Texarkana is a town in two states. It straddles Texas and Arkansas,where residents say the quality of their healthcare comes down to what side of the state line they live on because of the decisions of the two states that share this small Southern town.
The state line here is visible as two yellow stripes running north and south and it is that symbolic line that divides the community's healthcare. Under Obamacare, the state of Texas decided not to go with Medicaid expansion for the poor. Arkansas, along with 30 other states, did. And since they're right next door to each other it's much easier to see the vast differences in health and heathcare.
Texas resident Hattie Mclemore, is a 59-year-old mother of two. She displays her many different medications she takes daily. "I have kidney disease, congestive heart failure, Crohn's disease, high blood pressure, high cholesterol, fibromyalgia, and vertigo. Probably more, but that's all I can think of right now."
Even though she worked for years filling other people's prescriptions as a pharmacy technician, she doesn't qualify for Medicaid due to Texas' eligibility requirements. But if she lived on the other side of Texarkana, in Arkansas, she would.
She knows she could benefit from seeing specialists for things like kidney disease but she can't."I don't have insurance, of any kind," she says. It comes down to her neighbors not wanting to pay for her healthcare and voting no to Medicaid reform. To that she says, "It's not like I didn't work a day in my life. You work and can't get (Medicaid)."
A few miles away, on the Arkansas side, but still in the same city, Lashonda Ross says she's having a completely different healthcare experience. Specifically, how long it took for her to receive treatment after being diagnosed with cancer. "Immediately," she says. "Once I finished my surgery and I healed, I received treatment."
Lashonda is a 37-year-old mother of three with stage 2 breast cancer. She's able to receive treatment because she's on the Arkansas side of the line and receives Medicaid. She says it doesn't make sense. "You would think that by us being as close as we are and the only thing that separates these two places is a state line, because there's Texarkana, Arkansas and Texarkana, Texas. You would think that both sides would get equal benefits because they're both Texarkana."
Oncologist Dr. Hesham Hazin, sees cancer patients from both sides of the line. He says he's witnessing dramatic health care disparities. In some cases, the differences could mean life or death, depending on which side the patient is on. "As far as stage-wise, we are seeing more advanced cases from the Texas side, than the Arkansas side. We're seeing incurable patients more from the Texas side where they could be treated with surgery as well as chemotherapy."
As he sees patients and informs them of test results and diagnosis, he says there shouldn't be a difference anywhere, regardless of which state someone lives in. Texarkana however makes it more visible and also more simply defined.
"It's unfair that I have to see this 45-year-old female breast cancer patient who didn't get a mammogram because she didn't have funds," Dr. Hazin says. "As opposed to someone that is the same age, right across the border, got a mammogram, was cured with surgery and might not even need chemo."
Opponents to Medicaid reform say the it would overburden the system, but evidence within the 30 states along with Arkansas has not shown that at all. In fact the numbers show it has been comparable to patients with private insurance have.
Although Texas voted not to reform Medicaid and pay for those like Hattie, in a way they have been doing it already. Hattie goes to a clinic funded by federal taxpayer dollars and since 2015, county residents have paid more than $30,000 for her healthcare"
Hattie and others in her situation are quick to point out that none of them want to be on government assistance. They know there is a stigma that goes with it and they're not leeching off the government. They just have no alternative. But that could be different, and the proof is on the other side of a painted yellow line that runs down State Line Avenue.
"If people would listen to what's being said at this table and at what the doctors say, how could you turn your back on those people?" Hattie says, wiping tears from her eyes. Her voice breaking a little as she finishes, "Why do you want to turn your back on us instead of trying to get us to where we need to be?"
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