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For Congressional Republicans, Repealing Obamacare Is Political Theater. For These Tar Heels, It’s a Matter of Life and Death.

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On a rare Monday afternoon at home, Sarah Gamble, forty-nine, and her thirteen-year-old grandson, Cameron, banter in the living room as a TV blares in the background. There's a Judge Judy-type show on, with lots of gesticulation and shouting, but they're not paying attention. Gamble, in yoga pants and a T-shirt, grabs a moss green pillow shaped like a tennis ball and pretends to lob it at Cameron, who is clutching a furry Elmo plush toy; he laughs. Their stocky English bulldog waddles into the room, trying to get a piece of the action.

Behind this seemingly normal routine, however, is a hard-fought path that Gamble fears is at risk.

Thirteen years ago, Gamble made a decision that changed everything. She took in Cameron after he was born to her daughter, then a freshman at Norfolk State University. Gamble was disappointed when she found out about the pregnancy, but she knew how tough it would be for her daughter to take care of Cameron, who has cerebral palsy and a rare kidney disorder called Bartter syndrome. Gamble had never finished college, and she wanted to see her daughter graduate.

Before that, she had a steady income and stable life in the Triangle, a nice car and house, and everything more or less under control. But caring for Cameron, who is nonverbal and fed through a tube, was a full-time commitment. Gamble found herself running around to daily occupational, speech, and physical therapy appointments. Those responsibilities made it impossible for her to work, so she quit her job in human resources. Money ran low. In 2004, with financial burdens mounting, they moved to the projects in Durham. Gamble got rid of her car, and for about three years they were living just off Cameron's social security check of $377 a month. Once, a bullet pierced their wall.

"Our world changed," Gamble says. "It really changed our perspective on what was important. It was some of the little things that we took for granted before, like being able to have dinner together, watching some of the smaller things we started to do because we didn't have the money otherwise. And we had a big focus on Cameron and his care."

A year or so after moving to Durham, Gamble enrolled in the Community Alternatives Program, which uses Medicaid funds to provide services for children and adults with disabilities and extra needs. The program freed up enough time for Gamble to run errands and go to appointments; then Cameron started going to school, which allowed Gamble to work part-time as a waitress at Raleigh's 42nd Street Oyster Bar and eventually save up enough money to move to an apartment in Raleigh.

"So this is our normal," Gamble says, glancing over at Cameron. She ticks off a list of some of their favorite things to do: taking their bulldog for strolls, going to the movies, eating Ben & Jerry's. "As the old Southern saying goes, it takes a village to raise a child. And these benefits are an integral part of us being able to provide for him."

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