Nine of the 10 counties in this state that have benefited the most from Obamacare also voted for Donald Trump. How much are we obligated to care, then, when tens of thousands of them get thrown off health coverage?
Grays Harbor County, along the Washington coast, is getting a lot of attention because it flipped from blue to red this election for the first time in nearly a century.
Not since Herbert Hoover won back in 1928 had the county voted for the Republican, which it did this time, going hard for Donald Trump.
“I trace everything to the radiating fear and loathing against Seattle liberals,” is how John Hughes, the former publisher of the Aberdeen Daily World, explained the Trump vote to my colleague Jonathan Martin.
That analysis sounds as true as any. The trouble with it, though — for Grays Harbor County — is that loathsome Seattle liberals were not on the ballot.
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The health insurance of their friends and neighbors was.
It turns out Grays Harbor County is one of the places in our state that the dreaded Obamacare has been propping up the most. This issue got barely any attention in the election — though I bet it will now.
A few years ago, 19 percent of the people there had no health coverage, one of the higher uninsured rates in the state. Today, only 9 percent remain uninsured. Almost all of that improvement is because Obamacare provided Medicaid coverage, for free or nearly free, for more than 8,000 Grays Harbor adults.
An incredible one in five Grays Harbor adults signed up for it. That’s a sign-up rate more than double King County’s.
Yet the county that’s relying on it just voted for the candidate who vowed to get rid of it.
Trump promised to repeal the Affordable Care Act on the first day of his presidency. He’s lately gotten squishy on that, but on Tuesday Republicans in Congress signaled they intend to fulfill that pledge.
How will their own constituents, in red counties and states, respond?
It’s the red counties in our state that have flocked to Obamacare, using its subsidies and Medicaid expansion the most, according to data from the state insurance commissioner’s office. Nine of the top 10 counties where the Affordable Care Act reduced the ranks of the uninsured the most also voted for Trump.
Number one is deep-red Adams County, in Eastern Washington, home of rolling wheat farms and I-90 truck stops. Its uninsured rate plunged from 23 percent to 10 percent, almost all because Obamacare bought Medicaid coverage for about one in five Adams County adults between 18 and 65.
Adams County voted for Trump by 38 percentage points.
Or take Yakima County, which had the highest uninsured rate in the state a few years ago. Since Obamacare sign-ups started in 2014, nearly 30,000 adults there have gotten free insurance under the program. That’s a hefty 21 percent of the eligible adults (most kids were already covered before Obamacare, and adults 65 or older aren’t eligible because they qualify for Medicare).
Yet Yakima County voted for Trump by 13 points.
I know, health reform was hardly the only issue on the ballot — it was scarcely talked about. Trump promised jobs, and I’d be the first to agree that jobs are better than subsidized health insurance any day.
But the whole point of the Medicaid expansion under Obamacare was to be a safety net, to catch people when they fell or to give them health stability while they worked their way up. Bonus: The program was paid for by a tax on the rich.
Now the new plan — out of spite for annoying liberals I guess — is to start the year by cutting the tax on the rich, and slashing the safety net for the poor.
Oh well, Adams and Yakima and newly red Grays Harbor County — you voted for Trumpism, so this must be OK with you, right? That one in five adults between 18 and 65 in your communities is about to be thrown off health coverage?
This must be what H.L. Mencken was talking about when he defined democracy as “the theory that the common people know what they want, and deserve to get it good and hard.”