This is Whitley County. Like many counties in this region, voters here overwhelmingly
supported Donald Trump in November’s election. The county has a median per capita income
of around $16,000. It’s 97% white and 88% of the residents over 25 don’t have a college degree.
It also happens to be the birthplace for Kentucky Fried Chicken
And yet these are some the Americans who have
also benefitted most from Barack Obama’s signature healthcare policy. The Affordable Care Act
“I'm running around with Vox V O
X dot news and all that, and there's a news person and he's following me around to learn
about southeastern Kentucky and how the effects of the healthcare have been on us”
That’s Kathy. She works as an enrollment counselor for Obamacare, helping people sign
up for the program. Since the law was implemented in 2013, the
percentage of people in this county with health insurance went from 75% to 90%. And Kathy
has signed up a lot of those people.
"Over a thousand..I've lost count"
But here’s the curveball Who did you end up voting for? "Trump"
Since Obamacare launched in 2013 the number of lower income, less educated white Americans
with insurance increased by not just in Kentucky, but nationwide.
This group benefitted disproportionately from the law.
Yet this same demographic showed up in huge numbers for Trump in November.
I went to Kentucky to talk to Kathy. I wanted to understand why so many people would vote
for a candidate who swore to repeal a program they depend so much on.
Vox would soon be hosting an interview with President Obama and we invited Kathy attend
to share her perspective and ask a questions. …”they invited me to the white house
Oh my god oh my god oh my god, YES, the white house, right, guess where I'm going Friday?
To the White House. You've got to get on Facebook you've really missed out on a lot of stuff.
Oh, get on Facebook. Oh, you'll read all about it.”
Before going to DC, we traveled around South Eastern Kentucky, talking to Trump supporters
who are also enrolled in Obamacare to hear their opinions about the law and what they
think the next administration will do to make it better
We landed on a couple of explanations for this Trump-Obamacare paradox.
The first is that people in Kentucky believe Trump and the GOP would never actually repeal
a program that benefits over 20 million people “So you don't think that that, that they
would actually do that?” “No, they couldn't. That would be like He's
got children, he's smarter than that. you know what I'm saying”
A lot of people thought Trump’s campaign rhetoric against Obamacare was all talk and
that there’s really no way he would actually repeal a program that so many are
dependent on. And it wasn’t just these Trump Voters who thought that.
I have been covering the healthcare law as a journalist for about 7 years now.
It actually felt like a safe assumption that the ACA, rolled out, covering 20 million people
That it was going to stick around.
I remember I wrote a story for Vox and the headline was something like
"Obamacare survived its final hurdle and its here to stay"
Republicans up through the election and up after the election remained so committed to repealing the ACA.
I did not expect that. I thought we were going to see a backing off of those attitudes.
And I was wrong.
Many Obamacare enrollees in Kentucky, as well as policy experts and journalists all assumed
Obamacare was too widespread to be repealed. But Congressional republicans are proving
them wrong, moving as aggressively as they can to repeal it.
"Mr Ryan has said a top priority for the new congress is the repeal of Obamacare.
But perhaps the stronger theory on why Obamacare
beneficiaries voted for Trump was a general dissatisfaction with the cost of the program
and the believe that Trump would somehow make it better for them.
We met up with Perry, a security guard recently signed up for Obamacare. It’s the first
time he’s ever had health insurance in his life.
Perry: "I've not been to a doctor...you weren't even in this world last time I went to a doctor"
Thanks to Kathy, Perry was able to sign up at healthcare.gov just a few months ago. But
his deductible ended up being $2000.
"Unless something drastic was to happen, how many times will I have to go to the doctor,
to the hospital or something Before I, you know, use up over 2000 dollars,
I just wish that, if they're gonna shove it down your throat, have something that you can afford
We headed to an Antique shop in where the
owner Bobby, another Obamacare enrollee, talked to us about her experience with the ACA
"I had breast cancer last year. I was very happy to have my insurance.
But I didn't realize that the government was subsidizing my health insurance.
And I do think everybody deserves quality healthcare. I just think the American form
of healthcare is just totally out of hand price wise.
One of Bobby’s complaints with the program is that it’s been linked to a president she strongly dislikes
"And I absolutely detest hearing the word Obamacare. Detest it."
We traveled out to mall right on the border with Tennessee where Kathy sets up a booth
to sign people up for Obamacare.
We talked to the mall manager about all of what he see with his co-workers and employees.
“Initially, it seemed that everyone was excited uh that they were going to have an
opportunity to have health insurance that they could afford. To them, some of them,
first time in their whole life that they'd ever had coverage. The following year they
were faced with the the cost was increasing so they had to make changes again. And most
of the time, it meant they were looking for policies that had even higher deductibles
So that they could just try to keep insurance.”
While Obamacare lead to 20 million Americans getting health insurance, half of the enrollees
who get their insurance on the obamacare marketplace say deductibles are still too high.
“I'd say the people are disappointed, yeah, because some of them, because they have such tight budgets.
Frustrated with the high rates, ACA enrollees have high confidence that Donald Trump will
fix the problems with the health care law.
“I think he will try because he's a business person first. And he knows money.
So I think he'll fix a lot of things.
I think that he will replace it with, or I'm hoping that he will, at least
judging by the way he talks, you know, he's going to replace it with something even better.
Donald Trump didn’t campaign on a plan to replace Obamacare. Instead he focused on a
promise repealing it.
It will be repealed and replaced and we'll know and it will be great health care for much less money.
An analysis by the non partisan Commonwealth Fund found Trumps proposals
would lead up to 25 million people uninsured.
But the people we talked to didn’t seem to need a plan.
They felt frustrated with the current version of the law and seemed ok to take a gamble on Trump’s
promise to “ repeal and replace it with something terrific”
Kathy and many others took that gamble. We traveled through a snowstorm, to Fly to
DC to meet the president.
“Go ahead Kathy”
Hello, President Obama, I’m very excited to meet you.
Many Kentuckians are looking at the Affordable Care as unaffordable and unusable. how do
you think this happened? How can we fix it? Do we start all over again? What do you think
we should do?
“this is my main criticism of Obamacare is that the subsidies aren’t as high as
they probably should be for a lot of working people.
So the two things we could do that would really make it work even better for people in Kentucky
would be, number one, to provide more subsidies to folks who are working hard every day but
still find the premiums — even with the subsidies — hard to meet.
The problem is that’s not what’s being proposed by Mitch McConnell, the senator from Kentucky
Obama’s answer to Kathy lasted almost 8 minutes
and you should watch the full thing to really hear his defense
But the gist of his answer is that The Affordable Care Act is imperfect but that the existing
law can be improved upon.
But the GOP isn’t proposing improvements to the existing law. They are proposing repeal
and have yet to articulate how they will legislate something better to take its place
I am saying to every Republican right now: “If you can in fact put a plan together
that is demonstrably better than what Obamacare is doing, I will publicly support repealing
Obamacare and replacing it with your plan.” But I want to see it first. I want to see it first
Many took the gamble on Trump without seeing
any such plan. And now that the GOP controls congress we will see if they can make good
on their promise to build something better than Obamacare.
“I thought well, we need something different and that's why I made a joke it
was like Russian Roulette or pushing the little Vegas little bar saying hey, I'm going to vote."