Obamacare dilemma: Some got free care; some got squeezed

MERRIMACK, N.H. — Gwen Hurd got the letter just before her shift at the outlet mall. Her health insurance company informed her that coverage for her family of three, purchased through the Affordable Care Act marketplace, would cost almost 60 percent more this year — $1,200 a month.

She and her husband, a contractor, found a less expensive plan, but at $928 a month, it meant giving up date nights and saving for their future. Worse, the new policy required them to spend more than $6,000 per person before it covered much of anything.

“It seems to me that people who earn nothing and contribute nothing get everything for free,” said Hurd, 30. “And the people who work hard and struggle for every penny barely end up surviving.”

A few miles away in another wooded suburb, Emilia Dicola, 28, an aspiring opera singer who scrapes by with gigs at churches and in local theaters, has no such complaints. She qualifies for Medicaid — free government health insurance that millions more low-income Americans have gained through an expansion of the program under the Affordable Care Act.

“I am very lucky to have the coverage I have,” said Dicola, who lives with her parents along the Merrimack River in Litchfield.

President Donald Trump’s attempts to undermine the health law have exacerbated a tension at the heart of it — while it aims to provide health coverage for all, the law is far more generous to the poor and near poor than the middle class. By taking steps that hurt the individual insurance market, Trump has widened the gulf between people who pay full price for their coverage and those who get generous subsidies or free Medicaid. That, in turn, has deepened the resentment that has long simmered among many who do not qualify for government assistance toward those who do.

Such attitudes have helped shift white working-class voters to the right and were integral in Trump’s election. They underlie the sharp cuts to social welfare programs in the budget proposal he released this week. They help explain why the national debate over health insurance has been so bitter, and why the only government programs with broad

KAYANA SZYMCZAK /THE NEW YORK TIMES Gwen and Matt Hurd are shown with their son Harry on Jan. 20 at home in Merrimack, N.H. They pay full price for Affordable Care Act coverage, which has gotten so expensive they have considered forgoing health insurance. President Donald Trump’s efforts...