March 31, 2024 - PBS News Weekend full episode

JOHN YANG: Tonight on "PBS News Weekend," on this Easter Sunday, why more Americans are saying religion is losing influence in public life, then Georgia's unique and controversial program to expand Medicaid coverage, but only for those who meet a work requirement.

SHERRY BEAVERS, Director, Open Arms Clinic: You know, I have patients that I have to put A, on the pill bottles if they take them in the morning, and P, on the pill bottles if they take them at night.

And you expect these people to be able to upload documents and renew their health insurance monthly.

JOHN YANG: And a Brief but Spectacular look at vanishing structures throughout rural America.

(BREAK) JOHN YANG: Good evening, I'm John Yang.

Chaos in Central Gaza today after an Israeli airstrike hit a tent encampment in the courtyard of Al-Aqsa Martyrs Hospital in Deir al-Balah.

Two Palestinians were reported killed and 15 others wounded.

The Israeli military said it was targeting an Islamic Jihad command center and that the hospital was not affected.

Among the injured were journalists who had been working nearby.

ALI HAMAD, APA Photographer (through translator): They hit the tent without any warning.

We were staying in the tent as a group of journalists, peacefully, with no terrorists among us.

We were preparing our cameras and all of a sudden the tent was hit.

Everything went dark with debris and rocks flying above our heads and there were flames.

JOHN YANG: In Jerusalem, the biggest anti-government demonstration since the war began.

Tens of thousands of people rallied outside the Parliament Building, demanding that Prime Minister Benjamin Netanyahu get a deal to free the hostages held in Gaza and hold early elections.

In Ukraine, today marked the second anniversary of Russian forces leaving the Kyiv region.

President Volodymyr Zelenskyy visited a memorial site in Bucha, where Ukrainian officials say, two years ago, troops found mass graves and the bodies of men, women and children littering the streets.

The civilian death toll there passed 1,000.

Appeals for peace in both the Middle East and Ukraine were part of Pope Francis' Easter message today.

In St. Peter's Square in Vatican City, the pope renewed calls for an immediate cease-fire in Gaza, the release of all Israeli hostages and a prisoner exchange between Russia and Ukraine.

He told worshipers, peace is never made with weapons.

The pope made several loops of the square in his pope-mobile to greet the tens of thousands who had gathered for the culmination of Christians' Holy Week.

King Charles attended an Easter service at Windsor Castle today, his most significant public appearance since his cancer diagnosis in February.

Outside St. George's Chapel, the king shook hands and chatted with well-wishers.

The 75-year-old monarch is being treated for an unspecified type of cancer.

And former seven-term Democratic Congressman William Delahunt of Massachusetts has died after a long illness.

As a Boston-area prosecutor in the late 1970s, he created what's considered to be the first domestic violence unit.

Delahunt postponed his retirement from the House until 2011 to help pass former President Obama's legislative agenda.

Delahunt was 82 years old.

Still to come on "PBS News Weekend," how the State of Georgia is trying to expand Medicaid coverage, but with a unique controversial program.

And a photographer captures the stories behind the vanishing structures of rural America.

(BREAK) JOHN YANG: Today, Christians across America celebrate Easter.

Muslims are in the midst of Ramadan, and Jews, who recently marked Purim, are preparing for Passover in just a matter of weeks.

So, it's very timely for the Pew Research Center to be out with the results of a survey looking at Americans' attitudes about the role of religion in public life.

Eighty percent of the more than 12,000 respondents said religion's role is shrinking.

That's the highest proportion in two decades of asking the question.

Gregory Smith is Pew's Associate Director of Research.

He helps coordinate the domestic polling on religion.

So, a big proportion of Americans saying that religion is losing influence.

Do they say that's a good thing or a bad thing?

GREGORY SMITH, Associate Director of Research, Pew Research Center: Most people who think that religion's influence is shrinking in American life think that's a bad thing.

They're disappointed to see it.

In fact, the survey shows very clearly that most Americans have a positive view of religion.

Most people who think religion's influence is declining say that's a bad thing.

The smaller number of people who think religion's influence is growing think that's a good thing.

And if you put those things together, we see very clearly that most people in the United States have a positive view of religion's role in society.

JOHN YANG: I was also struck by the responses to the question of whether respondents felt that there was a conflict between their personal religion and mainstream American culture and whether they felt their religion made them part of a minority group.

What did you find there?

GREGORY SMITH: So, the share of Americans who say they think there's at least some conflict between their own religious beliefs and mainstream American culture is up six points to 48% since we last asked these questions.

Similarly, the share of Americans who say they think of themselves as a minority because of their religious beliefs is up five points since we last asked these questions.

Now, most people don't say they think of themselves as a minority because of their religion.

Only 29% of Americans say that.

Still, the trend is in an upward direction.

JOHN YANG: What do you think that tells you?

Does it say something about religious beliefs, or does it say something about people's connection with mainstream American culture?

GREGORY SMITH: It says a little bit about people's religious backgrounds.

We know, for example, that Jewish Americans and Muslim Americans, groups that make up small shares of the population, they are among the most likely to say they think of themselves as minorities because of their religious beliefs.

But there's also an element of this that is about how people perceive things to be going in society.

We have done other polling where we ask people whether they think their side is winning or losing on the political issues that matter to them.

And big numbers of Americans, including majorities of both parties, say they think their side has been losing more than winning recently.

So, some of this is just a dissatisfaction, tension with broader society.

JOHN YANG: Well, precisely on that point, you also asked whether people felt that either secular liberals or conservative Christians were going too far in trying to control government and public schools in terms of religion.

What did you find there?

GREGORY SMITH: What we see is that most Democrats and most people who aren't particularly religious themselves, they think conservative Christians are going too far trying to impose their religion in public life.

The flip side of that is also true.

Most Republicans and most Christians, including a huge majority of evangelical Protestants, say they think secular liberals are going too far in trying to keep religion out of the government and public schools.

So, it's sort of people on both sides think that the other side is going to extremes.

JOHN YANG: Of course, this is a presidential election year, what did you find about people's attitudes toward or their feelings toward whether a president has strong religious feelings or not?

GREGORY SMITH: The survey is really interesting.

It finds that a huge majority of the public, including people across every religious group we're able to analyze and people in both parties, say they want a president who personally lives a morally upstanding life.

So, that's something Americans can agree on.

Fewer people say they want a president who is personally religious or who shares their own religious beliefs.

But many people, most Americans, about two-thirds say they do want a president that they can count on to stand up for people with religious beliefs like their own.

JOHN YANG: So, it's not necessarily that they agree with the religious beliefs or have the same religious beliefs.

They just want the president to be standing up for them.

GREGORY SMITH: That's exactly right.

It's way more important for people to have a president who stands up for them than it is to have a president who shares their religious beliefs.

And we can see, for example, that many of the people who have favorable opinions of Joe Biden and Donald Trump don't necessarily think that those two are very religious themselves.

But the people who have favorable views of each candidate do think that their preferred candidate stands up for people with their religious beliefs.

JOHN YANG: You also asked a question about a topic that's been a hot topic recently, Christian nationalism, the ideology that the United States should be a Christian nation.

What did you find there?

GREGORY SMITH: Yeah, the survey finds that a lot of Americans say they want the Bible to have some influence on U.S. laws and policies, but fewer, only 28% of Americans say that, if the Bible and the will of the people are in conflict, we should rely more on the Bible than the will of the people in terms of making laws.

JOHN YANG: Well, you take all this together and put it together.

What does it tell you about the state of Americans when they look at religion and how their views are changing?

GREGORY SMITH: I would say there's two main things that jump out at me.

One is that we know that religion does -- the place of religion in American life is changing.

The United States has grown gradually less religious in recent decades, and we see that in the growing share of Americans who tell us they think religion is losing influence in American life.

The other thing that jumps out at me in this survey is that Americans are divided on these topics, as they are on so many other things.

People on both sides of the political and religious spectrum think that those on the other side are going to extremes trying to see their preferred policies and approach to life enacted in laws and in the public schools.

JOHN YANG: Very interesting look.

Gregory Smith from the Pew Research Center, thank you very much.

GREGORY SMITH: Thank you for having me.

JOHN YANG: Since Medicaid was created nearly 60 years ago, it's been expanded many times, and it's now the government's biggest public health insurance program.

Tonight, a look at the efforts to expand it even further, with a visit to the only state with a work requirement for Medicaid.

It's part of our ongoing series, America's Safety Net.

SHANAN ALLISON: Can we walk?

Come on.

JOHN YANG: For Shanan Allison, taking her emotional support dog, Wolf, for a walk in her Atlanta neighborhood can feel like an ordeal.

SHANAN ALLISON: You were inpatient for mama?

JOHN YANG: The 48-year-old has limited mobility because of hip dysplasia and degenerative disc disease.

SHANAN ALLISON: Come, come.

JOHN YANG: Her biggest health challenge came in 2018, when she was diagnosed with breast cancer.

She didn't have health insurance at the time, but the diagnosis qualified her for Medicaid's Women's Health Program for breast and cervical cancer.

SHANAN ALLISON: As an adult never having had private insurance, I mean, it was like it was a miracle.

It was like, wow, finally, somebody can see about this symptom, and somebody can treat that, and I can, you know, and maybe I can get back to work.

JOHN YANG: The coverage also paid for a hip replacement in 2020 and for medication to treat a heart condition and bipolar disorder.

So, now your cancer's in remission?

SHANAN ALLISON: Yes, thank God.

Yeah.

JOHN YANG: Well, thank God the cancer's in remission.

SHANAN ALLISON: Yes.

JOHN YANG: But what does that mean for your Medicaid?

SHANAN ALLISON: Well, it means, since I'm no longer seeing an oncologist, that it's been five years, and if you're not continuing to see an oncologist, you're not qualified for Women's Health Medicaid anymore.

JOHN YANG: The only other time Allison had health insurance was when her pregnancies qualified her for Medicaid.

Physical limitations have kept her from holding a job since 2012, and before that, she'd never had one that gave her coverage.

And despite having no income, she does not qualify for Georgia's traditional Medicaid program, which requires a participant to not only have a low income, but also be pregnant, have a child or have a disability.

SHANAN ALLISON: See here, it's got where I was approved, but there's a termination, and then denial for the regular Medicaid.

JOHN YANG: No eligible people in your household.

Not having Medicaid, how does that make you feel?

SHANAN ALLISON: Well, I'm scared, really.

I need a continuation of care for my hip, you know, and my psych meds, for instance, you know, a lot of things.

It's just like you fall -- I fall in a gap.

I don't know.

It's scary.

JOHN YANG: Georgia is one of 10 states that has not used the Affordable Care Act to expand Medicaid to cover all adults earning less than 138% of the federal poverty line, or about $20,800 a year for an individual.

Under the act, the federal government pays a generous subsidy for the additional cost.

LEAH CHAN, Director of Health Justice, Georgia Budget and Policy Institute: There's been a lot of momentum in our surrounding neighbor states.

And I think that legislators are seeing how it is a good deal for Georgia.

JOHN YANG: Leah Chan is Director of Health Justice at Georgia Budget and Policy Institute, a nonpartisan research group and a proponent of full Medicaid expansion.

She says it would benefit the estimated 400,000 uninsured Georgians in what's called the coverage gap.

Earning too little to qualify for federal subsidies in the ACA insurance marketplace, but not qualifying for Medicaid in the state because they're adults without a qualifying disability.

LEAH CHAN: This is just an economic imperative.

We can no longer ignore the financial benefits that we would get from closing the coverage gap.

And I think we can no longer ignore the mounting pressure that many communities are feeling as hospitals close and as more people fall into the coverage gap.

JOHN YANG: Since 2013, 12 hospitals across Georgia have shut their doors, including Atlanta Medical Center here in the heart of the city, which closed in 2022.

One reason for the financial squeeze, unreimbursed care for people with low incomes and no insurance.

Earlier this year, Georgia lawmakers signaled a willingness to consider Medicaid expansion.

But in February, legislative leaders said the issue needed more study.

Instead, Georgia has a new program called Pathways to Coverage.

NO NAME GIVEN: Georgia Pathways provides a hand up and a way for our citizens to thrive.

JOHN YANG: Pathways provides Medicaid to adults who are in less than 100% of the federal poverty line or about $15,000 a year for an individual and spend at least 80 hours a month either working, going to school, participating in job training or doing volunteer service.

Georgia is the only state with a Medicaid work requirement currently in place.

State officials estimated that 50,000 people would enroll in Pathways in its first two years.

But since it launched last July, only about 3,500 have signed up.

Georgia's Department of Community Health, which administers Pathways, declined an interview request.

But in a statement said the program puts Georgia at the forefront of innovation in health care and serves as a new way to increase access to affordable health care coverage.

CHRIS DENSON, Director of Policy and Research, Georgia Public Policy Foundation: And I would hope that the critics, those who are calling for full Medicaid expansion, would actually choose to embrace this program and help raise awareness, because it does provide a pathway to health care coverage for the recipients.

JOHN YANG: Chris Denson is the Director of Policy and Research at the Georgia Public Policy Foundation, a conservative free market think tank.

The fact that you're asking people in order to get the coverage, you have to put in something.

Is that -- do you think that's an important factor?

CHRIS DENSON: We believe it's an important factor because these are able-bodied working age individuals.

And so, in order to not only receive the program, we think it's important for them to have some skin in the game.

This is also a pathway to receiving private insurance.

And we want more patients on more private health insurance plans, where it's easier to see a physician because a physician or the hospital is paid more for seeing those patients.

JOHN YANG: Nationwide, about 30% of physicians don't accept new Medicaid patients.

In Georgia, according to one survey, it's 40%.

But Leah Chan says research on Medicaid, including from states that use the ACA to expand, shows that those on the program have better health outcomes.

What's more, she says, Georgia taxpayers pay more for each pathways participant than they would under full Medicaid expansion, because the federal subsidy is smaller.

You say that Pathways isn't as good as Medicaid expansion, but is it better than nothing?

LEAH CHAN: So we have the opportunity before us to bring billions of dollars to our state, create tens of thousands of new jobs, shore up the financial stability of our rural hospitals, and get access to health care for hundreds of thousands of Georgians.

And, instead, we have chosen this other path that is more expensive and covers fewer people.

JOHN YANG: In addition, Chan says the existing Pathways program has a big barrier.

Every month, participants must submit documentation to certify that they're meeting the requirements.

That's impossible for people like Donald Crawford in rural Toccoa, Georgia, northeast of Atlanta, near the South Carolina border.

Uninsured, he relies on the free Open Arms Clinic for all his health care needs, including prescriptions.

DONALD CRAWFORD: I have high blood pressure, diabetes, breathing problems.

JOHN YANG: Crawford hasn't had full-time employment since the threadmill where he worked shut down nearly a decade ago.

Now he does odd jobs, just a couple of hours a month.

The 58-year-old says, even if he had the hours to qualify for Pathways, there's no way he could do the reporting.

DONALD CRAWFORD: But this phone right here, I was old school.

I had to flip phone.

My daughter got this phone right here, been working with me and working with me and everything, you know, all this technology.

There ain't no way.

There ain't no way.

JOHN YANG: Clinic Executive Director, Sherry Beavers, is one of only two paid employees.

Everyone else, including the doctors, are volunteers.

SHERRY BEAVERS: You know that little room in your doctor's office that they take you to, and they give you a little sample?

This is our sample room.

JOHN YANG: Beavers says that in the absence of full Medicaid expansion, clinics like hers fill a vital need for low-income adults in Georgia, helping them manage chronic conditions like diabetes.

SHERRY BEAVERS: That's over a million dollars' worth of insulin right there, the difference between life and death for a person with diabetes.

JOHN YANG: Pathways is aimed at some of the people who use the Open Arms Clinic.

But Beavers says not a single one of the clinic's patients has enrolled in the program.

SHERRY BEAVERS: The qualifications are just too steep.

You know, I have patients that I have to put A on the pill bottles if they take them in the morning, and P on the pill bottles if they take them at night.

And you expect these people to be able to upload documents and renew their health insurance monthly?

It's not going to work.

JOHN YANG: For Shanan Allison in Atlanta, the documentation isn't the problem.

The problem, she says, is actually doing the required activities.

SHANAN ALLISON: If I could do a part-time job, I would do it for money.

JOHN YANG: Right.

SHANAN ALLISON: -- or Medicaid, either one.

JOHN YANG: Right.

SHANAN ALLISON: I would love to have the Medicaid over the money.

But the point is, I can't do it.

JOHN YANG: Recently, she was turned down for Social Security disability benefits.

But a recent mammogram spotted something that requires additional testing.

It could be another serious health challenge.

But, ironically, it could also give her coverage again, qualifying her for Women's Health Medicaid.

How does this make you feel about this whole system?

SHANAN ALLISON: Well, I feel cheated.

It's almost like, in a way, I feel discriminated against.

I'm just confused as to why Georgia did this, and some places didn't.

You know, it's almost making me want to move, you know, because I need the care that badly.

JOHN YANG: For more than two decades, Vermont-based photographer Jim Westphalen has documented old farmhouses, barns, churches and homes that have fallen into disrepair.

He calls it finding beauty in decay.

He's collected his works in a book and a film both called "Vanish: Disappearing Icons of a Rural America."

Tonight, Westphalen shares his Brief but Spectacular take on the vanishing structures of rural America.

JIM WESTPHALEN, Photographer: Just like taking a portrait of a person, when I'm looking right at the face of the building, I feel like it's looking back at me, and I can really look into the soul of the building, looking through the windows or looking into a front door.

That's what I'm looking for, to kind of evoke that emotion.

So this structure I happened upon a couple years back down a lonely little dirt road in Vermont here.

These vines that are on the outside of the building, they're actually growing from inside, so it looks like the building is weeping.

In 1996, we moved to Vermont.

As a photographer, it was just heaven.

I'd be out roaming the countryside with my camera, and I realized that a lot of the structures that I was passing, they were starting to decay, fall into disrepair.

And as a visual artist, I was drawn to what that meant visually, the rusted patina of a roof, or old barn sides, or faded clapboard on the old farmhouses.

And I spent every free moment out there photographing these old structures.

And without knowing it, I was building this body of work.

So I loosely started this project about 20 years ago, and it was without intention then.

I would just travel the countryside photographing these beautiful old buildings because I was really attracted to them.

And as the body of work grew, I realized there really was this tangible message here.

These structures are so fleeting.

And we're in this period of history where we're experiencing this profound loss.

It's more than just documenting it.

It really is depicting and capturing the soul of the structure in a way that really honors what it once was, and also honors the people who spent their lives there.

Of course, I would stop and ask permission to be on somebody's property before I went and photographed it.

Once I told them a little about what I'm doing, they just love to share their stories.

They tell me how, you know, their sixth-generation farming on this land, struggling to keep it going now.

You know, there was this rich history to be told behind the visual beauty of the structures, you know, as they sit today.

And if I can just ignite a little bit of a spark in people, and maybe ignite a spark in those who can tangibly do something about the loss that we're experiencing, to maybe restore, and if not restore, at least maintain these old structures, then I have done my job, because once the structures are gone, and that generation who are connected to those structures are gone, the stories go with it as if they were never there.

I'm Jim Westphalen, and this is my Brief But Spectacular take on the vanishing structures of rural America.

JOHN YANG: And that is "PBS News Weekend" for this Sunday.

I'm John Yang.

For all of my colleagues, thanks for joining us.

Have a good week.