For many rural Southerners, no health care to lose

  Last week, the Senate took a series of votes aimed at repealing parts or all of the Affordable Care Act. Under any of the plans put forth by Republicans – all voted down thus far – millions of Americans would lose their health care coverage, according to the Congressional Budget Office.

  But in places like southwestern Virginia, many simply have no health insurance — or access to medical care — to lose.

  Last weekend, more than 2,000 people in Wise, Virginia, waited in long lines and sweltering heat for basic health services from the Remote Area Medical Expedition. At a county fairground over a period of three days, volunteer doctors pulled teeth, performed chest X-rays, tested insulin levels, and handed out eyeglasses to people too poor or too sick to get health care any other way.

  "The past several months the toothaches have been so bad I've literally been counting down the days and praying I can make it through," Matthew Culbertson, 27, told Trip Gabriel for The New York Times.

  Culbertson is not alone. As Gabriel writes,

    Four years into the rollout of the Affordable Care Act's major provisions, 29 million Americans still lack health insurance. Millions live in states like Virginia that did not expand Medicaid to childless adults among the working poor, as the law allowed. Even for people helped by government programs like basic Medicaid, veterans' care and disability, there are many gaps: Low-income people struggle to afford co-payments, the gas to drive to a doctor and prescription drugs.

  These gaps are particularly devastating in the face of serious disease. In Marion, Alabama – where nearly half the residents live below the poverty line – an outbreak of tuberculosis is ravaging the black community. There is no hospital in town, and the nearest one, 20 minutes away, has few resources.

  For a low-income population like Marion's, according to Frances Ford, the head of a local nonprofit, the prospect of dismantling the A.C.A. "is an impossibility for people."

  "And these people are trying to work," Ford told Helen Ouyang for Harper's Magazine. "Some people here are going to say it's not worth working. You're working, and all your money is going to health insurance."

  In Marion, life expectancy is seven years lower than the national average, obesity a third higher, and cancer and cardiovascular disease more than one and a half times more common.

  By any measure, it's clear that people in places like Marion desperately need health care. As Southern Poverty Law Center Deputy Legal Director Sam Brooke says, "This is not about Obama or about Trump. This is about ensuring that we have a fair and functional health care system that serves every American" — including low-income people in the rural South.

  This article was published by the Southern Poverty Law Center, an Alabama-based civil rights organization.