Here’s a question that’s baffled health reporters in the months since the election: Why would people who benefit from Obamacare in general—and its Medicaid expansion specifically—vote for a man who vowed to destroy it?
Some anecdotal reports have suggested that people simply didn’t understand that the benefits they received were a result of the Affordable Care Act. That was the case for one Indiana family The New York Times described in December:
Medicaid has paid for virtually all of his cancer care, including a one-week hospitalization after the diagnosis, months of chemotherapy, and frequent scans and blood tests.
But Mr. Kloski and his mother, Renee Epperson, are still not fans of the health law over all. They believed that it required that Mr. Kloski be dropped, when he turned 26, from the health plan his mother has through her job at Target — not understanding that it was the law that kept him on the plan until he was 26.
We spoke a good deal longer about the Affordable Care Act, and the possibility of repeal. Mills said she had gone into the voting booth confident that Republicans wouldn’t dismantle the law, despite their promises. How could they, when people like her had become so reliant on it?
I, meanwhile, have encountered people who were on the Obamacare exchanges and, though they were glad to be able to afford health insurance for the first time in years, still wanted the law repealed because they felt Obamacare coverage was too expensive. Here’s one shop owner I interviewed in Pennsylvania:
“When Obamacare came along, I thought, it's going to be signed in, I'm going to take advantage of it,” she said, tearing up. “And I’m no further ahead going into the fourth year than I was at the beginning. I haven't gotten what I hoped for.”
A report out this week from the Kaiser Family Foundation puts some data behind these anecdotes. The answer is, it seems, all of the above: Many exchange enrollees thought their plans were too expensive, and many beneficiaries of the Affordable Care Act’s Medicaid expansion didn’t realize their free health insurance was the result of Obamacare. And Marketplace enrollees told KFF they trusted Trump to “craft a plan that would work better for them.”
The issue brief, written by KFF researchers Jennifer Tolbert and Larisa Antonisse, relies on focus groups KFF conducted in December in Michigan, Ohio, and Pennsylvania with a total of 48 Trump voters. Twenty-three were on Medicaid, 21 were covered through the Obamacare exchanges, and four were uninsured.