JUDY WOODRUFF: But first: As Republicans on Capitol Hill try to repeal and replace the Affordable Care Act, were 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 didnt. The states 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.

PAULA HILL, Clinical Director, The Health Wagon: My name is Dr. Paula Hill. Im 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 were the forgotten Virginia, because were down in the corner with Tennessee and Kentucky borders.

And were 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 its because of the economics here.

JOYCE CAMPBELL, Patient, The Health Wagon: All the mines and stuff have just about closed down. And there really isnt any jobs around here.

My name is Joyce Campbell. Im 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.

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 didnt benefit as much because there are such dire economic constraints here. Our patients couldnt afford the Affordable Care Act. They couldnt afford $400 a month for a family plan.

And Virginia didnt expand Medicaid. We actually didnt benefit any. It would have helped if we had expanded Medicaid. It would have helped some of our residents anyway, because theres a dire amount of poverty. Theres people dying every day, and dying senseless deaths, because they dont have equal right to health care.

TINA BEAN, Patient, The Health Wagon: My name is Tina Bean. Im 59, and Im from Haysi, Virginia.

I had congestive heart failure twice. I didnt have insurance. And thats when I started coming to Paula, or coming to the Health Wagon. Without the medicines and stuff, I probably wouldnt be here.

When I heard about the Obamacare a few years ago and checked it and stuff, you could tell then that it wasnt going to work. People cant afford it.

JOYCE CAMPBELL: They call it Affordable Care Act. But its not. And they said you could keep your doctors. You couldnt because your doctors wouldnt 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, Patient, The Health Wagon: My name is Jeff Tiller. And Im 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.

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 thats 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, its like this. We keep thinking, well, is it ever going to get better? Is anybody going to help these forgotten people? Theyre 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 its not going to be something they can do overnight, because the mess didnt 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 thats got insurance through the Affordable Care Act. And you reverse it, they lose their insurance.

WOMAN: If all of this goes through, I probably wont have anything. I dont know how Im going to get covered.

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 didnt expand, what they are paying out is going to be even subjected to even more cuts.

Then you have the preventive care thats being discussed that theyre not going to be paying for anymore. Just because it wasnt a perfect plan, it doesnt mean do away with the whole thing. Why cant we build on it and repair it, not take it away and then start over with another plan thats 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 didnt, and it still isnt.

Now, we cannot afford the high cost like Obama had there. Theres no way that people in Southwest Virginia can handle it. Now, maybe up Washington, or way up where theres money and jobs, you could. But theres 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 dont forget where you came from. Dont forget who put you in the position that youre 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.

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What Virginia's poorest citizens want from health care reform - PBS NewsHour