From NPR News, this is ALL THINGS CONSIDERED. I'm Michele Norris.


And I'm Melissa Block.

Springdale, Arkansas calls itself the chicken capital of the world. Tyson's Chicken is by far the town's biggest employer. Springdale also has another distinction: about 1 in 10 residents moved to the town from a string of tropical islands in the middle of the Pacific Ocean: the Marshall Islands.

NORRIS: That distinction gives Springdale a particular stake in the health care overhaul and how the House and the Senate merge their bills. The House bill would give Marshall Islanders in Springdale health insurance coverage.

Reporter Jenny Gold visited Springdale and brings us this story.

JENNY GOLD: Marshall Islands Consul General Carmen Chong Gum says people come to Springdale because there are jobs at the poultry plants, good schools and because they have family here.

Ms. CARMEN CHONG GUM (Consul General, Marshall Islands): We're able to travel this way, which is a passport, and we can also live, go back to our country whenever we want to. So, with that privilege, you know, why not?

GOLD: Right after World War II, the U.S. used the Marshall Islands as a nuclear test site. The country has been independent since the 1980s, but the U.S. still maintains a military presence there. And in exchange, the Marshallese are allowed to come live in the U.S. if they want to. Now, somewhere around 6,000 of them live in Springdale. And just as they do at home, the Marshallese often live in big, extended families. The women still wear long, flowery muumuus, but now over jeans and flip-flops, a perfect blend of their current and former environments. Carmen Chong Gum says her countrymen tend to be warm, generous people, quick with a smile, a little bit shy and very religious.

(Soundbite of music)

GOLD: There are about 20 Marshallese churches in Springdale - King's Chapel is one. It's in the office space off a fast food-lined highway that runs the middle of town. On a Wednesday night, about 50 people gathered for a prayer service.

(Soundbite of music)

Unidentified People: (Singing) (unintelligible)

GOLD: Forty-year-old Waston Attari sits in the front row pouring over a Bible. He moved here to seek a better life for his family. But sometimes, he says, the American dream feels more like a myth.

Mr. WASTON ATTARI: I've seen some people struggle with their day-to-day, you know, the lifestyles. And so, you know, people live paycheck to paychecks trying to take care of their family, trying to put food on their tables.

GOLD: For Attari, the biggest challenge has been getting health care. He's self-employed, helping other Marshallese do their taxes among other things. But he can't afford private health insurance. And the Marshallese don't qualify for Medicaid. Attari suffers from diabetes. He's been able to get free insulin from a local clinic, but it's not enough.

Mr. ATTARI: I cannot do any physical exams and go to see a doctor because I don't have the money to pay for the bills.

GOLD: What will you do if you get really sick?

Mr. ATTARI: I don't know. I don't know what I can do. Just keep praying.

GOLD: Some Marshall Islanders could get health insurance through the poultry plants. At Tyson's, a family plan costs about $120 a month. But they earn just over minimum wage and few of them can afford that premium.

County health worker Sandy Hainline Williams says many elderly parents, nieces, nephews and cousins in the Marshallese household wouldn't be covered under such a family health insurance plan anyway.

Ms. SANDY HAINLINE WILLIAMS (County Health Worker): It just makes me so sad to see them and know that they need to go see a doctor. I can't find a doctor for them. No one will see them. And St. Francis House is absolutely full.

This is our newly remodeled dental clinic. We've got nine operatories...

GOLD: The St. Francis House is a community health clinic that offers health and dental care on a sliding scale. Executive Director Kathy Grisham says St. Francis House sees about 1,000 Marshallese patients a year - more than any other health care provider in the region. Right now, the clinic is doing a lot of that care for free.

But a provision in the health care overhaul bill, recently passed by the U.S. House of Representatives, could bring relief. It would give Medicaid eligibility to the Marshallese, as well as migrants from Palau and Micronesia who are in a similar situation.

Kathy Grisham is all for the bill passing.

Ms. KATHY GRISHAM (Executive Director, St. Francis House): It would be an excellent thing. I'm not holding my breath, but I do hope health reform will bring that to us.

GOLD: But Mark Krikorian says Medicaid access isn't the solution. Krikorian is executive director of the Center for Immigration Studies, a Washington think tank that wants to reduce immigration. He supports the Medicaid provision in the overhaul bill, too, because, he says, right now the burden is falling unfairly to emergency rooms and federally funded clinics like the St. Francis House.

Mr. MARK KRIKORIAN (Executive Director, Center for Immigration Studies): The bigger issue is should we be letting in people with little education from underdeveloped countries into a modern post-industrial welfare state, because there's no way to avoid the costs. We're not going to let people die on the steps of the emergency room.

GOLD: Consul General Carmen Chong Gum in Springdale says the Marshallese are contributing to the economy by working and paying taxes. She says they should have the same access to government programs as everyone else.

Ms. GUM: It's like going to a party and you're bringing your potluck, you're bringing a dish of rice or fried chicken and fried fish. And you bring the food to the party and you're just sitting there not eating anything.

GOLD: The provision that could help them is just a tiny insert in the 2,000-page House health bill. There's still a long way to go before it could become law.

For NPR News, I'm Jenny Gold.

NORRIS: And that story was produced by Kaiser Health News, a nonprofit news service.

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