SACRAMENTO, Calif. — Many low-income Californians prescribed wildly popular weight loss drugs lost their coverage for the medications at the start of the new year.

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Jonna Quinn was initially thrilled when she got her first job after her medical residency, working as an OB-GYN in Mason City, Iowa. It was less than two hours down the road from West Bend, where she grew up on a farm.

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LODGE GRASS, Mont. — Brothers Lonny and Teyon Fritzler walked amid the tall grass and cottonwood trees surrounding their boarded-up childhood home near the Little Bighorn River and daydreamed about ways to rebuild.

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Congress returned from its holiday break to the same question it faced in December: whether to extend covid-era premium subsidies for health plans sold under the Affordable Care Act. The expanded subsidies expired at the end of 2025, leaving more than 20 million Americans facing dramatically higher out-of-pocket costs for insurance.

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In 2013, before the Affordable Care Act helped millions get health insurance, California’s Placer County provided limited health care to some 3,400 uninsured residents who couldn’t afford to see a doctor.

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A Texas boy’s second dose of the MMRV vaccine cost over $1,400. A Pennsylvania woman’s long-acting birth control cost more than $14,000.

Treatment for a Florida Medicaid enrollee’s heart attack cost nearly $78,000 — about as much as surgery for an uninsured Montana woman’s broken arm.

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ALEXANDER, N.C. — Aubreigh Osborne has a new best friend.

Dressed in blue with a big ribbon in her blond curls, the 3-year-old sat in her mother’s lap carefully enunciating a classmate’s first name after hearing the words “best friend.” Just months ago, Gaile Osborne didn’t expect her adoptive daughter would make friends at school.

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SPRINGFIELD, Ohio — Tyeesha Ferguson fears her 28-year-old son will kill or be killed. “That’s what I’m trying to avoid,” said Ferguson, who still calls Quincy Jackson III her baby. She remembers a boy who dressed himself in three-piece suits, donated his allowance, and graduated high school at 16 with an academic scholarship and plans to join the military or start a business.

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ORANGE, Calif. — Carmen Basu, bundled in a red jacket and woolly scarf, stood outside the headquarters of her local health plan one morning after picking up free groceries. She had brought her husband, teenage son, and 79-year-old mother-in-law to help.

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FORT HALL RESERVATION, Idaho — Standing atop Ferry Butte, Frances Goli scanned the more than half a million acres of Shoshone-Bannock tribal land below as she dug her hands into the pockets of a pink pullover.

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