Obamacare helped a large number of people at the expense of a small, affluent minority: basically, taxes on 2 percent of the population to cover a lot of people and assure coverage to many more. Trumpcare would reverse that, hurting a lot of people (many of whom voted for Trump) so as to cut taxes for a handful of wealthy people. That’s a difference that goes beyond political strategy.
But one way to say this is that Obamacare was and is a truly populist law, while Trumpcare is anti-populist. That’s reflected in the legislative struggles.
And yet, and yet: Trump did in fact win over white working-class voters, who thought they were voting for a populist; Democrats, who did a lot for those voters, got no credit — rural whites, in particular, who were huge beneficiaries of the ACA, overwhelmingly supported the man who may destroy their healthcare.
Populism and the Politics of Health