Brilliant thinking: Vote Trump, lose health coverage

    In this May 5

    In this May 5

    Winston Churchill once said, presumably half in jest, that “the best argument against democracy is a five-minute conversation with the average voter.”

    Like this average voter, quoted in the New York Times:

    Dalia Carmeli, who drives a trolley in downtown Miami, voted for Donald J. Trump on Election Day. A week later, she stopped in to see the enrollment counselor who will help her sign up for another year of health insurance under the Affordable Care Act.

    “I hope it still stays the same,” said Ms. Carmeli, 64, who has Crohn’s disease and relies on her insurance to cover frequent doctor’s appointments and an array of medications.

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    I’ll ask these questions as gently as I possibly can: What in blazes was this woman thinking? Did she not pay a scintilla of attention to what Trump said on the stump, when he promised over and over to gut the law that this woman depends on? She hopes her coverage “still stays the same”?! Breaking news, lady: It won’t!

    I’ve long been fascinated by people who vote against their own economic interests — Republicans have long been masters at goading voters to do it — and the latest election is Exhibit A.

    Obamacare, despite its flaws, has provided coverage to 20 million people who never had it before, it has reduced the share of uninsured Americans to 11 percent, the lowest on record, and, most notably, it has been a godsend for millions of low-income and working-class whites in rural and Rustbelt communities — the same people who voted heavily for the Obamacare-killing candidate.

    Go figure. According to new Gallup health stats, the uninsured rate among non-college-educated whites, with annual household incomes under 36 grand, has fallen from 25 percent to 15 percent since 2013 — thanks to Obamacare. Yet these people essentially voted this month to sabotage their own coverage. And Trump has indeed moved to fulfill his promise by tapping Georgia congressman Tom Price to run the Department of Health and Human Services. Price has long made it his mission in life to sabotage such coverage.

    Obamacare’s Medicaid expansion — which Price wants to cancel — has been a boon to the poor whites and illness-wracked coal miners of West Virginia. Many of those people finally had a way to address their unmet medical needs at minimal cost. Yet they voted for Trump. The same Obamacare benefit has helped lower-income white people in Ohio, cutting the state’s uninsured rate to six percent. Yet they voted for Trump. Kentucky’s poor white counties, particularly Clay and McCready, have arguably benefited the most from Obamacare, yet Trump got 86 percent in Clay and 87 percent in McCready.

    I understand that voters make up their minds for all kinds of reasons — in this case, “sending a message” to the establishment, venting their irrational hatred of Hillary (who vowed to protect their health coverage), pining for the return of lost factory jobs (um, they’re not coming back) — but isn’t health coverage crucial to a family’s bottom line? Surely there has to be a rational explanation for supporting a candidate who wants to repeal the kind of coverage they have finally managed to obtain. Coverage which the candidate repeatedly called “a disaster.”

    One possibility (which I’ve seen on the trail, and which studies have confirmed) is that lots of low-income people who rely on government help dislike the fact that they need it. They feel guilty for taking it, resent the feds for providing it, and often gravitate to candidates who vow to replace it (in Trump’s case, with “something terrific”). But the result is that they risk being worse off. By repealing Obamacare, Trump’s HHS secretary would nuke the subsidies that have enabled poor and working-class whites to get coverage. His replacement plan leaves these voters behind.

    But there’s a simpler explanation for how some of these voters behave. It’s called denial. In a recent letter to The New York Times, New Hampshire legislator Len DiSesa shared this classic anecdote: 

    When I was campaigning last year, I met an elderly disabled woman who lived in my ward. She gushed to me that since Obamacare came into being, she no longer had to pay any out-of-pocket costs for her monthly foot treatments at the local hospital. Figuring this was a sure vote for me and the Democratic party, I told her that I was counting on her vote in November. She looked at me and said: “Oh no, dearie, I will be voting Republican. I always vote Republican.”

    At first I thought she was pulling my leg, but when I realized she was dead serious, I asked her if she realized that if the Republicans had their way, they would repeal Obamacare in an instant. She looked at me and said, “Oh, they wouldn’t do that, would they?”

    Oh yes they would, dearie.

    Meanwhile, “anti-establishment” Trump voters who hated Hillary in part because she scored honorariums from Goldman Sachs will wind up with a Treasury secretary who’s an alum of Goldman Sachs. A guy who profited bigly from the housing meltdown, no less. So much for “draining the swamp.” But I suspect that most Trumpkins will handle these betrayals by dwelling in denial.

    Gee, how shocking. As the French say, plus ca change, plus ca meme chose.


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