The health care bill unveiled Thursday by Senate Republicans has been out in the open for less than a week, and there are many obstacles to clear before it can become law: an uncertain Senate vote, a return to the House for final approval, a presidential signature.

But in newspapers and on radios and TV stations from Anchorage to Miami, the effects of the bill are already being contemplated. These could vary considerably from region to region, state to state, even family to family. Thirty-one states expanded Medicaid under the Affordable Care Act, though the designs of these programs are not the same, and the states that did not choose to expand would still be significantly affected. Clinics in Pennsylvania desperately need funding to battle the opioid epidemic; rural hospitals in Maine rely on Medicaid for survival; Nebraskans struggle to cover rising premiums; and Floridians fear the loss of money to fight the Zika virus.

Yet while context varies, the reception to the bill described in these local news reports is almost uniformly unhappy, a sentiment reflected in the polling numbers for the health care bill approved by House Republicans and in many of the interviews.

“All of them are supposed to be there for us,” said JoAnn Johnson, 80, in an article on the front page of Sunday’s Argus Leader in Sioux Falls, S.D., “and we are lost in this.”