Darlene Hawes lost her health insurance about a year after her husband died in 2012.

Hawes, 55, is from Charlotte, N.C. She ended up going without insurance for a few years, but in 2015 she bought coverage on HealthCare.gov, the Affordable Care Act marketplace, with the help of a big subsidy.

“I was born with heart trouble and I also had, in 2003, open-heart surgery,” she says. “I had breast-cancer surgery. I have a lot of medical conditions, so I needed insurance badly.”

After the results of the 2016 election came in, she was scared she’d lose her insurance immediately. For years, Republicans have vowed to scrap the health care law. The new Congress is already working on a plan to undo the Affordable Care Act. But they have not settled on how to replace the health care structure that Obamacare set up.

Hawes is one of about 550,000 North Carolinians who relies on the Obamacare marketplace for health insurance. She was relieved after she talked with an enrollment specialist last month who told her she can renew her policy for 2017.

“And I’m like, ‘Oh my Lord, did she just say that?’ ” Hawes asks with a laugh. “It’s just like a whole load of burdens just fell off of my back because all the years I haven’t been covered since my husband passed away — I don’t want to be sad again. I was very sad.”

Most health care researchers and policy analysts agree not much is likely to change in 2017.

“Even the Republican Congress in one of their most recent bills to repeal it, they put in a two-year transition period, so that the premium subsidies and the other provisions of the law that are fundamental wouldn’t be repealed for a couple of years,” says Sabrina Corlette, a research professor at Georgetown University’s.

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Darlene Hawes (left) and her enrollment counselor, Julieanne Taylor, outside the Mecklenburg County Health Department in Charlotte, N.C. Michael Tomsic/WFAE hide caption

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Michael Tomsic/WFAE

Some Republican leaders say repeal should happen immediately with a transition period to come up with a replacement.

Still, the CEO of HealthCare.gov, Kevin Counihan, says he can’t guarantee coverage will remain. “It’s not my place to promise anything about a new administration,” he says. “But what I can tell you is not only are we moving forward, but our enrollment is higher than expected.”

At the end of 2016, enrollment for 2017 plans spiked and as of the end of December, North Carolina has the third-highest enrollment for 2017 plans among states using HealthCare.gov.

Julieanne Taylor with Legal Services of Southern Piedmont is helping people sign up. She says about a third of them have asked about the election.

“But generally when we’re calling, people are really excited to have their appointment and come in and look at the plans for 2017,” she says. “I think they’re mostly interested in how much they’re going to be paying.”

In some ways, North Carolina is in tough shape. Premiums are going up and insurance companies have dropped out, leaving Blue Cross Blue Shield of North Carolina as the only insurer in 95 percent of the state.

Blue Cross actuary Brian Tajlili says it’s simply an expensive market that has older, sicker people who cost more to cover.

“There is continuing demand for services and continuing high utilization within this block of business,” he says.

What he calls “this block of business” means the customers who buy insurance on the exchange. It’s a small slice of the overall health insurance market, because most people are covered through work or Medicare. The overwhelming majority of consumers who buy coverage on the exchange get federal subsidies that greatly reduce what they pay.

Still, it’s been a turbulent market for consumers and insurers. Over the past two years, Blue Cross has lost $400 million in North Carolina on that part of its business.

Amid the post-election uncertainty, Tajlili says Blue Cross is committed to offering plans in 2017.

“2017 will be another pivotal year for us as we look at the individual market,” he says.

One of Blue Cross’ new customers will be Sara Kelly Jones, 46, who works at Letty’s restaurant in Charlotte, N.C. She recognizes Obamacare isn’t perfect. But before the law, health insurance was a financial vise that kept tightening on her.

“I could not afford it at all,” she says. “Every year it was going up $100 to $120, $150 a month. It got to the point where it was going to be at least $200 more a month than my mortgage.”

But under Obamacare, Jones qualifies for a subsidy. Her premium will go up with Blue Cross, but she says she can afford it with that help.

Jones says the political debate over the law ignores people like her.

“I’m terrified,” she says. She’s worried about the Republican Congress’ pledge to scrap and replace Obamacare without presenting a detailed proposal. “If there had been any plan outlined that wasn’t just some vague, ‘We’re going to replace it with something awesome,’ ” she says she’d rest easier. “They have no plan! What on Earth are you going to do with all these people, myself included, that are counting on this?”

This story is part of a reporting partnership with NPR, WFAE and Kaiser Health News. You can follow Michael Tomsic on Twitter: @michaeltomsic.

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By many standards, Mireille Kamariza is at the top of the world.

She’s a graduate student at one of the world’s top universities, working on her Ph.D. with one of the world’s top chemists. And she’s tackling a tough problem — tuberculosis — that sickens nearly 10 million people a year.

Earlier this year, 27-year-old Kamariza and her adviser unveiled a potential breakthrough in fighting TB: a way to detect the culprit bacteria faster and more accurately.

But for Kamariza, the fight against TB is not just about scientific progress and prestige. It’s personal.

Kamariza grew up in the small African country of Burundi, where many around her were stricken with TB. A close relative lived with the disease for years — and eventually died from it. It was common for people in her town to get sick with TB and “wait to see if you’d die — and if you survived, you’d just kind of live with it.”

A World Health Organization report released in October states that an estimated 10.4 million people were infected with TB in 2015, up from previous years — and 1.8 million died from the disease.

TB is still a stigmatized disease in Burundi, so Kamariza doesn’t want to be specific about her relative’s identity. But, she says, he most likely didn’t get treated “because he didn’t know you could be treated, and even if he did know, [treatment] was far from where he was — and expensive.”

Kamariza’s journey hasn’t been easy. In Burundi, it’s rare for girls to attend college — not to mention work with world-class scientists.

“Science was something that Europeans and Americans did,” she says. “It was for other people — not for me.” When she was in high school, she didn’t have a clue about science careers. Neither did her parents.

“I never dreamed [Kamariza] would become a scientist because it is a career path that is unknown in Burundi,” says Denise Sinankwa, Kamariza’s mother.

Sinankwa had her hands full when Kamariza was young. She and her husband were raising four kids during a bloody civil war. Nearly 300,000 civilians were killed. The family moved a lot, and Sinankwa often worked multiple jobs to feed the family.

But Sinankwa still pushed Kamariza to do well in school. She wanted her daughter to land a good-paying job and be able to support herself.

Kamariza considers herself lucky. She attended a government-managed Catholic school, where “things were more rigorous” than other public schools. The “nuns’ school” instilled a mindset most of her peers lacked because generally girls “were raised to be a wife,” she says.

Kamariza wanted to pursue studies in the U.S., where her second-oldest brother had already landed. So, when she was 17, Kamariza packed up her belongings and traveled with her third brother half way around the world. She went to San Diego in the fall of 2006 and moved into a tiny studio apartment with her brothers. The four worked various jobs at grocery stores, restaurants, retail shops — “whatever we could get to pay the bills,” Kamariza says. Their earnings also paid for classes at a junior college.

Then Kamariza’s hard work started to pay off.

At San Diego Mesa College, she found a life-changing mentor. Her chemistry teacher, Saloua Saidane, was a fellow French-speaking African. Born to illiterate parents in Tunisia, Saidane was one of 12 children and knew what it was like to be a poor immigrant kid pouring herself into school as the only way to a better future.

“Kamariza was serene yet determined,” Saidane says. “She worked hard. She saw the opportunity to have a good life, a life different from what she left behind.”

Saidane started Kamariza’s journey into science. “She really pushed me and kept motivating me and telling me I should aim high. Whatever she told me, I did,” Kamariza says.

After quitting her job at Safeway to focus on school, Kamariza got into the University of California, San Diego, and began undergraduate studies. Through a National Institutes of Health diversity scholarship, Kamariza spent summers doing biology research. In 2012, she joined Carolyn Bertozzi‘s lab — then at the University of California, Berkeley, now at Stanford University — as a graduate student.

Kamariza wanted to focus on infectious disease. So she started brainstorming with another graduate student to figure out a quicker, better way to diagnose TB.

They eventually came up with a new test that recognizes a sugar, called trehalose, that is uniquely found in TB bacteria. In the presence of a special substance, TB bacteria cells glow green, making the microbes easy to spot on microscope slides of an infected person’s mucus or saliva.

Current TB tests are laborious and not very sensitive — some infections are missed. TB cultures are more reliable but take six weeks to produce a result. Kamariza — and other researchers elsewhere — are creating methods that could make TB diagnoses simpler and more accurate.

Kamariza’s method looked promising this year when she and her colleagues tested it on a small batch of samples from patients in South Africa. But the tools are still in the developmental phase. Larger, more rigorous studies are needed for the method to be considered for use in clinics.

Though unfinished, the research drew heavy crowds when Kamariza presented her data on a poster at a TB conference in September in Paris. Considering her improbable journey — from a child witnessing the tragedy of this disease to a young researcher contributing toward its eradication — “the whole experience is surreal,” Kamariza says.

“A lot of hard work, a bit of luck, perseverance and relentless support from friends and family are what got me here,” says Kamariza, She hopes her experience can “encourage others like me to pursue their passions, no matter the obstacles.”

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