By Renuka Rayasam, KFF Health News

Health policy changes in Washington will ripple through the country, resulting in millions of Americans losing their Medicaid or Affordable Care Act coverage. But there are still ways to find care.

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Over the next decade, the GOP’s One Big Beautiful Bill Act is expected to slash nearly $1 trillion in spending from Medicaid, the state-federal program for people with low incomes and disabilities. The implementation of new work rules will cause some beneficiaries to lose their Medicaid coverage.

Millions of Americans are facing enormous increases in their out-of-pocket costs for ACA coverage. So far, 1.2 million fewer people have signed up for Obamacare plans compared with last year, and health policy analysts estimate more will lose coverage as they fail to pay their premiums.

Health costs are a top concern for Americans. Two-thirds of the public say they are somewhat or very worried about affording health care, more than express the same worries about utilities, food, housing, or gas, according to a January poll from KFF, a health information nonprofit that includes KFF Health News.

“All of this pain just doesn’t have to be there,” said Cheryl Fish-Parcham, director of private coverage at the health consumer group Families USA.

Doctors and health policy researchers say health coverage, of any kind, is the best protection against major medical debt.

Caitlin Donovan, a senior director at the Patient Advocate Foundation, recommends exhausting every available option for health coverage before going uninsured.

Even a high-deductible plan can protect patients from medical bankruptcy “if the absolute worst-case scenario happens,” she said.

Here are five ways that the uninsured can find affordable care.

1. Don’t be afraid to talk with your doctor about money

Patients can be hesitant to tell their doctors they’re uninsured or be wary of expressing concern about being able to afford care.

But some hospitals, physicians, and other providers offer cheaper cash pay options, said Cynthia Cox, a senior vice president and the director of the Program on the ACA at KFF.

Often prices are negotiable. “Always ask,” she said.

Health care providers can make adjustments if they know patients are worried about money, said Ateev Mehrotra, a doctor and researcher at Brown University.

“If my patient tells me, ‘Doc, I’m gonna have to pay for this out-of-pocket,’ I’m gonna make a different risk calculus,” Mehrotra said.

That doesn’t mean a patient won’t get the care they need, he said. A doctor, for instance, might order an ultrasound instead of an MRI, which is more expensive.

2. Search for providers that specifically work with uninsured patients

If your usual provider won’t budge on prices, then search for providers that cater to patients without insurance.

Federally qualified health centers, or FQHCs, and other community clinics offer routine and non-emergency care, such as treatment for flu or infection, for low-income residents and the uninsured. Community health centers charge based on a sliding scale and see 52 million patients annually in some of the country’s most underserved areas, according to the National Association of Community Health Centers.

The Trump administration has made funding cuts that might lead some of the country’s approximately 1,500 FQHCs to close or cut services. But the administration still maintains a site to find a local center.

Planned Parenthood also accepts uninsured patients. Its centers test for sexually transmitted diseases, provide birth control options, and offer postpartum and gender-affirming care and other services.

And the National Association of Free & Charitable Clinics also offers a tool to help people find free or low-cost care.

Most community clinics don’t offer specialty care, but they can usually refer patients who need more intensive services to providers willing to work with uninsured patients.

And academic medical centers tend to have more charity care programs that help uninsured patients lower their bills.

“If you’re uninsured or even underinsured, you might be able to qualify for a significant discount on the cost of your care,” Cox said.

Still, be wary of heading to the emergency room, which is the most expensive place to get care. While ERs are federally required to stabilize all patients regardless of their ability to pay, they can still leave you with a big bill — and often do.

3. Call your local health department

Health services vary widely from county to county, but many offer free vaccinations, family planning services, and testing for sexually transmitted infections, as well as for flu, covid, and tuberculosis.

Some county health departments also offer more advanced care, such as dental services and mental health or substance abuse programs. And some states have consumer assistance programs that can guide residents in finding care, Fish-Parcham said.

In addition, the Centers for Disease Control and Prevention’s National Breast and Cervical Cancer Early Detection Program makes free or low-cost breast and cervical cancer screenings available to low-income women in all states and territories. And some states cover screenings for other types of cancer as well.

4. It’s easier to shop around for drugs than doctors

Don’t just fill your prescription at the closest pharmacy. Instead, research generic drug options and look around for the best price on brand names.

A handful of sites such as GoodRx and WellRx offer comparison shopping tools and information on other ways to get drug discounts.

And some retailers offer low-cost access to common prescription drugs — at prices cheaper than you would find if you had insurance. Walmart, for instance, sells 90-day prescriptions of dozens of generic versions of drugs for $10. As does Target, Costco, and a new site called the Cost Plus Drug Company.

Many drugmakers also offer patient assistance programs, coupons, and rebates on some medications. Check their websites for details on how to apply.

States also offer drug assistance programs. The steps to qualify and types of drugs vary, but this tool has a list of programs and how they work.

Joining a clinical trial is another way to access treatment. The National Institutes of Health and its National Cancer Institute have lists, but patients must first meet the criteria. Clinical trials aren’t necessarily free, even with insurance, Donovan said, so be sure to ask about any associated costs.

5. Your diagnosis might lead you to specialized resources

Patients with a specific diagnosis might have additional options for specialty treatment.

For example, someone with breast cancer should check with the American Cancer Society and the nonprofit Susan G. Komen organization, Cox said.

The Patient Advocate Foundation hosts a list of vetted foundations that can help offset the cost of medical bills and provide other resources such as transportation and lodging, Donovan said. Just type in basic information such as age, location, and diagnosis to see what is available.

Disease-specific foundations such as those for lupus or irritable bowel syndrome can also steer patients to free or low-cost resources or cover some costs of care, Donovan said.

“Everything is out there,” she said.

As you research affordable care options, don’t be tricked by plans that look like health insurance but don’t offer guaranteed protection against big bills.

Some short-term plans and health care sharing ministries might seem like good deals, but read the fine print. Some red flags to look for: too-good-to-be-true monthly payments; no coverage for preexisting conditions; morality clauses such as those prohibiting the use of alcohol or drugs; or a lack of coverage for benefits such as mental health counseling that are required in ACA plans.

KFF Health News correspondent Sam Whitehead contributed to this report.

©2026 KFF Health News. Distributed by Tribune Content Agency, LLC.

By ANNE D’INNOCENZIO, Associated Press Retail Sales

NEW YORK (AP) — Shoppers pulled back the pace of their spending in December from November, closing out the holiday shopping season and the year on a lackluster tone.

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The report, issued by the Commerce Department on Tuesday, raised questions about shoppers’ ability to spend this year as they worry about a slowing job market and uncertainty around President Donald Trump’s tariffs and their impact on prices.

Retail sales were flat in December from November, when business was up 0.6%, according to the Commerce Department. Economists were expecting a 0.4% increase for December.

The report delayed more than a month because of the 43-day government shutdown.

Sales in October fell 0.1%, rose 0.1% in September, but jumped 0.6% in July and August and 1% in June, according to the Commerce Department.

The retail sales figures, which are not adjusted for inflation, showed that many types of businesses including furniture and home furnishings stores as well as electronics and appliance retailers posted declines.

Among the few bright spots: building materials and garden stores, which had a small sales increase.

The snapshot offers only a partial look at consumer spending and doesn’t include many services, including travel and hotel lodges. But the lone services category – restaurants – registered a dip of 0.1%.

Economists will be closely monitoring a slew of economic reports on jobs and prices due out later this week.

But the economy is in a confusing place.

Growth is robust: Gross domestic product — the nation’s output of goods and services — advanced from July through September at the fastest pace in two years. But the job market is lackluster: Employers have added just 28,000 jobs a month since December.

In the 2021-2023 hiring boom that followed COVID-19 lockdowns, by contrast, they were creating 400,000 jobs a month.

When the agency releases hiring and unemployment numbers for January on Wednesday, they are expected to show that businesses, government agencies and nonprofits added about 80,000 jobs last month — modest but up from 50,000 in December.

Analysts will also be studying consumer price report, to be released Friday. In December, consumer prices matched the 0.3% increase in November. If inflation cools in the coming months, it could increase the likelihood the Federal Reserve will reduce its key interest rate later this year, economists say.

Against this backdrop, some chains like Walmart, whose everyday low prices have pulled in shoppers from rivals, are thriving but others struggle.

A growing number of retailers are closing stores as companies reorganize under bankruptcy protection or pare down their operations to focus on profitable operations.

On Monday, the operator of roughly 180 Eddie Bauer stores across the U.S. and Canada has filed for Chapter 11 bankruptcy protection, blaming declining sales and a litany of other industry headwinds.

Last month, the parent company of Saks Fifth Avenue that it was seeking bankruptcy protection, buffeted by rising competition and the massive debt it took on to buy its rival in the luxury sector, Neiman Marcus, just over a year ago. A few days later, the parent company said it was closing most of its Saks Off 5th stores.

Amazon said earlier this month that it was closing almost all of its Amazon Go and Amazon Fresh locations within days as it narrows its focus on food delivery and its grocery chain, Whole Foods Market.

By ANDREW DAMPF, Associated Press Sports Writer

CORTINA D’AMPEZZO, Italy (AP) — Ariane Raedler and Katharina Huber of Austria won gold in the new team combined event at the Milan Cortina Olympics on Tuesday when Mikaela Shiffrin surprisingly crossed fourth after wasting a first-run lead by teammate Breezy Johnson.

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Shiffrin, the most successful World Cup racer of all time with a record 108 victories — 71 of them in slalom, also a record — has now gone seven straight Olympic races without a medal.

After taking two golds and silver from her first two Olympics, Shiffrin also didn’t win a medal in any of her six races at the Beijing Games four years ago.

Kira Weidle-Winkelmann and Emma Aicher of Germany earned silver and Paula Moltzan and Jacqueline Wiles of the U.S. took bronze.

Shiffrin lost time to the leaders at every checkpoint and crossed 0.31 seconds behind — missing a medal by finishing 0.06 behind the other American team. In the finish area, Johnson — who was coming off a gold in the individual downhill — embraced Shiffrin, while the Austrians and other podium finishers began celebrating.

The team combined consists of one racer competing in a downhill run and another in a slalom run, with the times from the two added together to determine the results.

Shiffrin still has her individual events of giant slalom and slalom to come.

By KAITLYN HUAMANI and BARBARA ORTUTAY, Associated Press Technology Writers

LOS ANGELES (AP) — Comparing social media platforms to casinos and addictive drugs, lawyer Mark Lanier delivered opening statements Monday in a landmark trial in Los Angeles that seeks to hold Instagram owner Meta and Google’s YouTube responsible for harms to children who use their products.

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Instagram’s parent company Meta and Google’s YouTube face claims that their platforms addict children through deliberate design choices that keep kids glued to their screens. TikTok and Snap, which were originally named in the lawsuit, settled for undisclosed sums.

Jurors got their first glimpse into what will be a lengthy trial characterized by dueling narratives from the plaintiffs and the two remaining defendants.

Meta lawyer Paul Schmidt spoke of the disagreement within the scientific community over social media addiction, with some researchers believing it doesn’t exist, or that addiction is not the most appropriate way to describe heavy social media use.

Lawyers representing YouTube will begin their opening statement on Tuesday.

‘Addicting the brains of children’

Lanier, the plaintiff’s lawyer, delivered lively first remarks where he said the case will be as “easy as ABC” — which stands for “addicting the brains of children.” He said Meta and Google, “two of the richest corporations in history,” have “engineered addiction in children’s brains.”

He presented jurors with a slew of internal emails, documents and studies conducted by Meta and YouTube, as well as YouTube’s parent company, Google. He emphasized the findings of a study Meta conducted called “Project Myst” in which they surveyed 1,000 teens and their parents about their social media use. The two major findings, Lanier said, were that Meta knew children who experienced “adverse events” like trauma and stress were particularly vulnerable for addiction; and that parental supervision and controls made little impact.

FILE – The YouTube app is displayed on an iPad in Baltimore on March 20, 2018. (AP Photo/Patrick Semansky, File)

He also highlighted internal Google documents that likened some company products to a casino, and internal communication between Meta employees in which one person said Instagram is “like a drug” and they are “basically pushers.”

At the core of the Los Angeles case is a 20-year-old identified only by the initials “KGM,” whose case could determine how thousands of other, similar lawsuits against social media companies will play out. She and two other plaintiffs have been selected for bellwether trials — essentially test cases for both sides to see how their arguments play out before a jury.

Plaintiff grew up using YouTube, Instagram

KGM made a brief appearance after a break during Lanier’s statement and she will return to testify later in the trial. Lanier spent time describing KGM’s childhood, focusing particularly on what her personality was like before she began using social media. She started using YouTube at age 6 and Instagram at age 9, Lanier said. Before she graduated elementary school, she had posted 284 videos on YouTube.

The outcome of the trial could have profound effects on the companies’ businesses and how they will handle children using their platforms.

FILE – Attendees visit the Meta booth at the Game Developers Conference 2023 in San Francisco on March 22, 2023. (AP Photo/Jeff Chiu, File)

Lanier said the companies’ lawyers will “try to blame the little girl and her parents for the trap they built,” referencing the plaintiff. She was a minor when she said she became addicted to social media, which she claims had a detrimental impact on her mental health.

Lanier said that despite the public position of Meta and YouTube being that they work to protect children, their internal documents show an entirely different position, with explicit references to young children being listed as their target audiences.

The attorney also drew comparisons between the social media companies and tobacco firms, citing internal communication between Meta employees who were concerned about the company’s lack of proactive action about the potential harm their platforms can have on children and teens.

“For a teenager, social validation is survival,” Lanier said. The defendants “engineered a feature that caters to a minor’s craving for social validation,” he added, speaking about “like” buttons and similar features.

Meta pushes back

In his opening statement representing Meta, Schmidt said the core question in the case is whether the platforms were a substantial factor in KGM’s mental health struggles. He spent much of his time going through the plaintiff’s health records, emphasizing that she had experienced many difficult circumstances in her childhood, including emotional abuse, body image issues and bullying.

Schmidt presented a clip from a video deposition from one of KGM‘s mental health providers, Dr. Thomas Suberman, who said social media was “not the through-line of what I recall being her main issues,” adding that her struggles seemed to largely stem from interpersonal conflicts and relationships. He painted a picture — with KGM’s own text messages and testimony pointing to a volatile home life — of a particularly troubled relationship with her mother.

Schmidt acknowledged that many mental health professionals do believe social media addiction can exist, but said three of KGM’s providers — all of whom believe in the form of addiction — have never diagnosed her with it, or treated her for it.

Schmidt emphasized to the jurors that the case is not about whether social media is a good thing or whether teens spend too much time on their phones or whether the jurors like or dislike Meta, but whether social media was a substantial factor in KGM’s mental health struggles.

A reckoning for social media and youth harms

A slew of trials beginning this year seek to hold social media companies responsible for harming children’s mental well-being. Executives, including Meta CEO Mark Zuckerberg, are expected to testify at the Los Angeles trial, which will last six to eight weeks. Experts have drawn similarities to the Big Tobacco trials that led to a 1998 settlement requiring cigarette companies to pay billions in health care costs and restrict marketing targeting minors.

A separate trial in New Mexico, meanwhile, also kicked off with opening statements on Monday. In that trial, Meta is accused of failing to protect young users from sexual exploitation, following an undercover online investigation. Attorney General Raúl Torrez in late 2023 sued Meta and Zuckerberg, who was later dropped from the suit.

A federal bellwether trial beginning in June in Oakland, California, will be the first to represent school districts that have sued social media platforms over harms to children.

In addition, more than 40 state attorneys general have filed lawsuits against Meta, claiming it is harming young people and contributing to the youth mental health crisis by deliberately designing features on Instagram and Facebook that addict children to its platforms. The majority of cases filed their lawsuits in federal court, but some sued in their respective states.

TikTok also faces similar lawsuits in more than a dozen states.

Ortutay reported from Oakland, California. Associated Press Writer Morgan Lee in Santa Fe, New Mexico, contributed to this story.