WEBVTT 00:02.033 --> 00:04.600 align:left position:10%,start line:77% size:80% JUDY WOODRUFF: But first: As Republicans on Capitol Hill try to repeal and replace the 00:04.600 --> 00:09.300 align:left position:10%,start line:77% size:80% Affordable Care Act, we're going to spend the next couple of nights hearing what patients 00:09.300 --> 00:12.100 align:left position:10%,start line:83% size:80% and health care providers think should be done. 00:12.100 --> 00:17.100 align:left position:10%,start line:77% size:80% Our team visited West Virginia and Virginia, which made very different decisions about 00:17.700 --> 00:19.300 align:left position:30%,start line:89% size:60% Medicaid. 00:19.300 --> 00:22.500 align:left position:20%,start line:77% size:70% West Virginia did commit to expanding Medicaid through Obamacare. 00:22.500 --> 00:26.133 align:left position:20%,start line:83% size:70% But Virginia is one of 19 states that didn't. 00:26.133 --> 00:31.133 align:left position:20%,start line:65% size:70% The state's Republican-controlled legislature voted against expanding the program to 400,000 00:32.300 --> 00:35.000 align:left position:20%,start line:83% size:70% more citizens because of concerns over costs. 00:35.000 --> 00:40.000 align:left position:10%,start line:77% size:80% Tonight, we visit a clinic providing free care in the western corner of Virginia, a 00:41.466 --> 00:43.700 align:left position:10%,start line:83% size:80% region that strongly supported the election of President Trump. 00:43.700 --> 00:45.333 align:left position:40%,start line:89% size:50% DR. 00:45.333 --> 00:47.233 align:left position:20%,start line:77% size:70% PAULA HILL, Family Nurse Practitioner: My name is Dr. Paula Hill. 00:47.233 --> 00:50.633 align:left position:10%,start line:77% size:80% I'm a family nurse practitioner and clinical director here at the Health Wagon. 00:50.633 --> 00:53.700 align:left position:10%,start line:83% size:80% We are at the Smiddy Clinic in Wise, Virginia. 00:53.700 --> 00:58.433 align:left position:10%,start line:71% size:80% We actually say that we're the forgotten Virginia, because we're down in the corner with Tennessee 00:58.433 --> 01:00.566 align:left position:20%,start line:89% size:70% and Kentucky borders. 01:00.566 --> 01:04.666 align:left position:10%,start line:77% size:80% And we're very rural, very mountainous and very isolated from the rest of Virginia and 01:05.833 --> 01:08.066 align:left position:20%,start line:83% size:70% a lot of ways the rest of the country. 01:08.066 --> 01:13.066 align:left position:10%,start line:77% size:80% We have a high rate of heart disease, diabetes, and it's because of the economics here. 01:15.200 --> 01:19.866 align:left position:10%,start line:77% size:80% JOYCE CAMPBELL, Virginia: All the mines and stuff have just about closed down. 01:19.866 --> 01:22.600 align:left position:20%,start line:83% size:70% And there really isn't any jobs around here. 01:22.600 --> 01:24.566 align:left position:10%,start line:89% size:80% My name is Joyce Campbell. 01:24.566 --> 01:26.200 align:left position:20%,start line:89% size:70% I'm from Wise, Virginia. 01:26.200 --> 01:29.200 align:left position:10%,start line:89% size:80% You know, I get $800 a month. 01:29.200 --> 01:34.200 align:left position:10%,start line:77% size:80% And I am fortunate I do have an income coming in, with my Social Security. 01:36.833 --> 01:41.833 align:left position:10%,start line:77% size:80% And the time you pay your rent, your electric, your water, your gas, you either have a choice 01:43.433 --> 01:46.166 align:left position:20%,start line:77% size:70% of whether you want to buy your medicine or whether you want to eat. 01:46.166 --> 01:48.233 align:left position:40%,start line:89% size:50% DR. 01:48.233 --> 01:51.533 align:left position:10%,start line:77% size:80% PAULA HILL: The Affordable Care Act, when it was enacted, it did help a lot of Virginians. 01:51.533 --> 01:56.533 align:left position:10%,start line:77% size:80% Down here in this part of the state, in far Southwestern Virginia, we didn't benefit as 01:57.966 --> 02:01.533 align:left position:10%,start line:83% size:80% much because there are such dire economic constraints here. 02:01.533 --> 02:04.733 align:left position:10%,start line:83% size:80% Our patients couldn't afford the Affordable Care Act. 02:04.733 --> 02:08.433 align:left position:10%,start line:83% size:80% They couldn't afford $400 a month for a family plan. 02:08.433 --> 02:10.900 align:left position:20%,start line:83% size:70% And Virginia didn't expand Medicaid. 02:10.900 --> 02:13.566 align:left position:10%,start line:89% size:80% We actually didn't benefit any. 02:13.566 --> 02:16.100 align:left position:10%,start line:83% size:80% It would have helped if we had expanded Medicaid. 02:16.100 --> 02:20.566 align:left position:10%,start line:71% size:80% It would have helped some of our residents anyway, because there's a dire amount of poverty. 02:22.400 --> 02:26.233 align:left position:10%,start line:77% size:80% There's people dying every day, and dying senseless deaths, because they don't have 02:27.100 --> 02:28.333 align:left position:10%,start line:89% size:80% equal right to health care. 02:28.333 --> 02:30.133 align:left position:20%,start line:83% size:70% TINA BEAN, Virginia: My name is Tina Bean. 02:30.133 --> 02:35.133 align:left position:20%,start line:83% size:70% I'm 59, and I'm from Haysi, Virginia. 02:36.466 --> 02:38.300 align:left position:20%,start line:83% size:70% I had congestive heart failure twice. 02:38.300 --> 02:40.333 align:left position:20%,start line:89% size:70% I didn't have insurance. 02:40.333 --> 02:44.133 align:left position:10%,start line:77% size:80% And that's when I started coming to Paula, or coming to the Health Wagon. 02:44.133 --> 02:46.933 align:left position:10%,start line:83% size:80% Without the medicines and stuff, I probably wouldn't be here. 02:46.933 --> 02:51.266 align:left position:10%,start line:77% size:80% When I heard about the Obamacare a few years ago and checked it and stuff, you could tell 02:51.266 --> 02:52.666 align:left position:20%,start line:83% size:70% then that it wasn't going to work. 02:52.666 --> 02:54.200 align:left position:20%,start line:89% size:70% People can't afford it. 02:54.200 --> 02:56.266 align:left position:10%,start line:83% size:80% JOYCE CAMPBELL: They call it Affordable Care Act. 02:56.266 --> 02:57.700 align:left position:30%,start line:89% size:60% But it's not. 02:57.700 --> 03:00.466 align:left position:20%,start line:83% size:70% And they said you could keep your doctors. 03:00.466 --> 03:04.400 align:left position:10%,start line:83% size:80% You couldn't because your doctors wouldn't take the thing. 03:04.400 --> 03:09.400 align:left position:10%,start line:77% size:80% And they said you could go to the same hospital, but a lot of it was built on lies. 03:11.400 --> 03:13.633 align:left position:10%,start line:77% size:80% If you really want to know the truth, I think - - and I think somebody one of these days 03:13.633 --> 03:14.900 align:left position:20%,start line:83% size:70% is going to give an account for it. 03:14.900 --> 03:16.400 align:left position:20%,start line:83% size:70% JEFF TILLER, Virginia: My name is Jeff Tiller. 03:16.400 --> 03:17.666 align:left position:20%,start line:89% size:70% And I'm 47 years old. 03:17.666 --> 03:22.400 align:left position:20%,start line:83% size:70% And I have worked in the coal mines for 29 years. 03:23.566 --> 03:26.333 align:left position:20%,start line:83% size:70% They diagnosed me for black lung. 03:26.333 --> 03:31.333 align:left position:20%,start line:89% size:70% They done a chest X-ray. 03:32.466 --> 03:36.933 align:left position:20%,start line:83% size:70% They also have found some nodules in my lung. 03:39.133 --> 03:40.600 align:left position:40%,start line:89% size:50% DR. 03:40.600 --> 03:42.666 align:left position:10%,start line:83% size:80% PAULA HILL: We are overwhelmed here at the Health Wagon. 03:42.666 --> 03:47.133 align:left position:10%,start line:77% size:80% We have went to over almost 9,000 patients, and we have a staff of less than 20. 03:49.000 --> 03:52.600 align:left position:10%,start line:77% size:80% Every year, we have an outreach clinic event called Remote Area Medical. 03:54.633 --> 03:57.766 align:left position:10%,start line:77% size:80% You will see them standing in line for dental care, for medical care, for vision. 03:59.833 --> 04:04.566 align:left position:10%,start line:77% size:80% We have found people with dissecting aortic aneurysms that's had to be flown out. 04:06.466 --> 04:08.533 align:left position:10%,start line:77% size:80% We have had patients have stroke right there in front of us at these Remote Area Medical 04:08.533 --> 04:11.033 align:left position:40%,start line:89% size:50% events. 04:11.033 --> 04:14.033 align:left position:10%,start line:71% size:80% We have had brain tumors that have been discovered, lung cancers that have been discovered. 04:14.033 --> 04:15.700 align:left position:10%,start line:89% size:80% And every year, it's like this. 04:15.700 --> 04:18.366 align:left position:10%,start line:83% size:80% We keep thinking, well, is it ever going to get better? 04:18.366 --> 04:21.633 align:left position:20%,start line:83% size:70% Is anybody going to help these forgotten people? 04:21.633 --> 04:24.733 align:left position:10%,start line:83% size:80% They're like something you would see in a Third World country. 04:24.733 --> 04:28.633 align:left position:10%,start line:83% size:80% JOYCE CAMPBELL: The Obamacare could have helped some people. 04:28.633 --> 04:30.133 align:left position:10%,start line:89% size:80% I say it needs to be replaced. 04:30.133 --> 04:33.000 align:left position:20%,start line:83% size:70% TINA BEAN: I hope that they can replace it. 04:33.000 --> 04:36.833 align:left position:10%,start line:77% size:80% I know it's not going to be something they can do overnight, because the mess didn't 04:36.833 --> 04:38.833 align:left position:30%,start line:89% size:60% come overnight. 04:38.833 --> 04:42.833 align:left position:10%,start line:77% size:80% JEFF TILLER: When I first started hearing that Obama getting ready for health care, 04:44.466 --> 04:47.266 align:left position:20%,start line:83% size:70% Obamacare, I thought that was great. 04:47.266 --> 04:49.400 align:left position:30%,start line:89% size:60% We tried it. 04:49.400 --> 04:51.533 align:left position:30%,start line:89% size:60% We got it. 04:51.533 --> 04:52.533 align:left position:20%,start line:89% size:70% Does it have faults? 04:52.533 --> 04:53.866 align:left position:30%,start line:89% size:60% Yes, it does. 04:53.866 --> 04:55.266 align:left position:30%,start line:89% size:60% Is it working? 04:55.266 --> 04:57.300 align:left position:30%,start line:89% size:60% Yes, it is. 04:57.300 --> 05:01.666 align:left position:10%,start line:77% size:80% And I know right there in my hometown of people that's got insurance through the Affordable 05:02.566 --> 05:03.866 align:left position:30%,start line:89% size:60% Care Act. 05:03.866 --> 05:07.533 align:left position:20%,start line:83% size:70% And you reverse it, they lose their insurance. 05:07.533 --> 05:11.200 align:left position:20%,start line:77% size:70% WOMAN: If all of this goes through, I probably won't have anything. 05:11.200 --> 05:13.166 align:left position:20%,start line:83% size:70% I don't know how I'm going to get covered. 05:13.166 --> 05:14.666 align:left position:40%,start line:89% size:50% DR. 05:14.666 --> 05:15.833 align:left position:10%,start line:83% size:80% PAULA HILL: Because of the preexisting conditions? 05:15.833 --> 05:16.866 align:left position:20%,start line:89% size:70% WOMAN: Yes, right. 05:16.866 --> 05:17.866 align:left position:10%,start line:89% size:80% And I have had it for years. 05:17.866 --> 05:19.900 align:left position:40%,start line:89% size:50% DR. 05:19.900 --> 05:22.566 align:left position:10%,start line:77% size:80% PAULA HILL: If the Senate plan actually passes, there will be deep cuts to Medicaid. 05:22.566 --> 05:27.566 align:left position:10%,start line:77% size:80% Even though Virginians didn't expand, what they are paying out is going to be even -- subjected 05:28.300 --> 05:30.333 align:left position:20%,start line:89% size:70% to even more cuts. 05:30.333 --> 05:34.566 align:left position:10%,start line:77% size:80% Then you have the preventive care that's being discussed that they're not going to be paying 05:35.233 --> 05:37.266 align:left position:30%,start line:89% size:60% for anymore. 05:37.266 --> 05:41.133 align:left position:10%,start line:77% size:80% Just because it wasn't a perfect plan, it doesn't mean do away with the whole thing. 05:41.133 --> 05:46.133 align:left position:10%,start line:77% size:80% Why can't we build on it and repair it, not take it away and then start over with another 05:47.233 --> 05:49.300 align:left position:20%,start line:83% size:70% plan that's not perfect and not ideal? 05:49.300 --> 05:53.600 align:left position:10%,start line:77% size:80% JOYCE CAMPBELL: It helped the insurance company, because they made all kind of money off of 05:54.066 --> 05:56.033 align:left position:40%,start line:89% size:50% it. 05:56.033 --> 05:58.600 align:left position:10%,start line:77% size:80% But, as far as helping a lot of poor people, it didn't, and it still isn't. 05:58.600 --> 06:03.600 align:left position:10%,start line:83% size:80% Now, we cannot afford the high cost like Obama had there. 06:05.133 --> 06:07.766 align:left position:20%,start line:77% size:70% There's no way that people in Southwest Virginia can handle it. 06:07.766 --> 06:12.766 align:left position:10%,start line:77% size:80% Now, maybe up Washington, or way up where there's money and jobs, you could. 06:13.966 --> 06:15.900 align:left position:20%,start line:83% size:70% But there's neither money nor jobs here. 06:15.900 --> 06:18.800 align:left position:20%,start line:83% size:70% TINA BEAN: They need to do something to help it. 06:18.800 --> 06:22.300 align:left position:10%,start line:77% size:80% And, hopefully, the administration now, maybe they will do something. 06:22.300 --> 06:24.933 align:left position:10%,start line:83% size:80% JOYCE CAMPBELL: Washington, come to Southwest Virginia. 06:24.933 --> 06:26.433 align:left position:40%,start line:89% size:50% DR. 06:26.433 --> 06:28.000 align:left position:10%,start line:83% size:80% PAULA HILL: Come down here and look in their eyes. 06:28.000 --> 06:30.833 align:left position:20%,start line:83% size:70% And don't forget where you came from. 06:30.833 --> 06:33.533 align:left position:10%,start line:83% size:80% Don't forget who put you in the position that you're in. 06:33.533 --> 06:35.333 align:left position:20%,start line:83% size:70% JOYCE CAMPBELL: Check the people. 06:35.333 --> 06:36.333 align:left position:30%,start line:89% size:60% Look at them. 06:36.333 --> 06:38.033 align:left position:20%,start line:89% size:70% Go sit on the streets. 06:38.033 --> 06:42.533 align:left position:20%,start line:77% size:70% Go bring your car and park it and look at the people that are hurting. 06:42.533 --> 06:45.400 align:left position:20%,start line:77% size:70% And then, if you have got a heart, you will know what it needs.