The Washington PostDemocracy Dies in Darkness

Whom to trust when it comes to health-care reform? Trump supporters put their faith in him.

March 16, 2017 at 10:27 p.m. EDT
Supporters cheer as President Trump walks out to speak during a campaign rally in Nashville on Wednesday. (Jabin Botsford/The Washington Post)

— Soon after Charla McComic's son lost his job, his health-insurance premium dropped from $567 per month to just $88, a "blessing from God" that she believes was made possible by President Trump.

“I think it was just because of the tax credit,” said McComic, 52, a former first-grade teacher who traveled to Trump’s Wednesday night rally in Nashville from Lexington, Tenn., with her daughter, mother, aunt and cousin.

The price change was actually thanks to a subsidy made possible by former president Barack Obama’s Affordable Care Act, which is still in place, not by the tax credits proposed by Republicans as part of the health-care bill still being considered by Congress.

It has been difficult for many Americans to keep up with the changes brought by Obamacare and exactly how the Republican proposal, if enacted, would affect their lives. But for Trump’s most dedicated supporters, it’s simply easier to trust the president is making things better and will follow through on his promise to provide “insurance for everybody” and “great health care for a fraction of the price.”

McComic said she’s not worried about her disability benefits changing or her 3-year-old granddaughter getting kicked off Medicaid or her 33-year-old son’s premiums going up.

“So far, everything’s been positive, from what I can tell,” she said, waiting for Trump’s rally here to begin Wednesday night. “I just hope that more and more people and children get covered under this new health-care plan.”

McComic says she has never trusted a president the way she trusts Trump. Ahead of the election, she and her relatives turned their cars into a “Trump train” and drove across Lexington, waving flags and shouting: “Trump! Trump! Vote for Trump!”

“We said: ‘Who else would we do this for, besides Trump?’ ” McComic said. “We agreed on the Lord. We would stand here for the Lord, but that’s about it.”

Trump waited until the final minutes of his speech that night to discuss health-care restructuring. He glossed over the details of the legislation, blaming its troubles and complex path to enactment on Democrats and urging his followers to not believe their “dishonest attacks.” And he did just enough to distance himself from the bill, describing it as a plan created by House Republicans “based on the principles I outlined.”

“The end result is . . . it’s going to be great,” the president said to gentle applause. “It’s going to be great.”

Tennessee has become one of the GOP’s go-to examples of why the Affordable Care Act is not working. Premiums for plans offered to state residents through a federal exchange skyrocketed last year — especially for those who earn too much to qualify for subsidies — and competition has dried up, with residents of most counties having access to only one insurance company.

Serge Martin, a 63-year-old optometrist from Murfreesboro, said he doesn’t particularly like the proposed legislation but considers it a “framework to get started with” that will be strengthened before it passes.

Martin and his wife purchase health insurance through the exchange and have watched the price climb each year. For 2017, there was only one insurance company offering coverage in his area, UnitedHealthcare, and the couple’s bill now totals $1,800 per month, with prescriptions costing another $250. With a deductible of $6,400, they rarely go to the doctor.

“There just aren’t any alternatives,” he said. “That’s the problem. There are no choices.”

Martin earns too much money to qualify for subsidies, but under the Republican legislation, he would be likely to receive a tax credit of several thousand dollars — although by the time that perk kicks in, Martin will probably be old enough to switch to Medicare. In the meantime, he’s using savings to pay the bills.

His friend Tim Weinberger, a 48-year-old owner of a small maintenance company, doesn’t have that kind of cash and hasn’t had insurance in at least a decade. The last time he saw a doctor was six years ago, after an accident. When Obamacare first started, Weinberger said, it would have cost him about $250 per month for a plan, which he couldn’t afford. He assumes the price is even higher now. So Weinberger goes without insurance, as do his two employees. When filing his taxes, Weinberger says, he claims to have insurance to avoid having to pay a penalty he considers unfair.

“It would be nice to have a doctor,” he said, “just to check in on every once in a while.”

As several thousand of Trump’s supporters converged in the historic Municipal Auditorium on Wednesday, more than 2,500 protesters gathered outside. They urged their fellow Tennesseans to not trust the president’s vague promises and to study the Congressional Budget Office’s score of the bill, which estimates 24 million fewer people will have health insurance coverage by 2026 and that Medicaid would be cut by $880 billion over 10 years.

Many of these activists have been fighting for years for the state to expand Medicaid coverage under the Affordable Care Act, which it never did, and now they face a future that’s even bleaker. They warn that the proposed legislation is likely to lead to fewer children and pregnant women receiving care, less funding for nursing homes and rural hospitals, dramatic cuts to mental health and drug treatment programs, and less support for the disabled.

“People are going to die, and that’s the bottom line. People are going to die because of what we’re doing with this legislation,” said Sharon Cox, a former pediatric nurse who was once a director at a children’s hospital, during a news conference ahead of Trump’s visit.

As Trump’s supporters walked past these protesters, some said they weren’t sure what or whom to believe. Several said that while the Republican plan isn’t perfect, they believe it’s probably better than the Affordable Care Act and its plans, which can cost more than a mortgage payment.

A 51-year-old history teacher from Alabama said his 27-year-old son was kicked off the family plan on March 1 and has yet to find an affordable alternative. A 53-year-old self-employed construction worker watched his premium go from $133 per month several years ago to $803 this year, even though his income didn’t change. A couple in their 50s who own a manufacturing plant in Decaturville say they stopped offering their 60 employees health insurance several years ago when plans on the exchange were cheaper — only to see the cost of those plans skyrocket beyond their employees’ means.

When the federal health exchange launched, Nancy Ware, 58, researched plans for her son, who works in the service industry and is now 35. At first, she said, he covered the cost of a $250-per-month plan. When it jumped to about $500, she covered half of the cost. Last year, when it grew to $700 per month, he decided to go without coverage and pay the fine, according to Ware. Now, she said, the price tag is $900 per month, which would have been half of his wages.

Ware is a landscaper and often works near Section 8 housing in the Nashville area, and she becomes furious when she sees residents who “drive better cars than I do, they have weaves and hair color better than I can, they have manicures.” As Ware, who is white, waited in line for the rally to start, a group of young African American protesters walked by, and she yelled at them, “Go cash your welfare checks!”

“He gets penalized on his income taxes, while these people that don’t know how to pull their pants up can go get it for free,” said Ware, whose employer covers the full cost of her health care. “Make it even. Make it balanced.”

Ware hopes that Trump can change this, although she says she won’t fault him if he can’t. She doesn’t believe news reports saying that 24 million people could lose their coverage under his plan.

“Nothing is in concrete yet. Give the man a chance,” she said. “Until you hear it from Donald J. Trump himself — and not the news media — then don’t even worry about it. Wait until you hear the man say it, because he will tweet it, he will Facebook it or he will go onto national television and tell everybody at the same time.”