JUDY WOODRUFF: But first: As Republicans on
Capitol Hill try to repeal and replace the Affordable Care Act, we’re going to spend
the next couple of nights hearing what patients and health care providers think should be
done. Our team visited West Virginia and Virginia,
which made very different decisions about Medicaid. West Virginia did commit to expanding Medicaid
through Obamacare. But Virginia is one of 19 states that didn’t. The state’s Republican-controlled legislature
voted against expanding the program to 400,000 more citizens because of concerns over costs. Tonight, we visit a clinic providing free
care in the western corner of Virginia, a region that strongly supported the election
of President Trump. DR. PAULA HILL, Family Nurse Practitioner: My
name is Dr. Paula Hill. I’m a family nurse practitioner and clinical
director here at the Health Wagon. We are at the Smiddy Clinic in Wise, Virginia. We actually say that we’re the forgotten Virginia,
because we’re down in the corner with Tennessee and Kentucky borders. And we’re very rural, very mountainous and
very isolated from the rest of Virginia and a lot of ways the rest of the country. We have a high rate of heart disease, diabetes,
and it’s because of the economics here. JOYCE CAMPBELL, Virginia: All the mines and
stuff have just about closed down. And there really isn’t any jobs around here. My name is Joyce Campbell. I’m from Wise, Virginia. You know, I get $800 a month. And I am fortunate I do have an income coming
in, with my Social Security. And the time you pay your rent, your electric,
your water, your gas, you either have a choice of whether you want to buy your medicine or
whether you want to eat. DR. PAULA HILL: The Affordable Care Act, when
it was enacted, it did help a lot of Virginians. Down here in this part of the state, in far
Southwestern Virginia, we didn’t benefit as much because there are such dire economic
constraints here. Our patients couldn’t afford the Affordable
Care Act. They couldn’t afford $400 a month for a family
plan. And Virginia didn’t expand Medicaid. We actually didn’t benefit any. It would have helped if we had expanded Medicaid. It would have helped some of our residents
anyway, because there’s a dire amount of poverty. There’s people dying every day, and dying
senseless deaths, because they don’t have equal right to health care. TINA BEAN, Virginia: My name is Tina Bean. I’m 59, and I’m from Haysi, Virginia. I had congestive heart failure twice. I didn’t have insurance. And that’s when I started coming to Paula,
or coming to the Health Wagon. Without the medicines and stuff, I probably
wouldn’t be here. When I heard about the Obamacare a few years
ago and checked it and stuff, you could tell then that it wasn’t going to work. People can’t afford it. JOYCE CAMPBELL: They call it Affordable Care
Act. But it’s not. And they said you could keep your doctors. You couldn’t because your doctors wouldn’t
take the thing. And they said you could go to the same hospital,
but a lot of it was built on lies. If you really want to know the truth, I think
— and I think somebody one of these days is going to give an account for it. JEFF TILLER, Virginia: My name is Jeff Tiller. And I’m 47 years old. And I have worked in the coal mines for 29
years. They diagnosed me for black lung. They done a chest X-ray. They also have found some nodules in my lung. DR. PAULA HILL: We are overwhelmed here at the
Health Wagon. We have went to over almost 9,000 patients,
and we have a staff of less than 20. Every year, we have an outreach clinic event
called Remote Area Medical. You will see them standing in line for dental
care, for medical care, for vision. We have found people with dissecting aortic
aneurysms that’s had to be flown out. We have had patients have stroke right there
in front of us at these Remote Area Medical events. We have had brain tumors that have been discovered,
lung cancers that have been discovered. And every year, it’s like this. We keep thinking, well, is it ever going to
get better? Is anybody going to help these forgotten people? They’re like something you would see in a
Third World country. JOYCE CAMPBELL: The Obamacare could have helped
some people. I say it needs to be replaced. TINA BEAN: I hope that they can replace it. I know it’s not going to be something they
can do overnight, because the mess didn’t come overnight. JEFF TILLER: When I first started hearing
that Obama getting ready for health care, Obamacare, I thought that was great. We tried it. We got it. Does it have faults? Yes, it does. Is it working? Yes, it is. And I know right there in my hometown of people
that’s got insurance through the Affordable Care Act. And you reverse it, they lose their insurance. WOMAN: If all of this goes through, I probably
won’t have anything. I don’t know how I’m going to get covered. DR. PAULA HILL: Because of the preexisting conditions? WOMAN: Yes, right. And I have had it for years. DR. PAULA HILL: If the Senate plan actually passes,
there will be deep cuts to Medicaid. Even though Virginians didn’t expand, what
they are paying out is going to be even — subjected to even more cuts. Then you have the preventive care that’s being
discussed that they’re not going to be paying for anymore. Just because it wasn’t a perfect plan, it
doesn’t mean do away with the whole thing. Why can’t we build on it and repair it, not
take it away and then start over with another plan that’s not perfect and not ideal? JOYCE CAMPBELL: It helped the insurance company,
because they made all kind of money off of it. But, as far as helping a lot of poor people,
it didn’t, and it still isn’t. Now, we cannot afford the high cost like Obama
had there. There’s no way that people in Southwest Virginia
can handle it. Now, maybe up Washington, or way up where
there’s money and jobs, you could. But there’s neither money nor jobs here. TINA BEAN: They need to do something to help
it. And, hopefully, the administration now, maybe
they will do something. JOYCE CAMPBELL: Washington, come to Southwest
Virginia. DR. PAULA HILL: Come down here and look in their
eyes. And don’t forget where you came from. Don’t forget who put you in the position that
you’re in. JOYCE CAMPBELL: Check the people. Look at them. Go sit on the streets. Go bring your car and park it and look at
the people that are hurting. And then, if you have got a heart, you will
know what it needs.