her inheritance, Annie must solve her great-aunt’s murder in one week.

“Frances may be nutty, but she’s very calculating. And she likes to play games,” explains Annie’s mother. This game involves Annie assuming the role of amateur sleuth and working against the clock to unmask a killer.

She trawls through the photos, notes and reports that Frances has amassed over the years in her “murder room,” and delves into the past by way of Frances’ journal. She compiles a growing list of suspects that includes a shifty property developer, a gardener with a “side business,” Frances’ friends and family — even a vicar and a detective. Annie also tries to decode the fortune-teller’s cryptic prediction, a riddle about a queen, a bird and dry bones.

As Annie investigates, we join her in weighing the significance of seemingly innocuous details (Frances’ messy bouquet of flowers, her recent car trouble) and answering nagging questions. Is Frances’ death connected to the decades-old disappearance of her friend Emily? And why, after 60 years, did Frances’ killer strike now?

Perrin’s update on the classic murder mystery is impaired by its far-fetched premise and a plot that becomes convoluted rather than intricate. In addition, not all her characters’ voices ring true. On the plus side, the pace never lets up and tension mounts when anonymous threats and a body in a trunk make Annie realize that her life might be in danger. The result is a fun yet flawed whodunit.

How to Solve Your Own Murder

By: Kristen Perrin.

Publisher: Dutton, 360 pages, $28.

©2024 StarTribune. Visit at startribune.com. Distributed by Tribune Content Agency, LLC.

At the U.S. Supreme Court these days, judicial liberals don’t have much clout. The real fights mostly take place between the court’s far-right and its more traditional conservatives.

Tuesday’s argument over abortion pills provided a perfect example, and it highlighted the stakes the 2024 presidential election will have for the court. In particular, it illustrated one of the ways a second term for former President Trump could dramatically differ from his first, with huge consequences for abortion rights, among other topics.

Abortion endangers the GOP

The political backdrop to the high court’s argument is clear: The politics of abortion continue to bedevil Republicans.

The GOP achieved a long-standing goal in 2022 when the newly reinforced conservative majority on the court overturned Roe vs. Wade, the ruling that for nearly a half-century had guaranteed abortion rights nationwide. The court’s decision in Dobbs vs. Jackson Women’s Health tossed abortion policy back to the states, 15 of which now ban all or nearly all abortions, with six more imposing tight restrictions.

Those bans have not succeeded in reducing the number of abortions in the U.S., largely because of the wide availability of abortion pills. But they have generated a wave of anger among voters, especially women, that has sunk Republican candidates in swing districts and states.

The most recent example came a few hours after the high court argument, when a Democrat, Marilyn Lands, won a special election to fill a largely suburban state legislative district in northern Alabama. Lands had focused her campaign on reproductive rights.

Her landslide victory — a 25-point margin in a closely divided district — was the first test of voter sentiment since the Alabama Supreme Court’s ruling that frozen embryos created by in vitro fertilization should be considered children under state law, a decision that the state legislature hurriedly tried to overturn after furious voter reaction.

The conservative split

The lesson that many traditional conservatives have drawn from their election defeats is that the GOP should ease away from opposition on abortion. That may have influenced some of the Republican-appointed justices as they considered Tuesday’s challenge to the Food and Drug Administration’s rules that allow widespread dispensing of mifepristone: They treated the case like an unwelcome guest — to be ushered out as rapidly as possible with a stern admonition not to return.

To the justices on the far right, it represented something else — a missed opportunity for now and a chance to set down markers for the future.

Representing the Biden administration, Solicitor General Elizabeth B. Prelogar argued that the antiabortion group seeking to overturn the rules lacked standing to bring the case.

Standing refers to the legal principle that to challenge a law or rule, you have to be affected by it — you can’t just have a generalized grievance.

The antiabortion doctors who brought the case claimed they were affected because at some point, one of them might be in an emergency room when a woman who had taken mifepristone would show up seeking treatment for heavy bleeding, which is an occasional effect of the drug. If that happened, they would be forced to choose between their conscientious objections to abortion and their duty to care for a patient, they argued.

Prelogar said those claims “rest on a long chain of remote contingencies” that didn’t come “within a hundred miles” of establishing standing.

Even if the doctors had standing, the proper remedy for their claim would be to say that they could not be required to participate in an abortion — a right they already have under federal law, said Justice Ketanji Brown Jackson.

Justice Neil M. Gorsuch agreed. The case was “a prime example of turning what could be a small lawsuit into a nationwide legislative assembly on an F.D.A. rule or any other federal government action,” he said. He didn’t mean that as a compliment.

Gorsuch, of course, was appointed to the court by Trump. Another Trump appointee, Justice Amy Coney Barrett, also appeared skeptical that the doctors had standing. The third Trump appointee, Justice Brett M. Kavanugh, said very little, but the one question he asked suggested that he, too, would likely side with the FDA.

How Trump could ban abortion pills

Justices Samuel A. Alito Jr. and Clarence Thomas were the only members of the court who seemed open to the arguments presented by Erin Hawley, the lawyer representing the antiabortion group.

In their questions, both also circled back to a related legal issue, the potential impact of an 1873 law known as the Comstock Act. That law, best known for banning “lewd” material from the mail, also bans any “article, instrument, substance, drug, medicine, or thing which is advertised or described in a manner calculated to lead another to use it or apply it for producing abortion.”

The law hasn’t been enforced in decades, but up through the 1930s, it was repeatedly used to prosecute people for mailing birth control devices or even medical texts about contraception.

In 2022, the Justice Department issued a formal ruling that the law wasn’t applicable to mifepristone because the drug has medical uses beyond abortion.

That ruling, however, could be reversed by a future administration. Antiabortion groups have made clear that if Trump wins another term, they’ll make the Comstock Act a high priority.

The Comstock law is “fairly broad, and it specifically covers drugs such as yours,” Thomas said at one point to Jessica Ellsworth, the lawyer representing Danco Laboratories, which makes mifepristone. His remark sounded like a warning.

Why two Bush justices, not Trump ones, make up the far right

The comments by Gorsuch and Barrett on the one side and Thomas and Alito on the other highlighted a paradoxical reality of the current court: The justices Trump named to the court aren’t the ones most likely to side with the MAGA movement’s priorities. Instead, the far-right members, Thomas and Alito, were appointed by two avatars of the pre-Trump GOP establishment — the Presidents Bush, father and son.

That doesn’t mean that the three Trump appointees are moderates. They’re solidly conservative. But they are establishment conservatives.

During Trump’s tenure, the process of picking and confirming Supreme Court justices was largely driven by Senate Majority Leader Mitch McConnell of Kentucky, working with Trump’s White House counsel, Don McGahn. Trump had relatively little to do with it beyond ratifying the ultimate selections.

McConnell and McGahn looked for justices in their ideological image, not Trump’s.

By contrast, George H.W. Bush chose Thomas without knowing much about him. He wanted a Black jurist to replace Justice Thurgood Marshall, and he didn’t have a lot of Black Republican judges to choose from. The full scope of the new justice’s ideology was unknown when he was named.

Alito was more of a known commodity when George W. Bush appointed him, but he wasn’t the president’s first choice. Bush had tried to put his counsel, Harriet Miers, on the court. But he had to withdraw Miers’ name after intense opposition from the right. The choice of Alito was an effort at political damage control.

But McConnell won’t be Senate Republican leader after this year — he’s already announced his plans to step down. And Trump isn’t likely to appoint anyone to the White House staff like McGahn, who repeatedly thwarted him on key issues.

Trump owes his political survival to the steadfast support of the right wing, especially conservative, evangelical Christians. Whatever constraints the former GOP establishment managed to impose on him before would be largely absent in a second term.

Hence the main lesson from Tuesday: The high court has moved sharply to the right already, but it could go a lot further if Trump gets another term.

©2024 Los Angeles Times. Visit at latimes.com. Distributed by Tribune Content Agency, LLC.