With the resignation of state Sen. Phillip P. Puckett, the GOP gained control of the state senate and could doom Gov. Terry McAuliffe’s move to expand Medicaid. In a region where the decline of the coal industry has sent poverty and health-care needs soaring, another force has grown by at least equal measures: antipathy to President Obama and the Affordable Care Act.
June 17, 2014 Maggie Charles, who does not go to doctors and lives off her late husband’s black lung benefits, makes a sale to neighbor Augusta Hamilton in Trammel, Va., as James Kinney carts his portable oxygen tank down the street to see what Charles is hawking. Asked if he was aware of state Sen. Phillip P. Puckett’s resignation, Kinney said: “Of course. That boy done screwed a lot of folks up here.” He felt lucky to have health insurance for chronic obstructive pulmonary disease, which he developed after years of hauling and shoveling coal, but said the 20 percent he pays out of pocket is still a burden. Michael S. Williamson/The Washington Post Buy Photo