Can Obama Sell Health Care Changes To Appalachia?

President Obama holds town hall meetings in Raleigh, N.C., and Bristol, Va., on Wednesday. Raleigh is a fast-growing urban center where Obama did well in last year's election. But the president was far less popular in the mountain town of Bristol. He's expected to face challenges in Appalachia pushing changes to health care.

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Now, today, the president holds a pair of town hall meetings on health care. He talks with voters in Raleigh, North Carolina, where he did well in the election, and also in Bristol, Virginia, where he did not. NPR's Adam Hochberg reports.

ADAM HOCHBERG: The neighboring communities of Bristol, Virginia and Bristol, Tennessee are known for their mountain scenery, their country music heritage and their conservative politics. In this corner of the Appalachians, President Obama barely managed 30 percent of the vote against John McCain, and now his health care proposal is being met with skepticism.

Sarah Jane Walls owns a fashion boutique on Bristol's State Street, a downtown thoroughfare that forms the state line between Tennessee and Virginia. With just two part-time employees, Walls doesn't offer health benefits, and nothing the president has proposed would force her to. Still, she worries the plan will increase her costs and worsen medical care.

Ms. SARAH JANE WALLS (Fashion Boutique Owner): We, as Americans, do have a great health care system. Yes, there are some things that need to be addressed, but as far as entire reform goes, with a lot of government control, I don't think that needs to happen.

HOCHBERG: Walls, a Bristol native, says many people here share her fear that the president wants the government to take over health care. It's a concern Mr. Obama repeatedly has tried to dispel and one he's likely to address again today when he holds his town meeting at this Kroger supermarket.

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HOCHBERG: Yesterday, as workers tidied up the store, floral department employee Vera Lewis(ph) wore an Obama/Biden button on her vest. Lewis is the store's union shop steward and says she's optimistic the president's message will win him support in this area where about 15 percent of the population is uninsured.

Ms. VERA LEWIS: My mother's one of them. You know, she's been laid off from her job - been off for years - can't go to the doctor. She can't afford medicine. And we have a lot of shoppers that come in here that are in the same boat.

HOCHBERG: Today, the store's 70 or so employees will make up the audience for the town hall. Most are hourly workers - some full-time, some part-time. They're eligible for health insurance through their jobs, and University of Virginia political scientist, Larry Sabato, says Mr. Obama needs to persuade them that his plan would leave them better off.

Professor LARRY SABATO (Political Science, University of Virginia): Unless Obama and the Democrats can get more support for the health care reform plan from whites - middle-class whites in particular - I doubt they're going to get the whole enchilada.

HOCHBERG: Indeed, even some Bristol residents who are struggling with health costs aren't embracing the president's proposal. Yesterday, at the Burger Bar, a downtown diner, Richie Drake was eating a late breakfast. Drake's unemployed - disabled from his job as a sheet rock installer; his children are on Medicaid. But he wants no part of the president's reforms.

Mr. RICHIE DRAKE: The health care plan he's got, Obama, is going to hurt people in the long run. Minorities are going to get more attention than the whites and stuff like that. That's the way I take it from what the news was talking about.

HOCHBERG: Only one Burger Bar customer we spoke with gave the president's proposal a strong endorsement. College Professor Randy Smith said health care reforms are long overdue.

Professor RANDY SMITH: I'm like everyone. I think I have concerns when you look at the amount of debt that we're building up. But just to do nothing, as the president, I think, has correctly said, is not going to dig us out of the hole.

HOCHBERG: Smith says the health care needs of Appalachia are obvious. Just this weekend in a nearby county, almost 3,000 people showed up for a free medical clinic - some lined up for days to get treatment. Still, even if few people here would deny there's a problem, Smith questions whether President Obama can sell the idea that the federal government can be part of the solution.

Adam Hochberg, NPR News, Bristol, Virginia.

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Health Care Fight Spotlights Community Organizers

President Obama hugs Virginia Organizing Project volunteer Debby Smith. i i

hide captionPresident Obama hugs Virginia Organizing Project volunteer Debby Smith after she asks him about health care during a town hall meeting earlier this month.

Alex Brandon/AP
President Obama hugs Virginia Organizing Project volunteer Debby Smith.

President Obama hugs Virginia Organizing Project volunteer Debby Smith after she asks him about health care during a town hall meeting earlier this month.

Alex Brandon/AP

The Virginia Organizing Project is one of many community organizing groups that hoped to have more clout after the election of President Obama, a former community organizer. The group is finding that it has certainly been more active on national issues this year than it ever has been.

VOP usually works on local issues, but it has now found itself swept up in the biggest organizing effort of the year — overhauling health care.

And they are having some impact. Remember a town hall meeting Obama held earlier this month in Virginia where he hugged a woman with cancer who had no insurance? She was Debby Smith, a VOP volunteer from southwest Virginia.

"We got a note from the Office of Public Engagement at the White House saying, 'Would you like to send two people to the town hall meeting?' " says Richard Kirsch, who runs a national grass-roots campaign for health care called Health Care for America Now. "First thing we did was write to VOP and say, 'Do you have people you would like to send?' "

When Obama called Smith's story Exhibit A in the need to overhaul health care, that was no accident.

Collecting Stories

VOP participated in a health care overhaul rally at the U.S. Capitol last month. Organized by Health Care for America Now, it involved thousands of union and liberal grass-roots activists who back the president's health care plan.

Joe Szakos, VOP's executive director, says his group's participation is a win-win. He provides ground troops for the national campaign, about 150 for this rally. And Health Care for America Now gives him money to pay two full-time staffers and other costs.

"I call it revenue sharing because we're doing it not just to get health care for everybody in the country, but we're also doing it to try to build local community groups," says Szakos.

Community organizers were elated when one of their own, Barack Obama, was elected to the White House. They hoped it would lead to more influence in Washington. Throughout the year, NPR is following some of these community groups to see what they are able to accomplish.

And to strengthen VOP's statewide network. Szakos says after health care, there'll be many other issues Virginians care about. Now, VOP is trying to influence the debate by finding personal stories to illustrate the need for a health care overhaul.

VOP interns have been knocking on doors all summer — 140,000 in all — collecting stories like Smith's.

Going door-to-door in Alexandria, VOP intern Joe Huennekens asks a woman which issue she cares about most, and like many, she says health care. She says her son died from liver disease, and it was a nightmare dealing with the insurance companies. Huennekens suggests she call Sen. Mark Warner (D-VA) to push for a public health insurance option.

"It's toll-free. You call, you press a 1, it connects you and you ask for his office, and then it connects you with him," Huennekens says. He also asks for her phone number and e-mail address. "Cause you have such a strong story about health insurance reform," he says.

Huennekens and other VOP interns are collecting similar information from the people they talk to. They enter it into a huge database to be used later to generate phone calls and letters to wavering lawmakers.

Meeting Lawmakers

The following day, Huennekens and five VOP colleagues meet at the Capitol with the staff of Rep. Gerry Connolly (D-VA). Connolly is one of several freshman Democrats who oppose a House plan to pay for health care by raising individual taxes. Huennekens recounts the story he heard the day before.

"Her son had had liver disease and had had health insurance through his job, but when he got sick, he lost his job," he says.

VOP is trying to exert influence by showing lawmakers that it has its ears to the ground, that it knows what their constituents are thinking.

Kevin Simowitz, VOP's intern coordinator, realizes Connolly — like every lawmaker — is getting pummeled from every side.

"So if you all have suggestions about ways that we can be helpful to the congressman's position ..." says Simowitz.

"It's more important that you dispel the misconceptions. I mean the opposition is spending a lot of money to get their message out," says Connolly's communications director, George Burke.

Although it's difficult to know how much impact the group will ultimately have, Burke says VOP's grass-roots work is important. Still, Simowitz says VOP is in it for the long haul.

"I just watched five college-aged interns sit in a congressional office and talk with somebody about their summer experience," says Simowitz.

He says they now know a lot more than they did about community organizing. The hope is they can put it to use the next time an issue they care about comes along.

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