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Cartoon illustrating Medicaid gap using highway and road signs.

One U.S. city is providing a glimpse into the haves and have-nots in the Medicaid expansion fight: Texarkana, half in Texas, half in Arkansas. On the Arkansas side, the people who've fallen through the holes in the safety net have access to Medicaid. In Texas, they don't. Many are employed on one side or the other, but live—some in homeless shelters—on the other. The New York Times takes a close look.
TEXARKANA, Tex. — On a hazy, hot evening here, Janice Marks ate a dinner of turkey and stuffing at a homeless shelter filled with plastic cots before crossing a few blocks to the Arkansas side of town to start her night shift restocking the dairy cases at Walmart.

The next day, David Tramel and Janice McFall had a free meal of hot dogs and doughnut holes at a Salvation Army center in Arkansas before heading back to their tent, hidden in a field by the highway in Texas.

None of the three have health insurance. But had Ms. Marks, 26, chosen to sleep on the side of town where she works, or had Mr. Tramel and Ms. McFall, who are both in their early 20s, made their camp where they had eaten their dinner, their fortunes might be different.

They profile another person at the Texas-side shelter, Ed Miller who is 42 and has congestive heart failure, sleep apnea, and a recent diagnosis of bronchitis. He didn't seem to know about the possibility of Medicaid on the other side until this reporter spoke with him about it—many of the residents don't seem to be aware of it. Many are so used to being rejected by assistance programs they don't want to bother. Some don't have the necessary documentation to apply for assistance, wherever they live.
The expansion is already having an effect on the city’s biggest provider of charity care [on the Arkansas side], the nonprofit Christus St. Michael Health System. “We’re seeing more patients with a payer,” said Chris Karam, its president, referring to those with health insurance coverage.

On the Texas side, though, it’s business as usual. “It makes me mad,” said Mr. Miller, who is not receiving any federal benefits at the moment despite his array of illnesses. “They need to quit playing games with people’s lives. Rich people. Government people.”

Business as usual.

Originally posted to Joan McCarter on Mon Jun 09, 2014 at 10:30 AM PDT.

Also republished by TexKos-Messing with Texas with Nothing but Love for Texans, New Jersey Kossacks, Subversive Agitation Team Action Network, Street Prophets , Protest Music, Team DFH, Obamacare Saves Lives, and Daily Kos.

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Comment Preferences

  •  Tip Jar (35+ / 0-)

    "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

    by Joan McCarter on Mon Jun 09, 2014 at 10:30:53 AM PDT

  •  Should be interesting (4+ / 0-)
    Recommended by:
    cotterperson, alypsee1, nomandates, suesue

    Watching this experiment play out.

    “Texas is a so-called red state, but you’ve got 10 million Democrats here in Texas. And …, there are a whole lot of people here in Texas who need us, and who need us to fight for them.” President Obama

    by Catte Nappe on Mon Jun 09, 2014 at 11:03:22 AM PDT

  •  Uh, if we didn't have the governor we do, (2+ / 0-)
    Recommended by:
    nomandates, suesue

    this might all be a bit different.

    Vote for Wendy Davis for Texas governor!

    I'm part of the "bedwetting bunch of website Democrat base people (DKos)." - Rush Limbaugh, 10/16/2012 Torture is Wrong! We live near W so you don't have to. Send love.

    by tom 47 on Mon Jun 09, 2014 at 03:05:29 PM PDT

  •  That gentleman left something out. (7+ / 0-)

    Rich people. Government people. REPUBLICAN people.

    Hey GOP! You'll get my Obamacare when you pry it from my cold, dead hands. And thanks to Obamacare, that just may be awhile.

    by jazzmaniac on Tue Jun 10, 2014 at 07:38:42 PM PDT

  •  Movement Conservatism (8+ / 0-)

    requires, demands that we have boogeymen for the masses to be in utter terror of and that we have engineered object lessons in unnecessary human suffering that is advertised as being deserved. It's all interconnected.  

    They want you to hate your poor neighbor who is without, because if you don't see them as parasites whose nature has earned them a bad lot in life, you might raise some rich fuck's taxes.

    Then you get these quirks of map-making that make the plan so stark and so starkly absurd that the evil is hard to cloud in static and bullshit and noise.

    You live here, you have.

    You live there, across the street, you have not.

    And it's evil, and it's evil that is staring you right in the face, and it's manufactured suffering.

    One of the greatest triumphs of Movement Conservatism is making people, especially those who are being made to suffer for no reason except that the suffering is a part of the plan to keep people at each others throats, not see how interconnected all the bad things in our society is.

    If you are poor, you did something to deserve it.

    If you are sick, you are weak, lazy, don't take care of yourself.

    There is always a reason that the malignant engineered suffering is the fault of those in pain and those in need.

    There is always a reason why those benefitting the most and are asked the least are the "real" victims.

    It's evil. Everything has a vile reason for being the way it is.

    I bet Roger Ailes and his ilk thank their almighty dollars every damned day that the Village is in their back pocket. Else, these stories would be vastly bigger stories. They couldn't do the evil they do without being enabled.

    "Real journalism is printing what someone else does not want printed. Everything else is public relations." -George Orwell

    by LeftHandedMan on Tue Jun 10, 2014 at 07:58:06 PM PDT

  •  Wow, that is a great picture at the top. The Dems (3+ / 0-)
    Recommended by:
    rebel ga, dewtx, hbk

    should adopt it in every state where the Repubs blocked Medicaid.

    Sure the Faux Noise/RWNJ's will scream bloody murder, but they'll do that anyway. Might as well be hanged for a sheep as a lamb.

  •  The state lines run right through the center..... (4+ / 0-)
    Recommended by:
    dewtx, rebel ga, hbk, anonie1

    of the courthouse, so this is the perfect place to study the effects of the Arkansas ACA expansion -vs- the RPFY* to Texas.

    This is not a rich area of either state, most of the money comes from the paper pulp mills.  The smell of the pulp mills permeates everything in the area, I mean right down to the pores of your skin...I always wondered if the chemicals that produced that smell were health hazards.  FYRP*

    *   Rick Perry's F*ck You

    ** F*ck You Rick Perry

    "A weed is a plant whose virtues have not yet been discovered." Ralph Waldo Emerson

    by Yo Bubba on Tue Jun 10, 2014 at 08:18:59 PM PDT

  •  Rec'd, Tipped And Re-Published. (3+ / 0-)
    Recommended by:
    dewtx, hbk, foresterbob

    Brought To You By That Crazed Sociologist/Media Fanatic rebel ga Be The Change You Want To See In The World! Gandhi

    by rebel ga on Tue Jun 10, 2014 at 08:24:31 PM PDT

  •  Personal Responsibility (1+ / 0-)
    Recommended by:

    I wonder if this Mr. Miller is one of the three people who voted for Obama in Bowie County.  Or maybe on the the three people who voted against the US Representative, a representative who co-sponsored bills to gut the ACA, gut the EPA, and instead of insuring that the IRS collected tax money to pay for services, co-sponsored a bill to promote the myth that the IRS targets certain political group.

    This is not me saying that if only the white people would not be such morons and voted the way I think is right maybe they would have health care(Bowie county has about a rate of white non-hispanics that is about 50% higher than the texas average).  Of if the old people would not allow them selves to be brainwashed and voted the way I want maybe there would be some treatment for their illnesses(Bowie county has a rate of senior population that is about 50% higher then the texas average).

    No, what I am saying is when you consistently vote to put crackpots into office, officials that believe in personal responsibility and not government handouts, you can't really complain when there are no more government handouts.

    She was a fool, and so am I, and so is anyone who thinks he sees what God is doing. -Kurt Vonnegut Life is serious but we don't have to be - me

    by lowt on Tue Jun 10, 2014 at 08:25:45 PM PDT

  •  Medicare expansion under ACA (6+ / 0-)

    I live not far from Texarkana in Oklahoma, and  read the NYTimes piece. I am also living across that Red Line which divides those who can get health care from those who cannot -- a line drawn simply out of political spite. These Red Staters, including Rick Perry and Oklahoma's Mary Fallin are playing with peoples' LIVES to score short-term political gain. It has nothing to do with state finances. The Feds will pay! Yet they don't seem to give a damn. There is a level in Dante's Hell for these people, and it will be far lower than that of anyone reading this.

    And in months ahead, we will be reading of people dying because of these heartless, self-serving, ignorant governors.

    The only reason I have health care right now is because I'm a vet. And I must say, despite recent news, the VA in Tulsa, OK has done right by me.

    •  No, no, the Fedrul tyranny paying is the problem! (0+ / 0-)

      By which they mean that they would rather pay taxes to fund Medicaid expansion in other states than in their own, because if we expand Medicaid here more people who should by rights be Republicans will vote for the Evul Soshulist Dimocrats!

      Back off, man. I'm a logician.—GOPBusters™

      by Mokurai on Wed Jun 11, 2014 at 10:04:34 AM PDT

      [ Parent ]

  •  Please Help (2+ / 0-)
    Recommended by:
    dewtx, foresterbob

    Please help us and tell Governor (of Alabama) Bentley to expand Medicaid. (You can use his facebook page) (let him have it)

  •  Please Help! (1+ / 0-)
    Recommended by:

    Please help us and tell Governor (of Alabama) Bentley to expand Medicaid.  Here’s his contact number 334-242-7100 or fax 334-353-0004.

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