captioning sponsored by newshour productions, llc >> woodruff: good evening, i'm judy woodruff. gwen ifill is away. on the newshour tonight: russia flexes its muscle in the middle east, launching air strikes in syria. and sending military advisors into iraq. margaret warner sits down with the iraqi prime minister, haider al-abadi. also ahead this wednesday, a major setback in afghanistan as u.s.-led coalition forces grapple with taliban insurgents who have seized a crucial city in the north. plus, how a surge of patients on medicaid is overwhelming the health care system in california. >> why am i seeing all of those people? because nobody else is available in their communities to see them. why not? because the rates are unacceptable, the hassles from the managed care plans as well

as the state are unacceptable to most offices to deal with. >> woodruff: all that and more on tonight's pbs newshour. >> major funding for the pbs newshour has been provided by: ♪ ♪ moving our economy for 160 years. bnsf, the engine that connects us.

>> supported by the john d. and catherine t. macarthur foundation. committed to building a more just, verdant and peaceful world. more information at macfound.org >> and with the ongoing support of these institutions >> this program was made possible by the corporation for public broadcasting. and by contributions to your pbs station from viewers like you. thank you. >> woodruff: moscow's military buildup in syria came to full flower today, with the opening of an air barrage. the russians said they're targeting the islamic state, but that claim was disputed. and, american officials issued a series of warnings about where the air strikes could lead. we'll have a full report, after the news summary. in afghanistan, the taliban kept a tight grip on a major provincial capital they overran monday, and afghan government

forces faced a critical test when they try to take it back. william brangham reports on the day's developments. >> brangham: afghan troops could be seen in action around kunduz today, as fighting raged for a third day. and the local police chief insisted they're making progress, backed by u.s. air strikes. >> ( translated ): the situation is better now. as you are aware, some areas have been retaken by security forces. the operation is ongoing. we retook the new police headquarters, the jail and some parts of the city. >> brangham: but, there was no sign of a broader counter-offensive, and a regional official complained that afghan troops had no will to fight. the taliban seized kunduz on monday, sealing off roads and hunting down government officials. up to 5,000 police and soldiers retreated to the city's airport, which taliban fighters tried and failed to take overnight. but taliban forces did capture a key hilltop fortress today. and, civilians were in full flight. >> ( translated ): kunduz is

under fire as a result of the conflict over these few days. the situation is very bad. all of the residents are fed-up and thousands of families are escaping the province. >> brangham: the loss of kunduz was a blow to president ashraf ghani and his fractious "national unity" government. abdullah abdullah ghani and chief executive officer, abdullah abdullah faced angry denunciations in the afghan parliament today. >> ( translated ): the leaders of the afghan national unity government are unable to administrate the current situation in the country. the people must stand against them and the people must stone them and kill them in their palaces. >> brangham: all of this came with some 9,800 american troops still in afghanistan, largely in a training role. and, reports surfaced that u.s. commanders will recommend keeping several thousand in afghanistan beyond 2016. >> we're going to continue to monitor the efforts by the afghan government and afghan security forces to retake kunduz and that will factor into a longer term assessment of the conditions on the ground, which will influence longer term

policy decisions that the president will have to make. >> brangham: president obama's current plan calls for withdrawing all but about 1,000 u.s. troops by the end of next year. i'm william brangham for the pbs newshour in washington. >> woodruff: there's word that a ship carrying weapons from iran was intercepted last week off the southern arabian peninsula. a coalition led by saudi arabia says the vessel was smuggling arms to shiite rebels in yemen. sunni arab states are fighting against the rebels. a u.s.-backed naval coalition says, in fact, it actually stopped the vessel, and that the crew claimed to be bound for somalia. palestinian president mahmoud abbas declared today he will no longer be bound by agreements signed with israel. he addressed world leaders at the united nations general assembly, and said there's no point in further negotiations. >> ( translated ): as long as israel refuses to commit to the agreements signed with us, which

render us an authority without real powers, and as long as israel refuses to cease settlement activities, israel has thus left us no choice: we will not remain the only ones committed to those agreements. >> woodruff: israeli prime minister benjamin netanyahu dismissed abbas' remarks as "a speech of lies". back in this country, the state of georgia has executed a woman for the first time in seven decades. kelly gissendaner was put to death by lethal injection, just after midnight. she had been convicted in the 1997 murder of her husband. more than 100 supporters gathered outside the state prison in jackson. in addition, pope francis had asked that her death sentence be commuted. it turns out the kentucky county clerk who refused marriage licenses to gay couples met with pope francis last week. kim davis, told abc news she spoke briefly with the pontiff

in washington on thursday, and that he told her to, quote, "stay strong". the vatican had no comment. the atlantic coast is now >> a secret service official targeted chafeitz for investigating scandals at the agency. it said the officials suggest the leaking damaging information from an old job application by the utah republican. it also says scores of secret service employees accessed his file, possibly illegally. the atlantic coast is now waiting to see what hurricane "joaquin" will do. the storm gained hurricane strength today, brushed the eastern bahamas, and kept growing. the national hurricane center predicted it would churn north, possibly striking the u.s. eastern seaboard, by early next week. that's likely to add to flooding in several southeastern states. they've been hit by heavy rainstorms over the past two days. wall street has been flooded by

"sell" orders in recent days. but today, traders went looking for bargains. the dow jones industrial average gained 235 points to close near 16,285. the nasdaq rose more than 100 points. and the s&p 500 added 36. even so, stocks here and abroad ended their worst financial quarter in four years. a federal appeals court has struck down a plan to let colleges pay student athletes up to $5,000 a year. today's ruling said the proposal to offer cash to football and basketball players would destroy amateur athletics. still to come on the newshour: russia launches strikes in syria. the prime minister of iraq on fighting isis. a new round of drama on capitol hill. and much more.

>> woodruff: russian military aircraft bombed a number of sites in syria today, deepening it's involvement in that nation's civil war. but there are conflicting reports about exactly what russia was targeting. hari sreenivasan has this report. >> sreenivasan: this amateur video purports to be first evidence of russian warplanes in action over syria: plumes of smoke rising over cities, as fighters streak across the skies. the assault began hours after the russian parliament authorized action, and president vladimir putin vowed to forge ahead. >> ( translated ): the only right way to fight international terrorism in syria is to act preemptively, to fight and eliminate fighters and terrorists on the territories they have already occupied, not to wait until they come to our home. >> sreenivasan: but exactly what the russians hit, and why, remained unclear. there were strikes near homs and in hama province, and moscow reported attacking eight islamic

state targets. but by all accounts isis, or isil, has no significant presence in those areas. instead, the free syrian army charged its forces were targeted. the western-backed faction has fought syrian president bashar al-assad, an ally of russia. u.s. officials agreed the strikes may have hit moderate rebel factions, and not islamic state forces. the kremlin denied it, but also claimed most of the free syrian army has now joined isil ranks. and at the united nations, foreign minister sergei lavrov was dismissive. >> everything, everything was said by the russian ministry of defense. don't listen to pentagon about the russian strikes. >> sreenivasan: secretary of state john kerry was also at the u.n. he said washington would welcome any genuine effort to defeat isil, but he issued a warning as well. >> we would have grave concerns should russia strike areas where isil and al qaeda affiliated targets are now operating-- are not operating.

>> sreenivasan: meanwhile, at a u.s. house hearing, a top pentagon official complained the russians gave just one hour's notice of the strikes. >> sreenivasan: defense secretary ashton carter said later those military-to-military talks are set to take place in the coming days. but, he said, the kremlin is making a mistake. >> by supporting assad and thereby seemingly taking on everyone who is fighting assad, you're taking on the whole rest of the country of syria. that is not our position. that's why the russian approach is doomed to fail. >> sreenivasan: carter said the russian actions will not deter the u.s.-led air war on islamic state fighters, that's been under way for a year.

>> woodruff: late this evening, secretary kerry and russian foreign minister has rof came out together and agreed to military talks. we get a closer look at russia's military moves in syria with andrew weiss. he was the director of russian, ukrainian, and eurasian afairlz at the white house national security council during the clinton and george w. bush administration. he's now with the carnegie endowment for international peace. and steven simon. he's a visiting lecturer at dartmouth college. he served on the national security council staff during the obama and clinton administrations. we welcome you both back to the program. let me start with you, steven simon. is this an occasion for the u.s. to be pleased that it has a partner in going after isis or alarmed that the russians are in syria helping their friend president assad? >> i think on balance, there's

cause for some satisfaction, and the presence now in syria of a powerful military player with a serious strategic stake in defeating isis. it's really the only, i would say tacit partner. it's certainly not an explicit partner of the united states in this battle against isis. so at least the united states has a partner, even it's not official. on the other hand, it does mean that there is a serious friend of the assad regime also present in syria, and this is undoubtedly a cause for concern for the administration. >> woodruff: well, let me turn to you, andrew weiss, more cause for concern or a cause for some satisfaction? >> i think the cause for concern here is that russia is plunging head-long into a military adventure in a part of the world

where it's been absent for the better part of the last two decades. i defer to my friend steven simon on the impact on the ground. it certainly looks like this is a big shot in the arm for bashar al-assad. the question is have the russians thought two or three moves ahead? this to me looks suspiciously like what happened in ukraine, where what seemed like a good idea, a pressurized idea by the russians to unleash pressure in ukraine, has backfired badly. when i hear carter say this is ultimately going to be something doomed to fail or hurt russia, i have very little reason to doubt that. >> woodruff: what do you mean-- coming back to you, andrew weiss-- what do you mean it looks like what happened in ukraine? >> well, people like to talk about pint as if he is this great master strategist. in fact what, he is, is someone who is fairly intulsive. so the intervention in ukraine was done very spur of the moment, and we've had about three weeks or so of steady drip of russian military buildup in and around the western

mediterranean coast of syria, and now he's plunging into a military venture. there's no domestic russian support for military activity of this type. and i think there's a real question which is he is basically putting a target on the bask many russian soldiers and many russian civilians. he's creating a boon for the local jihadist movement and he's placing russia at the center of that, other than the united states or other western partners. >> woodruff: why was it so difficult today to figure out who the russians were targeting? >> because the situation on the ground is in fact confused, and there is no geolocation of the attacks that are publicly available yet. the information available to me is that they struck targets affiliated with al-nusra, which is another islamist group. but as a practical matter, the first priority for the russians right now is protection of the regime, and the survival of the regime and the viability.

so they're going to attack the targets so that they and the regime have decided are most threatening to the the regime right now, and then move on to targets that are less immediately threatening. so whoever was knocking at the gate right now is going to get the first russian blow. the other thing, of course, is that the syrians will be encouraging the russians to be attacking isis targets. the united states has thus far refraind from attacking because they're politically sensitive. if there's a target that looks as though its destruction would be mostly of benefit to the regime rather than to the syrian people at larm, then the united states will save its ammunition, keep its powder dry, and strike other targets that are less ambiguous, if i capitol hill put it that way. so that will be-- those will be

the russian priorities. >> woodruff: andrew weiss for anybody listening to this is sound like a very confusing situation to keep track of who is up and hois down and who is being targeted? how should americans view this? do we wait and withhold judgment until we see what the russians do over the next few days? >> well, i think president obama's been quite reluctant to get the u.s. more involved militarily, and that's been going on for some time now. so i think the idea the u.s. is either going to stand up to the russians and tell them to knock it off, all that i think is misplaced. the real question for us, the u.s. other and western partners in the regional partners in the fight against isis, is whether we're going to bump into the russians in some sort. and the russians up to now had talked a good game saying, "we want our militaries talking. this is really important." but they've plunged ahead without getting that coordination mechanism locked in, and i think there's a real risk here the russians who don't have the same level of experience, don't have the same kind of intelligence backbone to

support their operations could be doing things that are either dangerous or that put western pilots and others at risk. >> woodruff: steven simon, why isn't that a big worry? i mean, if there was a sense we were led to believe ahead of time the russians were going to give the west, the u.s.-led coalition, more advanced notice. it sound like they barely had an hour's word ahead of time. >> i think it is problematic. and we've got to get those talks going and there needs to be better coordination. but as a practical matter, the russians are going to be striking in sectors of syrian territory and syrian air space that lie outside of the areas that the united states has focused on, which are mainly targets that are close to the turkish border in the north. so as a practical matter, i think the risk of a collision are low. >> woodruff: let me just quickly conclude asking you both, what are you looking for in the next few days to tell you whether this is a positive

development or not? andrew weiss. >> i think the immediate question is how the russian people will react. i've no doubt that there's great sense of celebration inside assad's inner circle and, frankly, in tehran, but i don't think the russian people were prepared for any of this. this has all been thrown at them with maybe two or three weeks' notice. it plays to putin's domestic agenda, which is to say russia is a big, great power. it can thrust itself into the international stage at a time of its own liking and a place of its choosing, but there's no one i think at home who is really enthusiastic about this whole activity. >> woodruff: all right, we are gog have to leave it there. andrew weiss, steven simon, thank you both. >> woodruff: we now get the view from bagdhad on russia's bombing and the fight against the islamic state, or daesh, as the group is called in arabic.

newshour chief foreign affairs correspondent margaret warner spoke today with iraqi prime minister haider al-abadi. he is in new york attending the united nations general assembly. >> warner: mr. prime minister, thank you for joining us. >> welcome. >> warner: it's been confirmed today that the russians launched an air strike in syria right outside the sea of homs. is that kind of thing helpful, do you think, to the common fight against the islamic state? >> well, of course, it is beneficial. don't forget, iraq was attacked from across the syrian border into iraq by daesh, by isil. and that cost us a lot of human cost in terms of people killed, people being kidnapped, people being inn slaved, women, children. so any joining of this fight against daesh by anyone, we very much welcome. we established this international coalition. >> warner: you're talking about the u.s.-led coalition. >> correct. that's to help iraq to stand in

the face of daesh, and if the russians are moving against daesh now in syria, we very much welcome this. >> warner: well, that is really the question. the u.s. government was saying today that in fact that's not a daesh or isis stronghold where they bombed. in fact, it's held mostly by the opposition to president assad. what do you think are the russian intentions? >> our message to the russians-- i met with president putin-- please join this fight against daesh. daesh is a dangerous terrorist organization, not only against iraq. against syria, against the whole region, against the whole world. it is time that we all join the same forces to fight daesh. >> warner: but do you think that the russian intention is only to do that or to also prop up the assad government? >> i cannot be in the mind of what the russians want. but what i've been told by president putin, yes, they consider daesh a very dangerous organization. it is threatening the national security of russia, and the

russians are in it to fight daesh. >> warner: can you foresee the day iraq might ask the russians to come in and bomb in iraq to assist what your ground forces are doing? >> well, if the russians are prepared to join the international coalition, which is helping iraq, they are welcome. i think i would welcome the russians to do that. >> warner: but, i mean, they're not part of the u.s.-led coalition. they have a different group. are you saying they'd have to first join the u.s.-led coalition or just if they say they want to defeat daesh, that in fact you'd welcome their help, including bombs? >> yes, i think i would welcome that, but they need a liaison between everybody there. we need, like air, common platform where there should be no conflict. we have to deconflict any misunderstanding between the countries which are helping iraq inside iraq. >> warner: another thing, of course, that land over the last few days was news that iraq had entered an intelligence pact with russia and iran and syria

to share intelligence about isis. why did you join that? >> isil is an international terrorist organization. as far as the intelligence is concerned, we can only gather information about isil inside iraq. we need the help of other countries. russia now considers isil as a national threat to them. it is a national threat to syria and, of course, is a threat to iran as well. now, to share this intelligence with these countries is going to help us. i will do whatever it takes to protect the iraqi people, and there are many terrorist networks all over the world and fighters coming across different countries to syria, to iraq. i need the help of that intelligence, as well as the intelligence of the international coalition which is-- >> warner: but doesn't most of your intelligence in fact come from the americans? and are you worried that the u.s. will become more wary and less forthcoming sharing intelligence with you if they know it also goes to iran and

russia and syria? >> no, we will be careful not to share this information which comes from other parties with another party. but you see, russia has an interest. we have about 2,500 chechen fighters from russia who are taking part with daesh inside iraq. and inside syria. inside iraq, they are very dangerous guys. they kill a lot of people. so i think to have the the russians on pord will help me, will help my government to protect iraqis and to save more lieches. >> warner: now, you met with president obama privately after this news came out. did he seem upsed, annoyed? >> well, i think there is some political enmity between people of the united states and russia. that is very much understood. the the russians want to play a role in the middle east. they want to play another role in russia. i understand that. but for me, these minor political differences i should put aside. >> warner: what the u.s. was upset about is you, for whom,

you know, the u.s. is providing air cover for your troops, retraining of your troops, didn't even give the americans a heads-up. why not? >> i think, no, they knew about this, about this intelligence sharing of information. >> warner: they say they did not in advance. >> i mean, they were advanced-- well, probably not in advance before we've done it, but later after we've done it. i mean, this has been going on for about three months now. this is not new. i don't know why the news was broke recently. it's very low level. it's very low level. it is not high level. there is no military cooperation whatsoever. >> warner: so if i might, back to the meeting with president obama, what did he say? >> it's mainly to do with american and international coalition support to iraq. we need more equipment. we need more support. and i think that the president was very much forthcoming in escalating support for iraq, for our forces to achieve victory on the ground. we are, i think, the only army in the region who are fighting

daesh. >> warner: let me ask you about your fight in iraq. it seems to have hit a stalemate. you had a little early success, sort of freezing isis in place last summer, but since then you've been unable to retake major cities lycra mahdi. why is that? >> well, i think, last time was in april when we took back tikrit, and since then, of course, we lost ramadi. but after a month and a half after we lost ramadi, we started a counter-offensive, and we've already encircled not only ramadi but many areas other than ramaude tow kick daesh out. in fact, this summer, was very hot, extremely hot. i don't think when soldiers are caring about eight, 10 kilogramses of equipment and body armor you wouldn't expect them to fight in such heat weather. we have made progress but not as much as we anticipated because of the weather.

>> warner: many americans wonder why should we keep getting involved losing lives and treasure, trying to help these countries resolve their differences? why not just walk away and let them resolve themselveses? what would you say to those american taxpayers and voters? >> see, daesh, or isil, is not only threat to iraq or the region. it's for the whole world. we have blocked the advance of daesh to the south. if they are allowed to go to the south, they would control all the gulf areas, all the oil supply of the world. they will threaten the whole world. they will establish what they consider their rightful state, which is, of course, terror state, in the whole region. we have blocked that in iraq. we not only stopped it, but we are reversing it. we are the only country now reversing the acts of this terrorist organization. if we don't receive this spirm support, i'm not sure we can stand on our own. we gave a lot of sacrifices. we are prepared to give more. iraqis are sacrificing themselves to defend their land

and to push daesh out. if we don't receive this international support, god knows what is going to happen in this region and what's going to happen in the rest of the world. >> warner: mr. prime minister, thank you. >> okay, thank you. >> woodruff: stay with us, coming up on the newshour: questions about coca cola funding research on obesity. and a look at racial diversity in hollywood. just hours before a possible government shutdown, congress today passed a bill to keep funding flowing until december 11th. but today's votes showed the continued, sharp divide within the republican party and seemed to set up an even bigger fight in december. to unpack another dramatic day in congress, our political director lisa desjardins has been following the developments and joins us now from capitol hill.

so, lisa, they dodged a bullet. they avoided the shutdown, but this was despite the opposition of over 150 republicans in the house. what happened? >> reporter: that's right. you know, this seemed to be a fait accompli as we walked in the door this morning. of course, a shutdown would be averted. that was the expectation but i think there were several surprises today, judy and the biggest note for today was that two-thirds of house republicans voted against the bill to continue funding government. there were a variety of reasons, they said, for that, but at the top of that list, judy, was the fight over planned parenthood. now, it's an interesting contrast, judy, because because while to-thirds of house republicans voted against that funding bill to keep government running, two-thirds of senate republicans voted for it. so what we saw today, judy, was such a great contrast between the senate, which seems to be running on procedure and tradition right now, and the house, can where there is so much anger among house republicans that, really, republicans seem to be running there mostly on emotion and anger.

>> woodruff: but, you know, we've been told, lisa, that there's a group of, what, 40 or 50 hard liners in the republican party in the house who were giving fits to speaker boehner, leading to his resignation. but now you've got 150 republicans voting against keeping the government going over this planned parenthood issue. what does that say? >> reporter: well, i think we can't read too far into this, because i think it was a certain vote. republicans knew that government was not going to shut down, that enough democrats would vote yes to keep government going. so in a way it wasn't a complete test of what these republicans would do if it was solely up to them. but i think you're right, we have this caucus that is the most conservative group in the house, 40 or so members, and they are the most vocal. they are the ones that really are dominating discussion, even still, even after house speaker boehner's resignation, to the degree, judy, where today there was even a last-ditch, last-minute vote on planned parenthood in the house. it was completely symbolic. it will not have any effect on

funding. but just the fact that that came up yet again today shows that that group of house conservatives that is so vocal really has an outweighed amount of power on their conference. >> woodruff: so, again, they averted the shutdown now, but what does this say about the future? december, another funding vote, so many other things that could come up between now and then. >> reporter: i think any student of history or congress or legislation needs to pay very close attention to what happens the next few months. it is going to be exciting, potentially confusing, and potentially critical to the future of this country as we face yet another deadline for the debt ceiling, but also as their there may be an opening, judy, for the next month as house speaker boehner remains in his position there, might be an opportunity for him to get through or try to get through some legislation that moderate republicans like, things like the export-import bank, or highway funding to find a more secure source of highway funding, or even-- imagine this-- a two-year budget deal.

that's something that the senate leader mitch mcconnell was talking about, and sources on both sides told me there are staff discussion now. not a the love time to do it, but if they could, judy, that would certainly save the next speaker a lot of headache. now the next big problem, of course, comes in december, this funding that was extended today runs out then. and, judy, i have to tell you, democrats and republicans both are digging in. i think that will be a ginormous fight. if that's a word. >> woodruff: if those things come to pass that you describe in the next few months, a lot of conservatives will not be happy. so you're gog have a lot to cover up on the hill. lisa desjardins, thank you. >> reporter: thank you. >> woodruff: the number of people who lack health insurance has fallen substantially since the implementation of the federal healthcare law, known as the affordable care act. that's been particularly true in the 30 states that expanded medicaid.

but in more than a dozen of those states, enrollment in the public insurance program for the poor has far eclipsed projections, straining budgets and an overburdened health care system. special correspondent sarah varney has our report from san diego. this story was produced in collaboration with our partner kaiser health news. >> reporter: the affordable care act unleashed a building boom of community health centers across the country at a cost of $11 billion, more than 950 new health centers have opened with hundreds more on the way. all meant to accommodate millions of new medicaid patients. people like laurie simpson. >> hi, how are you? >> good, how are you doing? >> doing good. >> reporter: at age 58, after several worrisome decades without health insurance, she's finally getting treatment for her dangerously high blood pressure, as well as a thyroid disorder, and after years of double vision, surgery for her eyes.

>> i have nine medications that i get every month, and mine comes to a little over $200. my husband, he's a diabetic, and his medication alone without doctors' visits or anything comes to over $400 a month. >> reporter: for that, how much do you have to pay? >> we don't pay anything. it's all covered. it's just amazing. >> it's a little bit this way. >> reporter: simpson goes to the family health centers of san diego, which saw an increase of 24,000 patients, almost overnight, after the medicaid expansion. >> sit up straight, breathe normally. >> reporter: dr. chris gordon, the assistant medical director here, says it was a rush primary care clinics have been waiting for ever since president obama signed the health law. >> we've anticipated this for years, and been planning for it. we have capacity to take on patients. these are patients that haven't had access before because they just didn't have the financial means to get in. extend all the way out. and now all of a sudden, they actually get to come in, get to

spend time with somebody and get to feel, you know, like they're heard. >> reporter: that's not to say there haven't been problems. three million more people than expected have enrolled in medicaid in california. other states have also seen surges far beyond initial projections, including kentucky, michigan, oregon, and washington state. as successful as california has been in enrolling millions in medicaid and building new primary care clinics, patient advocates say the medicaid expansion has capacker baitd long-standing shortages in specialty care. community clinic directors say it's often difficult to find cardiologists, orthopedists and other specialists to see their patients and low-income californians still face formidable hurdles when they need treatment. for alexander gomez the search for specialty care has been burdensome. he spent years working as a car salesman and auto parts delivery driver. at age 60 and living along, he shuffles around his home

hampered by spells of dilziness. the spells disrupt his daily prayers and curtail his driving. he's now insured under medicaid, but most of the specialists he needs to see are an hour away. >> i didn't feel well at all. i started getting dizzy again so i turned and around went and told them i can't do this. it's too far. and i even asked for the director of the clinic, explained my problems. and she told me that that's the way it worked out, that there were only certain doctors that would contract with them. doctor. >> how you doing? >> okay. >> let's pull you up a chair right here. >> reporter: one of the doctors he has managed to reach is ted mazer. mazer is one of the few ears, nose, and throat surgeons who accepts medicaid. >> certain surgeries, i can be out of the office for two hours and we might get $300. my overhead is more than that. so that's a loss. >> reporter: dr. mazer sees

only a limited number of medicaid patients but he often degrees to treat those like this 19-year-old in need of a complicated nose surgery. >> lay your head back for me. >> reporter: but mazer said the state is failing to guarantee access to this type of care for all medicaid patients. >> if it was working i would not have patients coming here from ocean side and fall brook and the mexican border and the empeeler county area and riverside border. i'm one office. why am i seeing all of those people? because nobody else is available in their communities to see them because rates are unacceptable. the hassles from the managed care plans as well as the state are unacceptable for most offices to deal with. >> reporter: explaints extend beyond san diego. a withering state audit found regulators couldn't verify if the districts have enough doctors. the state's call centers were overwhelmed with phone representatives answering just half of all calls. in & too often, those obstacles have forced patients to seek help in expensive emergency

rooms. in a recent national survey, three out of four e.r. physicians said patient volume had increased, a pressing concern the medicaid expansion was meant to address. >> there are a lot of people here with chronic back pain. >> reporter: dr. tomiachef ski, the medical director of uc san diego's emergency department, says e.r. visits have increased 11% since the medicaid expansion >> a lot of these patient we're also noticing are coming here looking for subspecialty care. they need an orthopedist fair complicated fracture. they might need a head and neck doctor for some plymouth countied throat problem. and they're using the emergency department as a gateway to have access to that kind of care. >> reporter: at nearby scrips mercy hospital, visits by new medicaid patients are up 30% due to the health law, says dr. craykroft, the hospital's medical director. >> they have occurrence, they come for care, but the overall goal is to get them into a

primary care doctor's office or get them the specialty care that they need and oftentimes that's difficult for them to achieve. >> we're committed to having the conversation with you about how it needs to be spent. >> reporter: california's medicaid program is a budgetary behemoth that falls to jennifer kent to manage. she's the california department of health care services director. >> there's definitely growing pains as the system broadly has to stretch to accommodate the influx of enroll ease. >> reporter: kent says the state is fixing its phone system and looks closely at complaints but that problems with physician access are isolated and are being addressed. >> we are struggling just as every other state is in terms of how do we bring people into california, how do we grow primary care providers, and then more importantly, how do we provide specialists in areas where there may not be specialists today? >> reporter: california's governor, democrat jerry brown, has championed the medicaid expansion, but like other governors he's leery of paying physicians more money just as state confronts a drop in federal aid. the federal government is currently paying for the entire

medicaid expansion, but in 2020, federal drops to 90%. instead, he wants the state to spend its money revamping a system to better serve low-income patients who are often sicker and can be hard to reach. despite challenges, there is evidence progress is being made. a recent survey found that in states that expanded medicaid, 93% of new enrollees are satisfied with their coverage. assand row gonzales gomez said he'll continue the long drives across the country. >> next week i have to go to la jolla. >> reporter: because his medicaid card has opened up doors, even if those doors are often difficult to reach. for the pbs newshour, i'm sarah varney in san diego. >> woodruff: now we look at a second health story, one about childhood obesity, the role of sugary drinks in fueling the

epidemic and corporate influence. a series of reports is putting a fresh spotlight on the spending and role of coca-cola, a company that's known for its sweet products. hari sreenivasan has more from our new york studios. >> sreenivasan: coke is the world's largest producer of sugary beverages, so you might not think the american academy of pediatrics would partner with the company. but that had indeed been the case until this week. it was a main sponsor of the academy's website, healthychildren.org, and a past sponsor of the group's national conference. it's provided over $100 million in financial support to other professional medical and health groups. the academy is now ending its relationship with coke. and it comes after a recent story in the new york times laid out how the company has paid for scientific research that plays down the role of soda in obesity. anahad o'connor has been working on these stories and joins me now. i guess the first story or the

most recent story first, what's the connection between coke and the academy of pediatrics? >> so the first story i did was looking at coke, the money they were paying, a lot of researchers and institutions to do research that, you know, is downplaying the role of sugary drinks and obesity, and the response to that story, the c.e.o. of coca-cola said we're not trying to deceive the public. we're trying to work with institutions to promote active healthy living, and we are going to release all of the funding that we provided to scientists, universities, to health groups over the past five years, and so they released a trove of data showing this extensive number of grants. and in that data, we saw that the american academy of pediatrics was in there, and coke had provided something like $3 million to the academy, at least over the past five years. >> sreenivasan: and how do the pediatricians feel? >> so the actual members of the academy-- and there are more than 64,000 pediatricians who are part of this academy. it's very prestigious-- a lot of them are very upset.

when i spoke to them they said they couldn't believe the academy had partnered with coke or worked with it to any extent because sugary drinks are considered a very major factor in the obesity epibemmic, especially among children. these pediatricians see the effects of it firsthand. they see type two diabetes, hypertension, you know, all these diseases that used to occur in middle age and later in life, they see them in children now. and they think that sugary drinks are a primary influence of that. so pediatricians were very upset. >> sreenivasan: and yet here they are at a conference, and they're carrying around bags that have coke in it while they're trying to tell their patients don't feed your kids sugary drinks. >> yeah, so some pediatricians said it was analogous to, you know, a major lung association group or university partnering with, you know, the tobacco industry. it just was completely contradictory. >> sreenivasan: what's the correlation? is there influence on academic research? you point to a case in louisiana. >> so there was a case in louisiana at a biomedical center

at louisiana state university. they actually were one the of the largest recipients of coke money. they took something like $7 million over the past five years. and they recently released the results of a major worldwide study that looked at obesity in children, and the major factors of the epidemic, and they found that some of the major causes were a lack of sleep, a lack of exercise, television, and one thing they didn't mention was sugary drinks. and that seemed very striking because you look at other independent research, and it's all pointing to sugary drinks, but the universities and institutions taking comb coca-cola money many of them are, you know, seeming to exclude sugary drinks from, you know, the obesity epidemic. >> sreenivasan: how singular is coke in this? i mean, in the past there have been companies, industries lobbying efforts on capitol hill. certainly that still happens. are there other food companies

or beverage companies that are trying this? >> so, coke is certainly part of several lobbying and trade groups that are also include other large coperations and food and industry players. but coca-cola really seemed to have been out front on this. i talked to one expert at m.i.u., who wrote, "soda politics" and studies the beverage and food industry, and she said she had never seen another corporation that had such a hand in so many public institutions. you know, coke has partnered with all of these academic and medical groups. they've partnered with the boys & girls club. they've partnered with minority groups like the n.a.a.c.p., and the hispanic federation, and, you know, they're winning loyalty and allies. so, for example, when michael bloomberg, you know, tried to introduce his, you know, soda cap and restrictions in 2012, the beverage industry, supported by coke, filed a lawsuit against michael bloomberg, and the n.a.a.c.p., and the hispanic

federation actually filed amicus drinks supporting the beverage industry against bloomberg and that was very shocking buysut minority communities have a disproportionately high prevalence of obesity, and, you know, they seemed to be able to benefit the most from soda restrictions. and yet these groups were siding with industry. >> sreenivasan: thanks so much for joining us. >> thank you for having me. >> woodruff: now to another installment in our ongoing series "race matters". this year, a record number of african-american actors won emmy awards for outstanding performances on television. special correspondent charlayne hunter-gault explores why what we are seeing on television is finally becoming more diverse. >> viola davis. request can the how to get away with murder."

>> who viola davis won an emmy last week, she made history as the first black woman to win in that category. and she called on a history that dates back to the 1800ss with words spoken by the abolitionist harriet tubman. >> in my mind, i see a line, and over that line, i see greenfields and lovely flowers and beautiful white women with their arms stretched out to me over that line. but i can't seem to get there no how. i can't seem to get over that line. >> reporter: but davis was using tubman's words to illustrate lack of opportunities in the movie industry for african american women today saying. >> you cannot win an emmy for roles that are simply not there. >> reporter: to pursue that further, we met up with a man who's been involved in looking at just that issue over time.

he's darnell hunt, chair of the department of sociology at u.c.l.a., and the head of its ralph bunch center for african american studies. professor darnell hunt, thank you for joining us. >> i'm glad to be here. >> reporter: the other night at the emmy awards, viola davis seems to have really struck a nerve, which coin sides, incidentally, with the research you've been doing. tell us a little bit about what she had to say and how that resonated with your studies. >> well, you know, i think that viola made a really important point. it's hard to win awards if there are no roles, you know. and that's been the history. it's an industry that's been dom nailtd by white men for generations. and, unfortunately, it's woefully out of step with where america is going. we're almost 40% minority right now, and clearly a little more than 50% female. >> reporter: aside from the basic fairness-- and that's a huge one, obviously-- what else is wrong with the kinds of equations that you've spelled out? >> on the one hand, there's the question of employment. you know, it's just unfair that

talent of color aren't given the same opportunities as white and male actors, directors, producers, writers, et cetera. but more importantly, as a sociologist, i'm interestedly in the impact on society. so when we talk about representations, meaning the images that circulate, if you don't diversity in the media, it's not likely that you're going to generate and circulate the types of images that are healthy in a diverse, democratic society. the more we see images that reproduce this notion that white men are in charge, the more we start to normalize that idea, and it becomes hard for people of color, particularly youth, to think about the possibilities that are before them, to aspire to certain types of careers if they tonight see those role models reflected in the media. at the same time, we also know that people learn a lot about what they think they know about other people from what they see in the media. they see certain types of images reproduced over and over again for other groups that limit them to narrow types of roles and

portrails, they start to take those prejudices into their interactions with those people in real society, and that creates all kinds of discriminatory problems. i mean, right now, we're grappling with racial profiling, all these fears about young, black men, are some ways are related to types of images circulated about young black men throughout our history. from the beginning we designed our study to look at relationships between diversity and the bottom line, since that's what the industry is. it's about make money. tv shows that roughly reflect the diversity of american society-- that is, between 30%, 40%, diversity on the screen-- on average had the highest ratings and that was a clarion call for a lot of people in the industry who had no idea because there are so few shows that are that dwirs. >> reporter: you did something concrete to change that. tell us a little bit about that. >> the first thing we did, when we conceived of the study, we decided we were going to go to the industry directly for support. our rationale was if we went directly to the industry for support, they would be forced, if they supported the study, to read it. you know, it's as simple as

that. >> reporter: excuse me, who are you talking to? >> we're talking to people in industry directly. >> reporter: behind-the-camera people. >> the people make the decisions. we're talking to the people who make up the executive suite suites that are about 94% white and 100% male. you look at the major stiewd 94% white. we're talking about an industry heavily controlled by white men. we're talking to them. we're telling them what's wrong with this picture. >> reporter: and what kind of reaction are you getting? >> you know for years, people would say, "yes, diversity is a great thing." but they thought it was a luxury, something we'll get around to at some point. but when you start connecting diversity to the bottom line, the shareholder value, suddenly it becomes more of an imperative. >> reporter: how do you think this is going to impact racial discourse that we have in this country now which is really very difficult and often very toxic? >> yeah, yeah. yeah, i agree. where we are right now with race

is very difficult. i mean, it's sort of a period of contradictions. i mean, we have an african american president. and that has created the illusion for a number of people that we're beyond race, that race doesn't matter anymore. and yet we have all these high-profile cases around the country of racial profiling, of vigilantism, racial hate crimes, et cetera, et cetera, et cetera. race is a core reality of american experience. media images on television need to reflect that reality to help people who consume media and who don't have the day-to-day, face-to-face contact with others or where that contact is men mal, to help them have a greater appreciation of other experiences and how they're all part of the american fabric. >> reporter: so that's your solution, more diversity. and how long do you think it's going to take? and how do you see it happening? what is the solution? >> i don't believe that there's a silver bullet, that if you just do this one thing you solve

the problems of the world. i think that it will require lots of intervention interventif fronts. i think there needs to be continuing public pressure to demand the types of diversity on screen that are reflective of american diversity. people in the industry themselves-- that is to say, those who are in charge-- need to get the memo and recognize that the bottom line also is going to be increasingly dependent upon diversity. and i think you need more diverse voices in the writers' room. you need more diverse voices pitching tv ideas, movie ideas, and the stories themselves, not just the characters in the story but the stories need to be more diverse, and from the perspective of other types of people. >> reporter: you've sat down with industry executives. were they receptive to your positions that they needed to be more diverse? >> absolutely. we're getting really strong accept apse of our study among

major decision makers in the industry. in fact, a number of them, a number of major studios and networks have already signed on as financial sponsors of our study. and we were really careful to diversify that group because we want to maintain our independence and objectivity as researchers. but n.t.s.b., we think it's valuable to have them as stakeholders in the process because they're likely to use the results. >> reporter: professor darnell hunt, thank you. >> thank you. >> woodruff: that brings us to our newshour shares of the day, something that caught our eye which might be of interest to you, too. we have two events of note this evening: the first comes from east china, where a massive so-called 'tidal bore' pushed up the qiantang river today. thousands watched as the leading edge of the incoming tide roared in, crashing into river banks and dams along the way. it was the largest tidal bore in

the area in 10 years and was caused by high tides linked to the same lunar cycle that brought us sunday's 'blood moon.' and a new world record was set in the skies of southern california yesterday afternoon. for a brief moment, 202 skydivers from 30 different countries gripped each other's hands, arms and legs while 10,000 feet up in the air. by forming not one, but two massive human snowflakes, the skydivers created the largest aerial 'sequential formation' of all time. the accomplishment smashed the old record of 117 people. i'm glad there's somebody out there willing to do that. and that's the newshour for tonight. i'm judy woodruff. join us online and again here tomorrow evening. for all of us at the pbs newshour, thank you and good night. >> major funding for the pbs newshour has been provided by:

>> supporting social entrepreneurs and their solutions to the world's most pressing problems-- skollfoundation.org. >> and with the ongoing support of these institutions >> this program was made possible by the corporation for public broadcasting. and by contributions to your pbs station from viewers like you. thank you. captioning sponsored by newshour productions, llc

this is "nightly business report" with tyler mathisen and sue herera. shopping list. the third quarter in the books, one of the worst in years. what does it mean, if anything? and how should you invest? >> down to the wire. the house passed the short-term funding bill that averts the government shutdown for now. >> under the hood. why a growing number of investment choices in your 401(k) may look like mutual funds, but aren't. all that and more tonight on "nightly business report" for wednesday, september 30th. >> good evening, everyone, and welcome. a big finish to what was the worst quarter since 2011. and for investors, it was a volatile and turbulent three months. during that time, investors saw all three