With expanding Medicaid about to become a major issue for the administration of incoming Virginia governor Terry McAuliffe, it is curious to see exactly where the poor people in Virginia live.

An intriguing interactive from the New York Times provides clues and allows one to draw some rather disturbing conclusions.

With a few exceptions, Northern Virginia generally has a poverty rate in the healthy single digits, with poverty defined as individuals making less than $11,945 a year and a family of four making $23,283 a year. A few pockets of higher poverty include parts of Reston (38.4 percent) and Winchester (36.1 percent) percent.

The truly poor areas include some of the state’s largest inner-city areas and the coalfields of far Southwest Virginia.

The single worst pocket of poverty, at 76.7 percent, appears to be in an inner-city section of Hampton. Trailing not far behind are  parts of Norfolk (67.8 percent) and Portsmouth (64.9 percent).

Richmond also has plenty of low-income people. Its overall population registers about 26 percent, with some neighborhoods a few minutes drive from the State Capitol showing 67.2 percent and 50.7 percent poor.

In more rural areas, the rate was high in Halifax County in the dying tobacco and textile belt, but the level in the surrounding area was low. An area near Lynchburg showed 50 percent poverty. A tiny swatch of Charlottesville was at 61.6 percent.

One curiosity is how U.S. Route 19 divides impoverished counties from not. Giles County to the east of U.S. 19 has poverty rates of about 13 percent. But cross to the western counties and watch it double (Buchanan 23 percent; Dickenson, 21.3 percent; and Wise, 25.6 percent).

What do these counties have in common? A dying coal industry that has never helped its local communities very much, the supposed “war on coal” notwithstanding.

So what’s the takeaway for Virginians? McAuliffe has promised to make expanding Medicaid a major issue as he takes office. The state’s Republican leadership has opted not to go for billions in federal money to expand Medicaid to about 400,000 low-income people.

Their reason is that it supposedly would blow out budgets down the road. Another criticism one hears is that the poor would abuse emergency rooms and further drain resources if they got get government health insurance.

That’s why this interactive reality check is important. It tends to show that, if this is indeed the case regarding emergency rooms, the impacts would likely be limited to big hospitals in downtown areas such as Virginia Commonwealth University Health Systems in Richmond and Sentara Norfolk General Hospital.

The poor are unlikely to invade ERs in upscale hospitals in richer neighborhoods for the simple reason that they would be too hard for them to reach.

Rural areas have always had issues with convenient health facilities. And that is one reason why charities such as Remote Area Medical find that literally hundreds of people stand in line in the predawn hours to attend free medical and dental clinics in places such as mountainous Wise County.

Poverty and access to medical care are still a serious problem in Virginia. Simply denying care in the name of budget frugality helps no one.

Peter Galuszka blogs at Bacon’s Rebellion. The Local Blog Network is a group of bloggers from around the D.C. region who have agreed to make regular contributions to All Opinions Are Local.