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JUDY WOODRUFF: But first: As 
Republicans on Capitol Hill 
try to repeal and replace the

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Affordable Care Act, we're 
going to spend the next couple 
of nights hearing what patients

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and health care providers 
think should be done.

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Our team visited West Virginia 
and Virginia, which made very 
different decisions about

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Medicaid.

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West Virginia did commit 
to expanding Medicaid 
through Obamacare.

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But Virginia is one of 
19 states that didn't.

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The state's 
Republican-controlled 
legislature voted 
against expanding the 
program to 400,000

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more citizens because 
of concerns over costs.

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Tonight, we visit a clinic 
providing free care in the 
western corner of Virginia, a

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region that strongly supported 
the election of President Trump.

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DR.

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PAULA HILL, Family 
Nurse Practitioner: My 
name is Dr. Paula Hill.

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I'm a family nurse practitioner 
and clinical director 
here at the Health Wagon.

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We are at the Smiddy 
Clinic in Wise, Virginia.

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We actually say that we're 
the forgotten Virginia, 
because we're down in 
the corner with Tennessee

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and Kentucky borders.

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And we're very rural, very 
mountainous and very isolated 
from the rest of Virginia and

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a lot of ways the 
rest of the country.

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We have a high rate of heart 
disease, diabetes, and it's 
because of the economics here.

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JOYCE CAMPBELL, Virginia: 
All the mines and stuff 
have just about closed down.

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And there really isn't 
any jobs around here.

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My name is Joyce Campbell.

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I'm from Wise, Virginia.

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You know, I get $800 a month.

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And I am fortunate I do 
have an income coming in, 
with my Social Security.

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And the time you pay your rent, 
your electric, your water, your 
gas, you either have a choice

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of whether you want to 
buy your medicine or 
whether you want to eat.

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DR.

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PAULA HILL: The Affordable Care 
Act, when it was enacted, it 
did help a lot of Virginians.

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Down here in this part of the 
state, in far Southwestern 
Virginia, we didn't benefit as

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much because there are such 
dire economic constraints here.

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Our patients couldn't afford 
the Affordable Care Act.

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They couldn't afford $400 
a month for a family plan.

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And Virginia didn't 
expand Medicaid.

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We actually didn't benefit any.

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It would have helped if 
we had expanded Medicaid.

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It would have helped 
some of our residents 
anyway, because there's 
a dire amount of poverty.

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There's people dying every 
day, and dying senseless 
deaths, because they don't have

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equal right to health care.

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TINA BEAN, Virginia: 
My name is Tina Bean.

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I'm 59, and I'm from 
Haysi, Virginia.

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I had congestive 
heart failure twice.

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I didn't have insurance.

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And that's when I started 
coming to Paula, or coming 
to the Health Wagon.

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Without the medicines and stuff, 
I probably wouldn't be here.

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When I heard about the Obamacare 
a few years ago and checked 
it and stuff, you could tell

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then that it wasn't 
going to work.

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People can't afford it.

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JOYCE CAMPBELL: They call 
it Affordable Care Act.

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But it's not.

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And they said you could 
keep your doctors.

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You couldn't because your 
doctors wouldn't take the thing.

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And they said you could go 
to the same hospital, but a 
lot of it was built on lies.

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If you really want to know the 
truth, I think - - and I think 
somebody one of these days

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is going to give 
an account for it.

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JEFF TILLER, Virginia: 
My name is Jeff Tiller.

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And I'm 47 years old.

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And I have worked in the 
coal mines for 29 years.

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They diagnosed me 
for black lung.

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They done a chest X-ray.

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They also have found 
some nodules in my lung.

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DR.

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PAULA HILL: We are overwhelmed 
here at the Health Wagon.

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We have went to over almost 
9,000 patients, and we have 
a staff of less than 20.

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Every year, we have an 
outreach clinic event 
called Remote Area Medical.

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You will see them standing 
in line for dental care, for 
medical care, for vision.

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We have found people with 
dissecting aortic aneurysms 
that's had to be flown out.

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We have had patients have stroke 
right there in front of us 
at these Remote Area Medical

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events.

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We have had brain 
tumors that have been 
discovered, lung cancers 
that have been discovered.

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And every year, it's like this.

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We keep thinking, well, is 
it ever going to get better?

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Is anybody going to help 
these forgotten people?

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They're like something you would 
see in a Third World country.

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JOYCE CAMPBELL: The Obamacare 
could have helped some people.

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I say it needs to be replaced.

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TINA BEAN: I hope that 
they can replace it.

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I know it's not going to be 
something they can do overnight, 
because the mess didn't

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come overnight.

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JEFF TILLER: When I first 
started hearing that Obama 
getting ready for health care,

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Obamacare, I thought 
that was great.

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We tried it.

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We got it.

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Does it have faults?

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Yes, it does.

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Is it working?

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Yes, it is.

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And I know right there in my 
hometown of people that's got 
insurance through the Affordable

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Care Act.

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And you reverse it, they 
lose their insurance.

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WOMAN: If all of this 
goes through, I probably 
won't have anything.

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I don't know how I'm 
going to get covered.

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DR.

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PAULA HILL: Because of the 
preexisting conditions?

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WOMAN: Yes, right.

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And I have had it for years.

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DR.

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PAULA HILL: If the Senate 
plan actually passes, there 
will be deep cuts to Medicaid.

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Even though Virginians didn't 
expand, what they are paying out 
is going to be even -- subjected

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to even more cuts.

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Then you have the preventive 
care that's being discussed that 
they're not going to be paying

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for anymore.

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Just because it wasn't a 
perfect plan, it doesn't mean 
do away with the whole thing.

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Why can't we build on it and 
repair it, not take it away and 
then start over with another

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plan that's not 
perfect and not ideal?

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JOYCE CAMPBELL: It helped the 
insurance company, because they 
made all kind of money off of

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it.

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But, as far as helping 
a lot of poor people, it 
didn't, and it still isn't.

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Now, we cannot afford the high 
cost like Obama had there.

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There's no way that 
people in Southwest 
Virginia can handle it.

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Now, maybe up Washington, 
or way up where there's 
money and jobs, you could.

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But there's neither 
money nor jobs here.

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TINA BEAN: They need to 
do something to help it.

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And, hopefully, the 
administration now, maybe 
they will do something.

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JOYCE CAMPBELL: Washington, 
come to Southwest Virginia.

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DR.

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PAULA HILL: Come down here 
and look in their eyes.

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And don't forget 
where you came from.

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Don't forget who put you in 
the position that you're in.

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JOYCE CAMPBELL: 
Check the people.

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Look at them.

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Go sit on the streets.

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Go bring your car and 
park it and look at the 
people that are hurting.

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And then, if you have 
got a heart, you will 
know what it needs.