WASHINGTON/YORK, PENNSYLVANIA —
It's a state Dr. Monica Vohra says many of her low-income, mainly immigrant and minority patients are in when they arrive at Bread for the City's free medical clinic in Washington, D.C.
But lately, the internal medicine physician says that state has been heightened.
"I think the language out there has been disturbing. Some of it has retraumatized folks who have been traumatized by previous policies. There is a sense of feeling unsafe and insecure," Vohra said.
Watch: 43 Million Americans Live in Poverty, Worry About Future
That's because Vohra says many of her patients who have received health care coverage under the Affordable Care Act (ACA) are not sure whether they will still have those benefits under the new administration.
"It's definitely something that is on our minds. We encourage people to get insurance every day, and in the back of my mind I am thinking, 'What if this is not an option soon?' "
While President Donald Trump and the Republican-majority Congress look to repeal the ACA and replace the federal program with one that the president has said will be "great health care for much less money," many low-income Americans are waiting to determine what any such change will mean for them.
"We are just going to have to wait and see, because we really don't know what we are going to get," said Brian Nabinett.
On this day, the lifelong resident of the nation's capital is waiting in line at Bread for the City's food pantry for bread, chicken and other staples. The nonprofit organization runs a free legal, medical and dental clinic and offers food, clothing and other services to 10,000 Washington residents each month.
"It's one of the beautiful places in D.C. It helps a lot of people here," Nabinett said. "If I need counseling or food, I can always come here."
'It makes you wonder'
Just weeks into the Trump presidency, some at Bread for the City wonder what the new administration will mean for those who struggle to make ends meet.
"I do have concerns about the state of the poor and what services will be offered," said volunteer Patrice Ali. "Some of these programs, like Obamacare and Medicaid, have been an integral part of people's survival, and it makes you wonder if those programs will continue to get funding."
Ali benefited from Bread for the City's food and clothing program when she was unemployed. She says in recent years, she has noticed an unsettling trend in the United States — a growing income gap and a growing disconnect between politicians and the American public.
"Since I have been in my 20s, I have noticed that the gap has increasingly gotten larger, no matter who is in that position of power or authority to run this country," she said.
Still, Ali says she tries to remain optimistic.
"There is a spirit of despair that has kind of come over people, knowing where this administration may take them," said Ali. "I, on the other hand, am leaning more toward hope."
Coping in York
A two-hour drive north from the U.S. capital, Grace Geltrude is going through a walk-in freezer at the York County Food Bank in York, Pennsylvania.
The city, once a manufacturing hub that is still home to a number of smaller factories, voted overwhelmingly for Trump, who promised to bring economic change to working-class Americans.
On this day, Geltrude walks through the food bank, voucher in hand, to pick up extra food and toiletries she says are a big help to her family.
"It is very important because cost of living goes up all the time. We have a 3-year-old in the home. There used to be 13 people in the house at one time," Geltrude said, while looking through a box of canned products at the pantry.
Last year, the nonprofit York County Food Bank distributed more than 900,000 kilograms of food to local churches and agencies that work with the neediest families in southern Pennsylvania.
Debbie Krout-Althoff, director of development at the food bank, says 680 kilograms are distributed on Fridays alone.
"I think it is an eye-opening experience when you come back from lunch and you see people who are outside of our building lined up for blocks to receive the food in all kinds of weather," said Krout-Althoff. "We go through life with blinders."
She says some low-income residents have expressed concern about the uncertainty surrounding the ACA and the new administration's plans for programs like Medicare and Medicaid, but that most are more concerned about day-to-day survival — "how they are going to feed their family, how are they going to pay their bills. I also think they have been discouraged for so long that it doesn't really matter to them who is in control [of the government]."
For now, York resident Geltrude is just focused on filling in the gaps. She has relied on the food bank, welfare assistance and a local health insurance program when her paycheck and her husband's Social Security check have fallen short.
"I couldn't afford the insurance any other way, with the bills and all, taking care of a vehicle. I mean, it does get costly," Geltrude noted. "And without some of these programs, people are struggling."