Trump supporters who rely on Obamacare

This is a sad story. There were apparently a lot of people in Kentucky who voted for Trump, even though Trump has said he will get rid of Obamacare. And these people rely on Obamacare. Why they voted for Trump is, of course, a complex question. How much did their racial identity influence them, and how much were they simply desperate for an improvement in their economic prospects? Trump won’t be able to help their economic situation, but I understand those who were suspicious of Clinton, given that she is on the record supporting every free trade deal of the last 30 years. The centrist Democrats have lost the trust of everyone, having supported the Republicans all through the decades of deindustrialization. And when the public is not given a left-wing alternative to the status quo, and if status quo is intolerable, then people have no choice but to choose the right-wing alternative.

Oller voted for Trump too.

“I found with Trump, he says a lot of stuff,” she said. “I just think all politicians promise you everything and then we’ll see. It’s like when you get married — ‘Oh, honey, I won’t do this, oh, honey, I won’t do that.’”

…Many expressed frustration that Obamacare plans cost way too much, that premiums and deductibles had spiraled out of control. And part of their anger was wrapped up in the idea that other people were getting even better, even cheaper benefits — and those other people did not deserve the help.

There was a persistent belief that Trump would fix these problems and make Obamacare work better. I kept hearing informed voters, who had watched the election closely, say they did hear the promise of repeal but simply felt Trump couldn’t repeal a law that had done so much good for them. In fact, some of the people I talked to hope that one of the more divisive pieces of the law — Medicaid expansion — might become even more robust, offering more of the working poor a chance at the same coverage the very poor receive.

…“We all need it,” Oller told me when I asked about the fact that Trump and congressional Republicans had promised Obamacare repeal. “You can’t get rid of it.”

…A study from the Commonwealth Fund earlier this year found that four in 10 adults on Affordable Care Act plans didn’t think they could afford to go to the doctor if they got sick. Fewer than half said it was easy to find an affordable plan.

But Atkins’s frustration isn’t just about the money she has to pay. She sees other people signing up for Medicaid, the health program for the poor that is arguably better coverage than she receives and almost free for enrollees. She is not eligible for Medicaid because her husband works, and the couple will earn about $42,000 next year.

Medicaid is reserved for people who earn less than 138 percent of the poverty line — about $22,000 for a couple like the Atkinses. Ruby understands the Medicaid expansion is also part of Obamacare, and she doesn’t think the system is fair.

“They can go to the emergency room for a headache,” she says. “They’re going to the doctor for pills, and that’s what they’re on.”

Atkins felt like this happened a lot to her: that she and her husband have worked most their lives but don’t seem to get nearly as much help as the poorer people she knows. She told a story about when she used to work as a school secretary: “They had a Christmas program. Some of the area programs would talk to teachers, and ask for a list of their poorest kids and get them clothes and toys and stuff. They’re not the ones who need help. They’re the ones getting the welfare and food stamps. I’m the one who is the working poor.”

Oller, the enrollment worker, expressed similar ideas the day we met.

“I really think Medicaid is good, but I’m really having a problem with the people that don’t want to work,” she said. “Us middle-class people are really, really upset about having to work constantly, and then these people are not responsible.”

…Mills and her husband run a furniture store. They used to buy their own health insurance in the early 2000s, but the premiums became unaffordable, surpassing $1,200. They had gone without coverage for two years, paying cash for doctor visits, until the Affordable Care Act began.

“It’s made it affordable,” Mills says of Healthcare.gov. This year, she received generous tax credits and paid a $115 monthly premium for a plan that covered herself, her husband, and her 19-year-old son.

Earlier this year, Mills’s husband was diagnosed with non-alcoholic cirrhosis of the liver. He is now on the waiting list for a liver transplant. Obamacare’s promise of health coverage, she says, has become absolutely vital in their lives.