Rick and Letha Heitman, of Centennial, Colo., bought their health plan in 2015 through Colorado HealthOP, an insurance cooperative that will close at the end of the year. HealthOp's CEO says the co-op was "blindsided" when some promised federal subsidies failed to materialize. John Daley/CPR News hide caption

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Mendocino, Calif., lures vacationing tourists and retirees. But the lone hospital on this remote stretch of coast, in nearby Fort Bragg, is struggling financially. David McSpadden/Wikimedia hide caption

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Kalu James moved to Austin, Texas, eight years ago, but bought health insurance for the first time this year. Twenty percent of the city's musicians live below the federal poverty line. Veronica Zaragovia/KUT hide caption

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Vernon Thomas, a part-time music producer, is trying to decide whether it's worth it to sign up for health insurance. Fred Mogul/WNYC hide caption

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Health and Human Services Secretary Sylvia M. Burwell says she's willing to work with Texas leaders to craft a unique Medicaid plan for the state. Kevin Dietsch/UPI/Landov hide caption

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Anchorage dental hygienist Victoria Cronquist pays $1,600 a month for a health insurance policy that covers four people in her family. Next year, she says, the rate is set to jump to $2,600 a month. Annie Feidt/APRN hide caption

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Aymara Marchante (from left) and Wiktor Garcia talked with Maria Elena Santa Coloma, an insurance adviser with UniVista Insurance, during February 2015 sign-ups for health plans in Miami, Fla. Joe Raedle/Getty Images hide caption

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Aurora Sinai Medical Center in Milwaukee has found that connecting people with primary care doctors reduces the number of emergency room visits. Courtesy of Aurora Health Care hide caption

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Gov. Jerry Brown signed California's Medicaid expansion bill into law in June 2013. Since then, the number of people enrolled in Medi-Cal, the state's version of Medicaid, has surged. Rich Pedroncelli/AP hide caption

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Rep. Joe Courtney, D-Conn., proposed a bill in April to repeal the impending excise tax on employee health benefits that Obamacare deems excessive. Bill Clark/CQ-Roll Call, Inc. hide caption

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Laticia Aossey was hospitalized while a student at the University of Northern Iowa when she realized she hadn't signed up for health insurance. Matthew Putney/Courtesy of Youth Today hide caption

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Nurses Patricia Wegener (left) and Susan Davis at Mercy Hospital can monitor the condition of a patient who is miles away via the hospital's technology. But some health insurers and analysts remain skeptical that telemedicine saves money. Alex Smith/KCUR hide caption

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Doris Keene (right) talks with her acupuncturist before a treatment at Portland's Quest Center for Integrative Health. Keene says the treatments have eased her chronic back pain at least as effectively as the Vicodin and muscle relaxants she once relied on. Kristian Foden-Vencil/Oregon Public Broadcasting hide caption

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Marilyn Kruse couldn't get health insurance through her job as a substitute teacher in Jefferson County, Colo. Now she buys insurance through the state's health exchange. John Daley/Colorado Public Radio hide caption

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A Medicaid office employee works on reports at Montefiore Medical Center in New York in late 2014. New York expanded Medicaid eligibility under the Affordable Care Act and enrollment surged. Julie Jacobson/AP hide caption

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Isaiah Roggow, a third-year medical student at the University of California, Riverside, examines patient Becky Ketchum during the school's free clinic. Rebecca Plevin/KPCC hide caption

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Outreach coordinator Sonny Weahkee (left) talks with a restaurant customer about health insurance for Native Americans in Shiprock, N.M., in early August. Heidi de Marco/Kaiser Health News hide caption

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