What, then, do West Virginians actually do for a living these days? Well, many of them work in health care: Almost one in six workers is employed in the category “health care and social assistance.”
Oh, and where does the money for those health care jobs come from? Actually, a lot of it comes from Washington.
West Virginia has a relatively old population, so 22 percent of its residents are on Medicare, versus 16.7 percent for the nation as a whole. It’s also a state that has benefited hugely from Obamacare, with the percentage of the population lacking health insurance falling from 14 percent in 2013 to 6 percent in 2015; these gains came mainly from a big expansion of Medicaid.
It’s true that the nation as a whole pays for these health care programs with taxes. But an older, poorer state like West Virginia receives much more than it pays in — and it would have received virtually none of the tax cuts Trumpcare would have lavished on the wealthy.
Now think about what Trumpism means for a state like this. Killing environmental rules might bring back a few mining jobs, but not many, and mining isn’t really central to the economy in any case. Meanwhile, the Trump administration and its allies just tried to replace the Affordable Care Act. If they had succeeded, the effect would have been catastrophic for West Virginia, slashing Medicaid and sending insurance premiums for lower-income, older residents soaring.
