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Most states with largest insurance gains under Obamacare voted for Trump

New Gallup data shows that some of the places that benefited most from the Affordable Care Act were also those that supported the candidate who ran on a campaign of repealing and replacing it.


The three states with the biggest declines in uninsured rates — Kentucky, Arkansas, and West Virginia — all supported Trump in the 2016 election. These are all states that participated in the health care law’s Medicaid expansion, which provides government-run coverage to low-income Americans.

Why did these places that seem to benefit significantly from the Affordable Care Act also vote for the candidate running on a repeal platform? I spent some time late last year in southeastern Kentucky to find out. I kept hearing the same things over and over again, as I wrote in December:

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.

The political reality in Washington, however, looks very different from what these voters expected. Republicans are still committed to repealing the Affordable Care Act. The plans they have proposed so far would leave millions of people without insurance and make it harder for sicker, older Americans to access coverage. No version of a Republican plan would keep the Medicaid expansion as Obamacare envisions it.

Read my entire story here; you can also watch a video below from my colleague Johnny Harris on the same area of Kentucky.

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