>> Sreenivasan: TONIGHT, WE

BRING YOU THE THIRD STORY IN OUR

SERIES ABOUT POVERTY IN AMERICA,

THIS TIME IN WEST VIRGINIA.

NEWSHOUR WEEKEND SPECIAL

CORRESPONDENT SIMON OSTROVSKY

HAS BEEN FOLLOWING IN THE

FOOTSTEPS OF THE UNITED NATIONS'

SPECIAL RAPPORTEUR ON EXTREME

POVERTY AND HUMAN RIGHTS, PHILIP

ALSTON.

ALSTON RECENTLY TOURED AMERICA,

SPOTLIGHTING THIRD WORLD-STYLE

POVERTY IN OUR FIRST WORLD

COUNTRY.

SUPPORTED IN PART BY A GRANT

FROM THE PULITZER CENTER ON

CRISIS REPORTING, THIS REPORT IS

PART OF OUR ONGOING SERIES ABOUT

POVERTY AND OPPORTUNITY IN

AMERICA, "CHASING THE DREAM."

>> Reporter: McDOWELL COUNTY IS

EMBLEMATIC OF THE POVERTY STILL

DRAGGING DOWN PARTS OF AMERICA.

IT LEADS WEST VIRGINIA IN THE

NUMBER OF PEOPLE HOSPITALIZED

FOR OPIOID-RELATED REASONS, OVER

36% OF RESIDENTS LIVE BELOW THE

POVERTY LINE, AND THE POPULATION

HAS DROPPED FROM 50,000 TO LESS

THAN 20,000 SINCE 1970.

A DISPROPORTIONATE AMOUNT OF

RESIDENTS HERE RELY ON MEDICAID

AND MEDICARE AS THEIR PRIMARY

HEALTH INSURANCE.

BECAUSE THOSE PROGRAMS DON'T

COVER DENTAL IN A MEANINGFUL

WAY, IT'S LED TO A DENTAL HEALTH

CRISIS.

THE CRISIS IS PLAYING OUT IN A

TOWN CALLED WELCH.

THIS FACILITY IS RUN BY HEALTH

RIGHT.

IT'S A NONPROFIT MEDICAL GROUP

THAT DEPLOYS A MOBILE CLINIC

STAFFED WITH THREE HEALTH

PROFESSIONALS TO AREAS OF THE

STATE UNDERSERVED FOR DENTAL

CARE.

>> WE EXPECT ABOUT 17 PATIENTS

TODAY ALL FROM THE SURROUNDING

AREA, NEAR WELCH ITSELF.

WELCH IS ONE OF OUR COUNTIES

THAT WE CAN'T SEE AS MANY

PATIENTS BECAUSE WE HAVE TO

TRAVEL LONGER TO GET HERE.

>> Reporter: NEARLY 57 MILLION

PEOPLE IN THE U.S. LIVE IN AREAS

DESIGNATED BY THE HEALTH

RESOURCES AND SERVICES

ADMINISTRATION AS "LACKING BASIC

ACCESS TO DENTAL CARE."

>> AND OPEN.

>> Reporter: McDOWELL COUNTY IS

ONE OF THEM BECAUSE OF ITS

DISTANCE FROM LARGER CITIES, A

SHRINKING POPULATION, AND AN

INCREASING AMOUNT OF THOSE

LIVING IN POVERTY, STATE

OFFICIALS SAY.

>> A LOT OF PATIENTS THAT WE SEE

NEVER HAD ANY TYPE OF DENTAL

CARE BEFORE BECAUSE THEY COULD

NEVER AFFORD IT.

WELL, I GREW UP IN INDIA, AND

YOU SEE THIS A LOT.

I DIDN'T REALLY EXPECT TO SEE

THAT IN A DEVELOPED COUNTRY, BUT

WE DO SEE THAT PRETTY MUCH EVERY

DAY.

>> I HAVE 60-YEAR-OLD PATIENTS

WHO HAVE NEVER BEEN TO THE

DENTIST, WHO DON'T KNOW WHAT

DENTAL FLOSS IS.

NO ONE'S EVER TAKEN THE TIME TO

SHOW THEM HOW TO BRUSH THEIR

TEETH.

>> Reporter: IN 2014, WEST

VIRGINIA'S THEN-GOVERNOR,

DEMOCRAT EARL RAY TOMBLIN,

EXPANDED MEDICAID UNDER

OBAMACARE, PROVIDING NEARLY

170,000 LOW INCOME PEOPLE

MEDICAL COVERAGE WHO HAD NONE

BEFORE.

BUT MEDICAID DOESN'T HELP MUCH

WITH DENTAL PROBLEMS.

NEITHER DOES MEDICARE, WHICH

SERVES THE ELDERLY.

>> OPEN FOR ME AS BIG AS YOU

CAN.

>> Reporter: MEDICARE PATIENT

PATRICIA McCGUINNESS IS WELL

AWARE OF THAT.

>> DENTIST WANTS ANYWHERE

BETWEEN $230-$500 TO PULL A

TOOTH, AND I DON'T HAVE THAT

MUCH MONEY.

>> DEEP BREATH...

>> AND THANK GOD TO THE HEALTH

RITE.

I'M GRATEFUL.

THEY'RE GOING TO LET ME COME AND

GET MY TOOTH PULLED.

>> HERE IT COMES, OKAY?

DEEP BREATHS.

I'M DONE.

>> YOU'RE DONE?

>> YEP.

>> OH, THANK YOU, JESUS!

THANK YOU, JESUS.

>> NO PROBLEM, DEAR.

>> SOME OF US WHO ARE ON

MEDICARE, NO OFFENSE, BUT THE

PROGRAM IS NOT WORKING LIKE IT

SHOULD BE WORKING.

EVEN WHEN OBAMA WAS IN AND EVEN

THOUGH TRUMP IS IN, IT'S NOT

HELPING US ANY.

>> THANK YOU.

>> NO PROBLEM, NO PROBLEM.

>> THANK YOU.

(SOBBING )

>> NO PROBLEM.

ALL DONE, DEAR, OKAY?

>> MEDICARE PAYS FOR NOTHING AS

FAR AS DENTAL GOES.

ALL THAT A MEDICAID CARD WILL

COVER IS EXTRACTIONS.

>> THANK YOU!

>> NO PROBLEM, NO PROBLEM!

SEE YOU NEXT TIME.

>> Reporter: A COUPLE OF DAYS

AFTER OUR FIRST VISIT, THE

MOBILE CLINIC HAD MOVED ON TO

ANOTHER AREA OF THE STATE.

>> START THERE AND DON'T STOP

TILL YOU GET OVER HERE!

>> Reporter: LEDFORD HUNT, A

RETIRED COAL MINER WHO ONCE

WORKED FOR A UNIONIZED MINING

COMPANY, HAS ARRIVED TO HAVE HIS

ENTIRE TOP ROW OF TEETH REMOVED,

A PROCEDURE THAT WOULD HAVE COST

HIM ONE MONTH'S SOCIAL SECURITY

CHECK HAD HE GONE TO A PRIVATE

DENTIST.

WHEN YOU WERE STILL IN WORK,

WHAT WAS YOUR DENTAL CARE LIKE

BACK THEN?

>> DENTAL CARE, I HAD DENTAL

CARE COVERED, EVERYTHING.

DIDN'T HAVE NO PROBLEM.

I HAD A GOOD HOSPITAL CARD.

IT COVERED EVERYTHING AND DIDN'T

HAVE NO PROBLEM WITH IT.

>> Reporter: WHAT DO YOU THINK

IS THE OVERALL REASON THAT THERE

ARE SO MANY PEOPLE WHO CAN'T

AFFORD THEIR DENTAL OR THEIR

OTHER MEDICAL CARE?

>> THERE'S NOT ENOUGH WORK.

I'VE WORKED ALL MY LIFE SINCE I

WAS A BABY, BUT THIS IS

SOMETHING ELSE.

IF IT WASN'T FOR THIS, I

COULDN'T HAVE MY TEETH FIXED.

I COULDN'T AFFORD IT.

>> Reporter: THIS BLACK ROCK WAS

ONCE THE LIFEBLOOD OF THE WEST

VIRGINIAN ECONOMY, BUT, THESE

DAYS, RETAIL CHAINS ARE THE

BIGGEST EMPLOYERS, AND THE SHARE

OF WEST VIRGINIANS GETTING

HEALTH INSURANCE THROUGH THEIR

EMPLOYERS HAS DROPPED FROM 62%

IN 2000 TO JUST OVER 52% IN

2017, ACCORDING TO THE U.S.

CENSUS BUREAU.

AND SO, THE STATE STEPPED UP.

REMEMBER HOW WEST VIRGINIA,

UNDER A DEMOCRATIC GOVERNOR,

EXPANDED MEDICAID TO COVER

ANOTHER 170,000 PEOPLE?

THAT COVERAGE HAS CONTINUED

UNDER THE CURRENT REPUBLICAN

GOVERNOR, JIM JUSTICE.

HE DECLINED AN INTERVIEW REQUEST

WITH NEWSHOUR WEEKEND ON GAPS IN

HEALTHCARE COVERAGE AND

FREQUENTLY HARRANGUES REPORTERS

FOR NEGATIVE PRESS.

>> WHEN ALL WE WRITE AND ALL WE

LOOK FOR IS BAD, YOU KNOW WHAT

IT DOES?

IT DRIVES PEOPLE AWAY.

WE HAVE TO STOP THAT BECAUSE WE

WANT PEOPLE TO COME HERE, AND WE

WANT TO BE HAPPY.

>> IF YOU LOOK IN THE WEST

VIRGINIA FIRST CONGRESSIONAL

DISTRICT...

>> Reporter: SETH DISTEFANO IS

THE POLICY OUTREACH COORDINATOR

FOR THE WEST VIRGINIA CENTER ON

BUDGET AND POLICY, WHICH

CAMPAIGN'S ON BEHALF OF LOW

INCOME WEST VIRGINIANS.

HE BELIEVES SEVERAL PIECES OF

LEGISLATION BACKED BY GOVERNOR

JUSTICE AND PASSED BY THE

LEGISLATURE WILL ULTIMATELY

HURT THE STATE'S POOR.

>> TO THE SURPRISE OF A LOT OF

PEOPLE, THERE WERE A SERIES OF

BILLS TOOK UPWARDS OF CLOSE TO A

$100 MILLION OUT OF MEDICAID AND

PUSHED IT TOWARDS THINGS THAT

HAD NOTHING TO DO WITH

HEALTHCARE.

AMONG THOSE THINGS, SENATE BILL

385 TOOK A SIGNIFICANT CHUNK OF

MONEY AND PUT IT TOWARDS FIXING

FACILITIES UNDER THE DOMAIN OF

THE DEPARTMENT OF MILITARY

AFFAIRS AND PUBLIC SAFETY--

PRISONS, BASICALLY.

>> Reporter: DISTEFANO SAYS HE

AND OTHER ADVOCATES HAD LOBBIED

FOR A DIFFERENT STATE-SPENDING

PATH.

>> ONE OF THE THINGS THAT WAS

PUT FORWARD WAS THAT MAYBE WE

SHOULD LOOK AT TAKING, YOU KNOW,

THIS MONEY THAT WAS BEING

DEDICATED TO, YOU KNOW, THE...

YOU KNOW, FIXING ROOFS ON, YOU

KNOW, CORRECTIONAL FACILITIES

AND INSTEAD MAYBE DEDICATE IT TO

RESTORATIVE DENTAL WORK.

WE COULD HAVE MADE A

GENERATIONAL IMPACT ON SOMETHING

THAT HAS DRUG WEST VIRGINIA DOWN

FOR A VERY, VERY LONG TIME.

>> Reporter: BACK AT THE HEALTH

RIGHT MOBILE MEDICAL UNIT, I

ASKED DENTAL HYGIENIST GRETA

NELSON IF SHE EXPECTED THE

SITUATION TO CHANGE ANY TIME

SOON.

>> IN MY LIFETIME, I DON'T SEE

IT CHANGING TO WHERE WE'RE GOING

TO GET A HEALTH CARE SYSTEM

THAT'S GOING TO TAKE CARE OF

PEOPLE THE WAY THAT IT SHOULD.

A LOT OF OUR PATIENTS ARE

WORKING POOR.

THESE PEOPLE WORK TWO JOBS BUT

STILL DON'T HAVE THE MEANS

NECESSARY TO PROVIDE, YOU KNOW,

DENTAL CARE FOR THEIR FAMILY OR

FOR THEMSELVES.