Monday, March 20, 2017

Not Just Kentucky, But Ohio Too

I know we've read a lot of stories about Obamacare here in Kentucky, where 440,000 stand to lose health coverage under the GOP bill.  But the story in Ohio is even worse, where a million people could end up with no coverage  John Kasich went with Medicaid expansion through an overwhelmingly GOP state legislature (and Lord knows they did everything they could to try to stop it) but now the reality of Obamacare repeal in this newly-minted Midwest Trump state is hitting home.

James Waltimire, a police officer on unpaid medical leave, has been going to the hospital in this small city twice a week for physical therapy after leg surgery, all of it paid for by Medicaid.

Mr. Waltimire, 54, was able to sign up for the government health insurance program last year because Ohio expanded it to cover more than 700,000 low-income adults under the Affordable Care Act. He voted for President Trump — in part because of Mr. Trump’s support for law enforcement — but is now worried about the Republican plan to effectively end the Medicaid expansion through legislation to repeal the health care law.

“Originally the president said he wasn’t going to do nothing to Medicaid,” Mr. Waltimire said the other day after a rehab session. “Now they say he wants to take $880 billion out of Medicaid. That’s going to affect a lot of people who can’t afford to get insurance.”

As Republicans in Washington grapple with how to meet their promise of undoing the greatest expansion of health care coverage since the Great Society, they are struggling with what may be an irreconcilable problem: bridging the vast gulf between the expectations of blue-collar voters like Mr. Waltimire who propelled Mr. Trump to the presidency, and longstanding party orthodoxy that it is not the federal government’s role to provide benefits to a wide swath of society.

If they push forward the House-drafted health bill, which could come to a vote as early as this coming week, Republicans may honor their vow to repeal what they derided as Obamacare, but also risk doing disproportionate harm to the older, working-class white voters who are increasingly vital to their electoral coalition.

Many of those voters live in small Midwestern cities like Defiance and neighboring Bryan, home of a candy company that makes Dum Dum lollipops but has moved many of its jobs to Mexico. Though unemployment is low in the region, where farmland stretches for miles between towns, the slow erosion of manufacturing has taken a toll, and “what’s left in our communities are lower-paying jobs,” said Dr. Neeraj Kanwal, the president of Defiance Regional Hospital.

The region has voted Republican in presidential contests for decades, but its support for Mr. Trump — he took 64 percent of the vote in Defiance County and an even larger share in most of the surrounding counties — was more resounding than for any candidate since Ronald Reagan. Yet many people here tend to have conflicting values that make repeal of the health law appealing on its face but ultimately hard to swallow.

“People in this community are very conservative. They struggle with the federal budget deficit, and they like the idea of personal responsibility,” said Phil Ennen, the president and chief executive of Community Hospitals and Wellness Centers, which has a 75-bed hospital in Bryan. “But at the same time, we have a lot of friends and family and neighbors who just don’t have a lot going for them. There is a population out there that needs Medicaid. That’s the dilemma.”

And yet most of the people who voted for Trump, if not every single one of them, bought the promise that Trump would never take Medicaid away from them, personally. 

But here we are.

Oh I don't feel sorry for them.  They gladly voted to take health care coverage away from those people who "didn't deserve it", anyone black or brown.  They knew what Trump was selling.  They just figured he wouldn't screw them over this early.

But again, here we are.  

Only now are people like Jim Waltmire asking questions. Only now are they showing up at town halls.  Only now are they worried about losing what Obama gave them.  Only now.  And the rest? They think Trump will fix it all for them.

When that doesn't happen, then what?

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