MARY LOUISE KELLY, HOST:
Gila County, Arizona, went big for Donald Trump and backed the president 2 to 1 in last year's election. The county also relies a lot on Medicaid, the federal health insurance program that Trump's Republican allies in Congress are looking to cut. Well, that makes for some complicated feelings about Medicaid. Noam Levey with our partner KFF Health News reports.
NOAM LEVEY: Globe, Arizona, is an old copper mining town about 90 miles over the mountains from Phoenix. Down by the former train depot, there's a street festival every month with food trucks and live music.
(SOUNDBITE OF MUSIC)
LEVEY: I visited to find out what people in a conservative place like this thought about the Medicaid debate in Washington. House Republicans just advanced a plan to cut more than $700 billion from the safety net program.
Can I interrupt you guys for a second?
HEATHER HEISLER: Sure.
LEVEY: I'm a health care reporter from Washington, D.C.
It wasn't hard to find people who were on Medicaid or knew someone who was. Heather Heisler's husband has relied on the program for years.
HEISLER: We're ranchers, and there's not much money in ranching. Most people think there is, but there isn't.
LEVEY: Heisler was selling crafts at the festival. She says Medicaid was especially helpful after her husband had an accident. A forklift tipped over and part of his left foot was amputated.
HEISLER: If anything happens, he's able to go to the doctor, he's able to go to the emergency room, get medicines.
LEVEY: And if he lost the coverage?
HEISLER: Oh, we would - it would be very bad for him.
LEVEY: GOP lawmakers want to put work requirements on some Medicaid enrollees and make people file more paperwork to prove they're eligible. The result, according to the nonpartisan Congressional Budget Office - 10 million people will likely lose Medicaid insurance. In Gila County, close to 4 in 10 residents are on Medicaid and the related children's health insurance program. That's nearly double what it was 15 years ago.
FERNANDO SHIPLEY: And a lot of people think that, oh, well, those are the people that aren't working. Not necessarily.
LEVEY: Fernando Shipley runs a State Farm office in town. He's a city council member and former mayor.
SHIPLEY: If you're a single parent with two kids and you're making $20 an hour, you're not making ends meet. You got to pay rent. You got to feed those kids.
LEVEY: The growing importance of Medicaid to places like Globe, Arizona, helps explain why congressional Republicans face so much resistance to their proposed cuts. Bob Ward has been polling for a coalition trying to protect Medicaid. His firm also works for Trump.
BOB WARD: There's been a shift in the public's attitude and particularly, you know, voters on the right that sometimes government plays a role in getting people health care, and that's OK. And if you take away that health care, people are going to be angry about it.
LEVEY: Back in Globe, I found people who might be OK with some cuts to Medicaid. I met Debbie Cox at her property management office just outside downtown. The squat building is by a McDonald's on a busy road where trucks roll by every few minutes.
DEBBIE COX: Service First Realty. OK, go ahead.
LEVEY: She was wrapping up some calls on a Friday afternoon.
COX: Would you give me a call next week? 'Cause I need to start and do a walk-through inspection.
LEVEY: Cox has tenants who rely on Medicaid. And at the domestic violence shelter where Cox is president of the board, she says staff always look to enroll women and their kids. Still, she has mixed feelings about the program.
COX: It's not that I don't see the need for it. I see the need for it literally on a weekly basis. But I also see a need for revamping it significantly because it's been taken advantage of for so long.
LEVEY: How many people are actually taking advantage of Medicaid and how much waste there is in the program are hotly debated. But to retiree Rick Uhl, the problems feel real. I caught up with him at the Globe Senior Center as he was stacking chairs after lunch.
RICK UHL: There's a lot of waste, of money not being accounted for, and I think that's a shame.
LEVEY: Downtown at the fair, I talk to David Sander and his wife Linda about Republican plans for Medicaid.
DAVID SANDER: I've heard that they really aren't cutting it. Now, some people want to have more money spent, and they're not going to spend that much, but they're actually not cutting back. That's my understanding.
LEVEY: The Sanders have a neighbor on Medicaid. Linda says the neighbor wouldn't be able to live without the program.
LINDA SANDER: Couldn't afford to have an apartment, make her bills and survive.
LEVEY: Her fate and the fate of millions of others who rely on Medicaid now hang on what Congress decides 2,000 miles away in Washington.
In Globe, Arizona, I'm Noam Levey. Transcript provided by NPR, Copyright NPR.
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