Obamacare Faces Unprecedented Test as Economy Sinks

So Ms. Childers, 30, signed up for Cobra, which lets laid-off workers stay on their former employer’s health plan for 18 months under federal law, but requires them to pay the full cost unless the employer chooses to help. She is paying $560 a month — substantially more than a subsidized plan would cost at her income level, and an amount she will not be able to afford for long. She has several autoimmune conditions, and without insurance, would owe at least $3,000 a month just for her oral medications; she also gets regular infusions that cost even more.

“If my unemployment runs out and I don’t have a job,” she said, “I don’t know what I’ll do.”

In contrast, most of the 13 states that operate their own A.C.A. marketplaces not only opened enrollment to everyone during the pandemic, but worked hard to publicize the option. In California, where

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Three Weeks in April: An E.M.T. Crew Faces Exhaustion, Isolation and Death

After three years living in Nairobi, Kenya, working as a photojournalist throughout Africa and the Middle East, I decided I wanted to move home and pursue a career in public safety. I had always been interested in emergency medicine and was an emergency medical technician in college, so I got recertified and was hired by Empress Emergency Medical Service in a suburb of New York City last September.

I remember reading briefly about the coronavirus earlier this year but not thinking much of it — until the second documented case in New York State was announced in early March, in Empress’s coverage area, New Rochelle.

As cases multiplied, and our work became riskier and more intense, I felt an obligation to document. Over the course of three weeks in April, I photographed my colleagues as we worked to do our part to combat the pandemic that has frozen our country.

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