Even an institution as deeply disappointing as the ACA was hard to budge once tens of millions of people came to depend on it and hundreds of billions of dollars began to flow through its channels. Indeed, among the states that benefited most from the extension of health coverage under Obamacare were Kentucky and West Virginia, diehard Trump country.55 As Trump took office, support for the ACA among the most important group of voters, Independents, had risen from 36 percent in 2010 to 53 percent.56 By the summer, when the desperate Republican congressional leadership made a last bid simply to
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