ADRIENNE HOAR McGIBBON: Brenda Moore grew up in Danville, a rural town that sits just north of the border between Virginia and North Carolina.

As an adult, she worked as a daycare provider and sometimes juggled multiple jobs.

BRENDA MOORE: I love doing anything that interacts with people.

That's my main focus.

I like to be- I like to caregive.

ADRIENNE HOAR McGIBBON: But Moore struggles with rheumatoid arthritis and bipolar disorder, a combination that's made it difficult for her to work.

BRENDA MOORE: Well, I have physical and mental limitations.

So, with my arthritis... Wow... (deep sigh) Only thing I can say is pain, pain, pain.

It really is a hindrance when you can't move, you can't do the things that you would like to do.

ADRIENNE HOAR McGIBBON: She spent two months in a homeless shelter before finding support and getting disability through Medicaid, which helps her pay for a place to live and an aide.

She worries if Congress makes cuts to Medicaid, she could lose her home once again.

I'm the face of Medicaid or reason why you need Medicaid.

You know, we don't want to see people on the street.

Budget talks will be a primary focus for federal lawmakers this spring.

Republicans who control both chambers have said they want to cut $880 billion in spending to pay for tax cuts, which some say is likely to impact Medicaid.

BRENDA MOORE: We want to see people thriving, and having their own and being a community member.

ADRIENNE HOAR McGIBBON: In Danville, nearly a third of adults under 65 are on Medicaid.

That's according to a recent Georgetown University study.

Danville was once a thriving textile and tobacco town that hit hard times when the town's industries shuttered.

Despite plans to spur economic development, including a newly opened casino, Danville still has an unemployment rate that's higher than the national average.

VICTORIA RICHARDSON: A lot of people, you know, get their coverage through their employer, but if you're unemployed, then, you know, you have to go to other sources for insurance coverage.

ADRIENNE HOAR McGIBBON: Victoria Richardson of the Virginia Poverty Law Center says areas with higher unemployment depend on Medicaid.

VICTORIA RICHARDSON: The rural areas are actually a lot more reliant on Medicaid funding than the urban areas, which might go against what people might believe actually happens.

ADRIENNE HOAR McGIBBON: Kathy Gibbs had a job as a home health care provider until a sudden illness forced her to stop working.

KATHY GIBBS: In January ‘19, I was fine and then by April I couldn't walk.

ADRIENNE HOAR McGIBBON: Finally, she was diagnosed with an extremely rare condition called POEMS syndrome that attacks the nervous system and can be deadly.

While Gibbs was out of work and searching for answers, her bills piled up.

She fell behind on her mortgage and nearly lost her home until getting on Medicaid and eventually Medicare.

KATHY GIBBS: Until I was diagnosed, I had no means of paying for anything.

So, once I got the disability, it went back and picked up, when I was actually first put in.

ADRIENNE HOAR McGIBBON: The federally funded insurance retroactively covered Gibbs costs.

And now it helps pay for medicine.

She needs to stay alive.

KATHY GIBBS: Without it I wouldn't have much time, but with it, you know, I can extend my lifespan.

So, I mean, it's critical that I do get the medicine.

Without Medicaid, I wouldn't be able to afford it.

ADRIENNE HOAR McGIBBON: Martina Tatum, a community health worker who cares for both Moore and Gibbs, says federal cuts to Medicaid could have devastating effects for her clients.

MARTINA TATUM: This is like, because this hits the people that are struggling anyway.

You know, it's like that hits the most vulnerable population.

ADRIENNE HOAR McGIBBON: Congress is set to discuss possible spending cuts, which could impact Medicaid this spring.

Adrienne Hoar McGibbon, VPM News.