In this Oct. 16, 2018 photo, Amanda Gershon, of Lincoln, testifies at a public hearing in Lincoln, Neb., on Initiative 427, the Medicaid Expansion Initiative. Gershon worked in various low-wage jobs while struggling with a rare autoimmune disorder that eventually led to $60,000 in medical debt and bankruptcy when she was 22 years old. (AP Photo/Nati Harnik)

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