JUDY WOODRUFF: And speaking of the efforts to replace the Affordable Care Act, let’s continue hearing how some citizens and health care providers see it.
Producer Jason Kane visited a pair of clinics in the heart of coal country.
Last night, we took you to the town of Wise, Virginia, in a state that opted not to expand Medicaid for low-income residents.
Just across the border, in West Virginia, the Affordable Care Act and its Medicaid expansion meant the rate of uninsured residents dropped from at least 21 percent before the law took effect to 9 percent in 2015, and nearly a third of families in the state do get Medicaid. More than 83 percent of Mingo County voted for the president in the election.
And the state has been ravaged by the opioids epidemic. But at the Williamson Health and Wellness Center, nerves are now on edge as patients recount their personal stories.
REBECCA HICKS, Patient, Williamson Health & Wellness Center: My name’s Rebecca Hicks, and I’m from Chattaroy, West Virginia. I’m 37 years old.
When I was younger, I was raped. I guess I got on drugs to cope with it, regular pain pills. First, it started with, you know, snorting the pills. Then it led to shooting the pills.
And I have always struggled to have a doctor. And this place kind of takes care of all of it. My access to Medicaid has helped me pay for medicines that I would never have been able to pay for and to see specialists that I wouldn’t be able to see if I didn’t have that medical care.
JEROME CLINE, Family Nurse Practitioner: My name’s Jerome Cline. I’m a family nurse practitioner.
With the passage of the Affordable Care Act, the state had expanded Medicaid programs. Right now, it’s just under 50 percent of our patients, I think, are Medicaid.
VICKI HATFIELD, Family Nurse Practitioner: My name is Vicki Hatfield. I’m a certified family nurse practitioner and a certified diabetes educator.
Once we started seeing more patients qualify for Medicaid, they were able to come in, and we were able to start getting them caught up on their preventive screenings and health promotion activities, and just be able to treat their chronic illnesses that had been neglected.
The increased funds for Medicaid services brought more revenue into the clinic, so that allowed us to hire more people here. It also allowed us to do some other things in the community to promote healthy living.
JEROME CLINE: We have a farmers market every Saturday.
VICKI HATFIELD: We also had community gardens start. And we see more people growing their own vegetables.
JEROME CLINE: We have a community 5K almost every month.
And then we have a community health worker program. It’s certainly a lot of cheaper to keep people healthy at home than it is once they get into the system.
VICKI HATFIELD: Now, as we watch what’s happening with possible repeal or replacement of the Affordable Care Act, it’s very concerning. I know patients are concerned, particularly patients who had chronic diseases that now they’re able to get medications for, or patients who need annual screening.
CONNIE SUE MAHON, Patient, Williamson Health & Wellness Center: I have got a head injury. I have got a sleeping disorder. I have got back problems. I have got knee problems. I have panic attacks.
My name is Connie Sue Mahon. We need the medical. And if they take it, it’s going to hurt a lot of families in West Virginia. President Trump promised us a better plan. And we all voted to get him in there because we thought he’d do this country better. But if we ain’t got that medical, we won’t have nothing. And that’s how people in Mingo County live.
JERINEL TAYLOR, Patient, Williamson Health & Wellness Center: My name is Jerinel Taylor. I’m 58 years old. I have diabetes. You have to have the medication to keep the diabetes down. If you don’t, you lose your eyes, your kidneys, and all this stuff, so I try to keep up with it.
I started receiving the Medicaid after the Obamacare, the Affordable Care Act, or whatever it was called. With the care I receive here, my numbers have come down, my blood pressure, and they keep everything pretty much took care of for me, the mammograms and all the cancer screenings that I need.
Affordable Care Act has helped me, but it has hurt other people, especially people like my brother. It’s hurt him. And he works hard. And then they take it out of his taxes because he doesn’t have insurance. He can’t afford the insurance under the Affordable Care Act. So, it has hurt him. So, if they drop me, they drop me.
JEROME CLINE: Thinking about the possible changes to the health care system and the drive to save money with Medicaid, I’m not sure if there’s an accounting of these people now seeking their primary care through the E.R.s, when they can come here and the visit, and pay a small co-pay, vs. going to the E.R., and all of a sudden, it’s a $2,000 bill.
REBECCA HICKS: About two years ago, I had been in the hospital, like in the mental ward for my mental health at least 25 times. And now I have hadn’t had to be hospitalized for over two years, because of all the doctors here that has helped me so much.
JEROME CLINE: Especially now, with the drug epidemic around here, what are we going to do with the people who have found an improved quality of life, and they have moved beyond, you know, a life of addiction, and we have got them into recovery? If we curtail that treatment, what potentially happens to those patients?
VICKI HATFIELD: I would like to see the Medicaid expansion continue. I would like to see also a revision for some of the premiums.
I have some patients who did not qualify for Medicaid expansion, but they also could not afford the premium and the deductible. I think that needs to be revisited.
I think there are good parts to the program, but there are also some things that do need improvement.
REBECCA HICKS: I would tell the politicians that they might want to think real hard about it and take a break from it a little bit until they know more about it, because what they’re dealing is, if they take health care away from somebody that’s an addict, they’re going to resort to worser things.
I chose those people. I put my faith in those people that they would make this place better, not take away the only things that were helping this area.
What Medicaid patients in West Virginia want from health care reform