"In other parts of the country, the primary impact of the ACA has been requiring people to have private health insurance, but in poor and sick communities like McDowell County, the law’s dominant effect has been the Medicaid expansion, which has given more people access to the kind of health care that wasn’t widely available or affordable to them before. With an insurance card in her pocket, the patient at Tammy’s window can venture into the realms of medical care that are typically out of reach to those without one: blood work, immunizations, specialized doctors, surgery, physical therapy.
If she needs mental health counseling, the clinic no longer sends her to the next county over; last July, Tug River was able to hire a psychologist, who is now treating 180 people, many of whom are trying to overcome opioid addictions.
If she needs medication, the nurses won’t go digging in a closet of samples left by drug reps as they used to do for the uninsured. The medication will come from a pharmacy and cost no more than a few dollars."