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.