Four East Texas counties, including Smith and Gregg are on a list of the 200 poorest counties in America.
It surprised us, but isn't a shock to the doctors and nurses who work at county-funded indigent health clinics. More people without health insurance walk through their doors, having almost no place else to go.
"We are definitely a clinic of last resort, the next thing to take care of this is the hospital," says Doctor Craig Gunter, Medical Director of the Community Health Clinics of Northeast Texas.
He says his patients are no different than anyone else. For the past year, he and the community health clinics in Smith County have struggled to treat more people, with fewer dollars.
"It's definitely getting worse. There are more people who are uninsured and underinsured and the cost of things are higher and higher every year," Gunter says.
Michelle Skyrme at the county-funded clinic in Gregg County agrees.
"The state is telling us to provide certain services, but the funding is not there," she says.
There are many East Texans living in poverty. In Smith, Gregg, Upshur, and Marion counties from 14 to 21 percent of the entire population lives under the poverty line.
Gregg County has started screening patients to make sure only county residents get taxpayer-funded treatment. In Smith County, the same, but they're also going after federal dollars to ease the budget crunch.
But that's just a bandage, not a cure as costs skyrocket. To ease the burden on taxpayers here, doctors say it'll take national action to make sure the proper level of care is there for the future.
"Everyone is ultimately going to have to pay a higher price for medical care if we don't find a solution to this issue," Gunter says.