Trumpcare: A Tough Pill to Swallow for His Supporters? 

Julia Carver

September, 2017

The 2016 United States Presidential election birthed a new era of Republican dominance in one of the world’s highest offices. Simultaneously, it widened the deep chasm of polarization within the American electorate.

President Donald Trump’s ability to mobilize and retain his voter base allowed him to capitalize on the hardening partisanship divide, and national discontent towards the dwindling economy. Vowing zealously to fulfill his campaign promises, Trump ushered in a multitude of bills, including the heavily criticized move to repeal Obamacare.

Activist organizations such as MoveOn, the Town Hall Project, and the Women’s March, have come together to form the Payback Project. The project has gain national recognition and has organized events such as the “Die-In” protests to illustrate the fatal implications of the American Health Care Act of 2017 (AHCA).

The Payback Project movement has spread across the country to demonstrate against Trump’s healthcare legislation, which would cut $800 billion from Medicaid and could cause some 21 million people to lose their health insurance.

Trump’s proposed replacement is only estimated to help 1 million Americans. The potential ramifications of implementing AHCA are catastrophic. But to what extent will Trump’s new healthcare reforms impact his voter base?

On May 4th, AHCA was passed in the GOP-majority house upon multiple revisions. While Republicans appear to have reached some agreements, analysts continue to debate the implications of the act.

Critics argue that AHCA’s recent MacArthur Amendment includes provisions that allow insurance companies to legally “price out” the sick, essentially blocking coverage by considering the “health status” of the applicant as a factor in setting rates. As a whole, Trump’s AHCA places over 130 million Americans at risk of losing safeguards provided by Obamacare.

A major point of concern about AHCA is that it does not have a guarantee against insurance providers discriminating against pre-existing health conditions. Pre-existing conditions may include high blood pressure, asthma, and pregnancy.

Health analysts predict that if AHCA is enacted, maternity care and other essential health benefits will come at a higher cost. These provisions may particularly disadvantage Trump’s female voters, who comprise 50.7% of the American population.

More notably, a significant portion of Trump’s supporter base are older individuals, who statistically have a higher chance of harbouring a pre-existing health condition. For example, in the swing state of Florida, one in five voters were over the age of 65, and 57% of this group voted in favour of Trump. The same demographic that attributed to Trump’s win in Florida may be significantly negatively affected by AHCA.

Data by Families USA revealed in the demographic of adults aged 55 to 64, almost 50% have pre-existing conditions -  which would affect their health insurance coverage under AHCA.

Mature Trump supporters may not be the only ones impacted by the lack of coverage for pre-existing conditions. Eleven states, including West Virginia and Mississippi, are home to populations in which at least 30% of citizens under 65 years of age have pre-existing conditions. And all eleven states voted in favour of Trump in the 2016 election.

Moreover, Trump supporters may become disenchanted by AHCA’s new tax credit structure. It repeals Obamacare’s system of assigning tax credits according to income, replacing it with a 5:1 age-rating ratio. Under this system, insurance companies can charge older demographics up to five times more in cost. The consequences of this change mean that people who are older, residing in areas with higher insurance premiums, or who have a lower income level will receive smaller tax credits. It is quite possible that Trump’s older and less wealthy voters will be negatively affected by these changes.

On the other hand, the wealthy portion of Trump’s voter base may not experience the same negative aspects of the new AHCA tax credit system—instead reaping the result of what critics deem a “tax cut for the rich.”

According to findings by the Pew Research Centre, Trump won votes by the largest margin among the demographic with income levels between $50,000 to $100,000 per year. A nonpartisan tax policy centre calculated that taxpayers with an income of $75,000 per year and above will benefit from AHCA, while those with less will experience reduced coverage and higher costs.

The implications of AHCA on Trump supporters are conflicting. For older voters and those with incomes below $75,000, health analysts predict that the new bill could detrimentally impact their health coverage, and consequently, their quality of life. However, his younger voters, although they comprise a smaller percentage of his support base, will not be as negatively affected by AHCA. In fact, healthy young adults will likely benefit from lower insurance premiums.

Cost remains the major barrier for Americans to attain health coverage. According to the Kaiser Family Foundation, 46% of adults cite this as the primary reason that they are uninsured. The Foundation’s statistics demonstrate that people of colour are at higher risk of being uninsured, with Hispanics (17.2%) and blacks (12.2%) experiencing significantly higher uninsured rates compared to whites (8.1%).

Data from the Pew Research Centre reflects these racial and economic divisions; overall, 58% of white non-Hispanic voters selected Trump over Clinton, while Clinton won the majority of Latino and black votes. The new AHCA provisions such as the tax credit benefits the privileged and wealthy—a tier overwhelmingly dominated by white Americans—and conveniently, a large portion of Trump’s support base.

AHCA’s new provisions should not be a hard pill for Trump supporters to swallow. Increasing party polarization widens the negotiating divide on the American political landscape, increasing the likelihood that Trump’s Republican voters will remain red, unless there is a crisis with his administration.

The AHCA has yet to be implemented, as it still requires a great deal of political compromise among GOP Representatives and the Democratic opposition. Perhaps amendments will be introduced that could better articulate some of its provisions for coverage, including pre-existing health conditions.

Regardless, the majority of Trump supporters should at the very least stomach the more detrimental effects of its new provisions - and lack of coverage - due to their generally higher income level and hardening partisanship. For the Americans who do not easily fit within the “privileged”, “healthy” or “low-risk” profiles, their diagnosis for the effects of Trumpcare may be terminal.

As leader of the free world, Trump not only has the nationwide scrutiny on his proposed reforms, but also an international reputation to uphold. If AHCA fails to provide Americans with sufficient health coverage, its breakdown may just become another symptom of Trump’s growing international disrepute and the prognosis for a degenerative Presidency.