With Trump Front of Mind, New Hampshire Voters Cite Abortion and Obamacare as Concerns

Yves here. Yours truly has said abortion is the best card Biden has to play in 2024. Widespread antipathy to the Supreme Court undoing old Roe v. Wade protections was widely seen as the reason the Democrats did better in the 2022 midterms than generally anticipated. But I am surprised to see Obamacare as another reason, given that for many it is effectively a very high price catastrophic coverage policy. But we instead see Team Biden doubling down on the TDS “Protecting our democracy” meme rather than focusing on the pocketbook issues where the Democrats have a good, or at least plausible, storyl

By Phil Galewitz, a KFF Health News Senior Correspondent, former board member of the Association of Health Care Journalists. and previously worked for The Palm Beach Post, Associated Press and The Patriot-News in Harrisburg, Pennsylvania. Originally published at KFF Health News

Health care issues are important to Lana Leggett-Kealey, who works as a genetic genealogist. But on Tuesday, as she walked out of her polling place at a local high school and into a frigid New England morning, she said she had something bigger on her mind when she cast her vote.

“I want to make sure we have someone competent in the White House,” she said. She wrote in President Joe Biden’s name on her ballot in New Hampshire’s Democratic primary.

The Affordable Care Act’s future is important to Robert Stanhope, a retired bill collector. He said he also wrote in Biden, whose administration has worked to reduce costs under the ACA.

But that wasn’t his motivation for his early-morning visit to the polls. “I’m here to keep Trump out of office,” Stanhope said.

Dave Avery, 61, of Merrimack, New Hampshire, said health care wasn’t on his mind either. He sought to put the former president back in the White House. “Immigration and the economy are my issues,” he said. “We also need more money to stay in our country.”

Voters casting their first ballots in the 2024 presidential election cycle on Tuesday framed health care as a back-burner issue, capping years of political wrangling over Obamacare and a pandemic that strained the nation’s health system.

Donald Trump defeated former South Carolina Gov. Nikki Haley in the state’s GOP primary, according to The Associated Press. Biden, who did not appear on the ballot due to disagreements over the primary schedule, won the Democratic contest owing in part to a vigorous write-in campaign.

In interviews with more than 50 voters this week in New Hampshire — a state where 95% of residents have health insurance, one of the highest rates in the country — most people said their vote was about Trump, like him or hate him. But health care concerns — about costs, access, and, especially among Democrats, abortion — weren’t far from many voters’ minds.

“I have two daughters and five sisters and a mom, so making sure women’s reproductive rights are protected is important to me,” said Rob Houseman, 60, a town official in Hanover. Worried that Republicans will try to “weaponize health care” instead of ensuring access, he said he voted for Biden.

Many opposed to Trump cited concerns about his fitness to lead, while most Trump voters who spoke with KFF Health News said they supported him for two main reasons: They hoped he would reduce illegal immigration and lower inflation.

Democratic voters were more likely than Republicans to cite heath care as a key issue in the election.

“Oh my, yes,” said Ben Gilson, 90, a retired orthopedic surgeon. “Health care is my No. 1 issue.”

While he said he has excellent coverage and pays little in out-of-pocket costs, he worries many younger people struggle and wants to make sure Obamacare is retained. One of Trump’s earliest promises during his 2016 campaign was to repeal and replace the ACA — a vow he has recently revived in his latest attempt to win the White House.

Elaine Kozma, 73, of New London said health care issues are vitally important to her as a cancer survivor. She said she voted for Haley, a former U.S. ambassador to the United Nations, whom she thinks she can trust more than Trump.

In New London, Kate Turcotte, a professor at Colby-Sawyer College, said she voted for Biden to keep Trump out of office — and because she trusts Democrats more to improve health coverage and protect abortion rights.

She said she also worries Trump will try to cut health care for the most vulnerable. “Health care should be a right, not a privilege,” she said.

Trump voters frequently cited immigration as a top concern. Republicans have accused Biden of allowing record numbers of immigrants to cross into the U.S. from Mexico.

In Merrimack, Mary Clancy, 69, said she was satisfied with her Medicare coverage and was voting for Trump mainly to secure the southern border.

Kathy Franqui, 54, of Merrimack, said the border and immigration were her main reasons for voting for Trump. But she also said Trump would reduce health costs.

Tim Beauchene, 48, of Hanover, who is a cook at Dartmouth College, said he’s concerned about the rise of prices for medical care, along with other goods and services. His vote for Trump “was more about the economy,” he said. “Prices are so high in the grocery store and for gas.” Prices for regular unleaded in New Hampshire averaged $3.03 a gallon on Tuesday, according to the AAA auto club.

At a coffee shop in Warner, Susan Hencke, 62, said she pays $1,100 a month for health insurance. But she said health care was not among the factors determining how she would vote.

She said having a president who will protect civil rights matters most to her. She was undecided about whom to support.

Both she and her husband, who declined to give his name, said they were concerned about abortion restrictions Trump may impose.

Sitting outside the coffee shop in the freezing weather was Art Sullivan, 75, of Hooksett, who said immigration was his overriding issue in the election — and why he was voting for Trump.

Asked if he had been personally affected by immigration, he said he was worried his children would have to shoulder the financial burden of people coming into the U.S. without authorization.

“The border is a disgrace,” said Sullivan, who said he’s a registered independent voter and sells swimming pools.

Asked if health care was something he thought about when comparing candidates, he said he had a Medicare Advantage plan that covers his bills and provides access to care.

DJ Annicchiarico, co-owner of United Shoe Repair in downtown Concord, said he is a registered Democrat. But while he prefers Biden on health issues, he is not yet persuaded to vote for him in November.

His main concern is inflation. He said the ACA, which he described as a step in the right direction, had helped lower his insurance premiums but hadn’t controlled health care prices. “Something needs to be done to rein in inflation,” he said.

Annicchiarico said he wants to see health care prices regulated by the federal government and worries Trump would try to repeal the ACA. He noted access is still an issue and said getting a dermatology appointment for his daughter meant waiting eight months.

Aalianna Marietta, 21, a college student, said health care was important to her, particularly abortion rights, so she would be voting for Biden. “I am 100% pro-choice, and I cannot see myself voting for someone who is racist and a misogynist,” she said of Trump.

Deb Shope, 57, out walking her dog in Lebanon, said health care is a top issue for her because she works as a clinical social worker and sees how important good health coverage can be. She said she was voting for Biden because she liked how he has tried to help people get coverage and address their mental health care needs.

Shope said it’s hard to look beyond how Trump acts as a person. Asked if she is worried about him getting reelected, she said people shouldn’t worry about things out of their control.

[UPDATE: This article was updated at 10:18 a.m. ET on Jan. 24, 2024, to add Trump voters Dave Avery and Tim Beauchene.]

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  1. Pat

    In New London, Kate Turcotte, a professor at Colby-Sawyer College, said she voted for Biden to keep Trump out of office — and because she trusts Democrats more to improve health coverage and protect abortion rights.

    Why do I have a feeling that this professor is fine with students quoting what she says right back to her because that is how she got her degree(s)? Clearly this a person who has not been taught to put think or put facts together in a logical manner.
    Admittedly as a college professor she might not have noticed that healthcare has become harder to access and increasingly unaffordable in the last decade, a period where Democrats had the White House and majorities in one or both Houses of Congress over half the time. But she is both old enough to remember and should have the ability to think enough to know that Obama partly ran on codifying Roe v. Wade and had the largest Congressional majorities in this century but took it off the table after getting elected. In truth, the Obama administration spent more time and political capital trying to get the Trans Pacific Partnership done than on any aspect of reproductive rights. Or that Hillary Clinton picked a running mate ho was complicit in restricting women’s reproductive rights, and that pesky fact that as long as proposed judges held acceptable opinions about lack of restrictions on corporations they could be against not just abortion but access to other forms of birth control and still get the approval of Democratic Senators. Largely because they would campaign on support for women’s rights, raise money on it and people like Turcotte would still vote for them despite the record…like now.

    It isn’t just the delusion but the lack of logic and stunning ignorance that the supposedly highly educated Biden and Democratic Party supporters regularly show that is mind boggling to me.

    1. Jason Boxman

      Clearly this a person who has not been taught to put think or put facts together in a logical manner.

      This. A real democracy requires each citizen to possess critical thinking skills. We haven’t had a democracy here in some time, judging by what liberal Democrats claim that they believe. Perhaps when speaking about “their” democracy, the liberal Democrat Establishment means a continuation of the status quo in which the majority of their voters lack critical thinking skills and continue to buy into whatever propaganda is on offer.

      To miss quote Serenity, they believe hard, never ask why.

      1. Lefty Godot

        Clinton and Obama, and now Biden, have ruined the Democrats’ “brand identity”. But they refuse to admit it and still send out appeals for donations so they can give us, for instance, “Medicare for all”. Well, they had the opportunity to do that multiple times and they didn’t even exert the minimum amount of effort toward that supposed goal, so why do they still think we’ll fall for that line now? They could have done something much more limited, but equally revolutionary, like eliminate all the patchwork programs covering children’s health care and extended Medicare to everyone from birth through middle school. And maybe lowered the age of Medicare eligibility at the top end to 60 or something like that. Just those steps would’ve been a huge benefit to working people. But, nooooo! Glass-Steagall repeal, TPP, and bank bailouts were more important.

        1. Arizona Slim

          On YouTube, I’m being bombarded with Biden ads. A recent one featured Obama banging on about Our Democracy [TM].

          Not that I’m persuaded, but the barrage doesn’t stop.

          A few weeks ago, I got a desperate-sounding text. The Arizona Democrats are looking for people to run for office. I mean, it’s bad. They are really hurting for candidates.

          Well, Dems, I have news for you: I’m not a Democrat.

          Yes, I did change my registration from Independent to Democrat so I could vote for Bernie in 2016 and 2020. But trust me, after both primaries were stolen from Bernie, I went right back to being Indie and that’s where I am today.

        2. Pat

          Hell, they are citing the fact they let Medicare negotiate prices for ten, count them ten, drugs.
          The fact that that alone is considered an achievement by the Dems makes it clear that healthcare is of no importance to them. Medicare should be able to negotiate every drug price. I don’t often bring up if government were run like a business nonsense, but frankly the fact that one of the largest healthcare providers in the country is constrained from negotiating prices is ridiculous.
          (And no I am not ignoring that they privatized drug coverage. I figure that Congress is being hit by two big donor groups on this one – Big Pharma AND the Insurance Companies. That’s a lot of board positions for those who do the most to make sure the profits remain obscenely high.)

    2. JBird4049

      >>>It isn’t just the delusion but the lack of logic and stunning ignorance that the supposedly highly educated Biden and Democratic Party supporters regularly show that is mind boggling to me.

      Fifty years of relentless and unending, propaganda, propaganda, and propaganda all meant to divide, demonize the targeted other, and short circuit the mental processes and emotional health including the practical skills necessary to be informed, open minded, yet realistic and practical citizens.

      It does not matter what “side” someone is one. I find those who are putatively right wing or conservative the same with only the stock phrases programmed into their minds to react to the unwanted or problematical phrases and their associated ideas. Same with the Democrats and the American Libertarians. Since the emotional pressure is so high, it becomes almost impossible to reach anyone as their anger just explodes and cut off rational thought and reasoned debate.

      Going Godwin’s Law here, I am starting to get just how essentially decent and rational people go big on evil especially if it happens over time. I am going to have to take another run on Hannah Arendt’s Origin of Totalitarian. One of my two copies along with a pencil.

      And to anyone reading this, if you have not, you should too read her. For most, her writing is dense, much more than the regular writing online and with a very, very different rhythm of modern American writing. This means it is can be a slough, but it is worth it as it explains much of the insanity that we are seeing including ourselves.

      Anyways, I said all this because I want people to see that it is not just the “other” or in this case, the Democratic Professional and Managerial Class, that well off upper, upper middle class and higher of putatively liberal and democratic people giving the country to the Orange Man Bad. It is almost everyone, everywhere and after being programmed by the professional mind-benders your entire life, it will be very hard to even see it. Like that aphorism, how can a fish in water see or notice the water? Or someone, the air?

  2. zagonostra

    Widespread antipathy to the Supreme Court undoing old Roe v. Wade protections was widely seen as the reason the Democrats did better in the 2022 midterms than generally anticipated.

    Could not agree more. I have two daughters who are as apolitical as you can get and an ex-wife who watches CNN and has a subscription to NYT so thinks herself informed. All three have protection of of Roe v. Wade as the number 1 reason they voted for Biden in 2022. Sadly, I’m not sure it’ll be any different in 2024.

    Jacques Ellul, who I’ve recently become acquainted with, has expanded my view of the power of propaganda to a much wider angle than that I picked up from Noam Chomsky and Edward Herman, as well as Michael Parenti. The “Hegelian dialectic” wielded threw the instrument of the political party apparatus structure to keep the controllers in control will make certain that Trump/Biden or anyone else will have little impact on the policy preferences of the Power Elite.

    1. Pat

      I realize it is a hard thing but is there any chance you can steer your daughters to look at and think about the actual actions of Democrats outside the campaign rhetoric about their number one issue?
      For instance, how often top Democrats support some one like Henry Cuellar for office. Or how elected Democrats who sign off on anti abortion Judges (particularly early in the confirmation process) are either protected or face no consequences for this from the party. How candidates with far stronger support of women’s reproductive rights are discouraged from challenging incumbents who are tepid or outright impediments to any legislative actions on the issue. And how there are few active attempts to codify these rights when Democrats hold the majority (which put elected officials’ positions on record) in either house of Congress. Especially compared to Republican actions regarding their priorities.

      I just don’t want them to waste time like I did when young. Yes, I bought the vote for Democrats because of the judges campaign bull. It took me a lot of years to truly embrace the adage it is what they do not what they say that is truly important. I may still kid myself that they are a lot more blatantly two faced today than two or three decades ago, but there was plenty of evidence of how much pandering was done during the campaigns about issues important to me only to have those issues promptly forgotten as soon as the votes were counted. If I could wish for anything for the youth of this country it is that they catch on sooner than I did.

      1. jefemt

        It seems Trump delivers empty promises with equal aplomb? The Wall? Immigration reform? Replacing Obamacare with something perfect and glorious?
        Maybe the President -whomever —really is hamstrung by a divided, divisive Congress?
        Seems to me that is a feature- not a bug- we have the worst government money has bought, and issues like immigration reform, funding border security, bodiliy autonomy and choice, are best left unresolved, if one is a grifting nest-feathering politician.
        As to bodily autonomy, I cannot figure out the belligerent no-freedom of choice from BOTH Dims and Repugs: Mandates for non-sterilizing under-tested ‘vaccine’, no reproductive rights/ choice, no freedom to choose one’s end of life. Freedom my Aunt Fannie.
        Granted it does seem like personal responsibility and good citizenship have falen to the way-side.
        We have no leaders imploring us, asking us, for anything. The last time we did was Trump rallying folks to come to DC for Jan 6th. It’s gonna be wild. Not the Leader for me.
        I believe little to nothing that comes out of the mouths of American office-holders, or the media that reports on them. Sad, but here we are. Or at least I yam….

      2. Jason Boxman

        I think the Casey 505 U.S. 833 (1992) decision laid bare what liberal Democrats thought about abortion, as it more or less de facto canceled it, by giving states overwhelming latitude to set “reasonable” restrictions, and those proved to be anything but reasonable over the ensuing 20 years. Voting for liberal Democrats to protect women’s rights has always been a poisoned chalice.

      3. tegnost

        issues important to me only to have those issues promptly forgotten as soon as the votes were counted

        yes, it’s just lip service.
        The Democrats, craven globalist liars with an authoritarian streak (section 702 re warrantless surveillance, no right to privacy) If the dems didn’t have abortion to run on what would they say they stand for then? As to the aca, all those who like it as the PMC orthopedic surgeon and the professor noted in the post do, already support the dems. And for all of the defensiveness around bidens accomplishments, I have yet to hear someone tell me what they are. The economy as it is amounts to reaganomics and trickle down supply side nonsense. One more thing re aca, I have yet to see a media report noting that higher hourly pay is pushing people from medicaid to the exchanges makes ocare numbers better, but not life for the downtrodden who are put on an exchange” “, and by the way does exchange sound more like healthcare or banking? I’m no longer sure whos the lesser evil anymore. Ukraine, genocide, censorship, vax and relax, socialism for the coddled rich (um…orthpedics, tenured perfessers, and more so than any other group, banksters) and competition from the global population for the student loan burdened locals. Yay Democrats! (/s)

    2. i just don't like the gravy

      It’s no big deal if your daughters and ex-wife vote for Biden this year.

      The POTUS is a vacuous position and this country is destined for the dust bin of history within the next decade or two. Not to mention the inevitable collapse of the biosphere and concomitant panic.

      What matters is you love and appreciate your family while we still have a modicum of peace and “normalcy” in this country. Also, stock up on canned food and ammo for a rainy day.

  3. Randall Flagg

    >make sure we have someone competent in the White House,” she said.

    Good Lord. This must be a joke. If there is competency in the White House I hope it’s at least in the President’s handlers.
    I can’t imagine Biden being let out on his own for more than a few minutes lest he wander away, never mind what he might say off script. Not seeing much competency at the moment as the world is starting to go up in flames.

      1. Randall Flagg

        Clips like those are almost a daily occurrence and my mind drifts back to not long ago when Putin went 4 HOURS +/- in a conference/ Q and A.
        Can you imagine Biden doing that? It would be comical if not elder abuse. Or cause for an immediate implementation of the 25th ( I think) amendment.
        I’m sure Trump could but with half of what he says heads would be exploding all over the place.
        Though, it would give NPR and the rest of the media something to glom onto for a few weeks.

        1. Lefty Godot

          Putin is younger than me, but not by that much. And just reading the schedule of activities he embarks on is exhausting. From talking to multiple foreign leaders in a day to visiting school kids and veterans, the guy is on the go most of the time. No wonder they keep him around.

          And when he speaks, it’s not word salad, and it’s even polite most of the time. The people we have running for office (Nikki “Finish Them” Haley is first in this regard) can only only be coherent when they’re uttering threats and exhortations to violence. It’s embarrassing.

    1. JonnyJames

      No worries, the other geriatric freak will be POTUS again, and he’s “going to save our country”. I’m told that he can do no wrong, and is the most competent POTUS ever.

      1. Pat

        Sadly, I do prefer him to this one. But then Biden is the worst president of my lifetime. And a trifecta of Clinton, Bush 2 and Obama that was a pretty high bar to meet.

  4. ilsm

    Noteworthy terms like: aimless war, Ukraine, Gaza, Israel, NATO, pentagon waste, doomsday clock were not mentioned.

  5. John Steinbach

    It’s my experience that most PMC have little understanding of the high deductible/cost barriers to actually using Obamacare. “Healthcare Access” is what they care about. Actual healthcare is irrelevant.

    1. Neutrino

      Twoish worlds of health care.

      Concierge medicine for those paying out of pocket, or having people for that, with their ill-gotten gains.

      Scrimping and saving, endless hours of trying to manage the PSA, check around for medication availability and finally gasping at the prices. Then navigating forms, waiting on hold, learning more about pre-approved conditions, medical coding and other arcana to crapify further what used to be simple, accessible and honest.

      The -ish part is for those exempt from the Affordable Care Act. They say, Health care for me, not for thee. Or for those who have no access to healthcare except for the absolute bare-bones version, if they can take the time and disrupt their lives.

      Storefront Urgent Care Kiosks, the next franchise?

    2. Randall Flagg

      Does “ healthy access “ mean being able to walk through the unlocked front doors of the emergency room? I think the PMC confuses access to healthcare with actually being able to pay for it.

  6. Judith

    Biden, when it is convenient, likes to pretend he is a good Catholic. I recently saw, in western MA, a bumper sticker “Catholics for Biden”. I suspect Biden will not be campaigning on abortion rights.

  7. jefemt

    I posted this under links- probably should have inserted here- indulgences? From Jesse’s Cafe

    “I am not very excited about the upcoming Presidential election.

    I would never even consider voting for Trump, but I also would not vote for Biden, the Clinton-Obama-Biden clan, and the Reagan-Bush-GOP cult of Molok.

    And I don’t like the idea of being shamed into voting for the ‘lesser of two evils’ which has been the core Democratic strategy since 1990. Tough to make a meaningful pick for the national level.

    But this doesn’t seem to be just a US phenomenon. If one starts naming leaders around the world, the ‘leaders’ do not inspire much confidence. Actually, it gathers in the throat, like a sour mix of dark humor and horrified astonishment.

    Maybe I am too picky, but perhaps it also says something about those that are drawn to great power.”

  8. Camelotkidd

    Over at Caitlin’s–
    protesters: “Genocide Joe, how many kids in Gaza have to be killed?!”

    Democrats in the background: “FOUR MORE YEARS! FOUR MORE YEARS! FOUR MORE YEARS!”

    Not to be outdone, here’s the Hildabeast–

    “Greta & Margot,

    While it can sting to win the box office but not take home the gold, your millions of fans love you.

    You’re both so much more than Kenough.”


    Can’t make this sh*t up

    1. Pat

      And then there were those that cheered that tweet, and jumped on anyone that pointed out it was cringeworthy. Almost as much cognitive dissonance going on there as writing in a vote for someone who actively disenfranchised the voters in their state because the state couldn’t change the legally mandated primary date to suit his payoff to another Democratic power mover.

      (And since I am not going to let that go I have to find a succinct way of putting it. Something similar to “Joe Biden still owes me $600”.)

  9. albrt

    I have been highly critical of Obamacare and the Democrats, but I recently discovered that my wife and I are the beneficiaries of a major change that I don’t think has been widely publicized. The subsidies for moderately well off working people have increased dramatically so that my monthly premiums have gone down from $1200 per month to around $500 to $700 (not confident until I actually see what the tax true-up will be in April).

    This appears to be a combination of eliminating the so-called “subsidy cliff” under Biden and the increases in the standard deduction that were mostly done under Trump.

    If somebody more knowledgeable about taxes and Obamacare can comment, I would be very interested. I don’t recall either party publicizing this effect, which is why I was surprised by it.

    1. JonnyJames

      While benefiting some, Romney/Obama care is basically a giant subsidy to the insurance industry. It does nothing to lower overall costs. IMO it uses public funds to pad the profits of an already parasitical insurance industry.

      The Obama regime, with Pelosi said “Single-Payer is off the table”. A majority of US dwellers have wanted a real health care system for many years. The US could have had a comprehensive, modern health care system in 2009, but BOTH the Ds and Rs (oligarchy-backed duopoly) told us to fk off instead. Nice democracy eh?

      If you compare % of GDP spent on “health care costs” and health outcome stats of other OECD countries, it becomes very clear that we are getting extorted badly.

      For all his faults, even Richard Nixon had proposals for health care reform a half century ago. Congress crooks shot it down of course. The oligarchy wants “Health” Insurance Extortion, not a comprehensive health care system. But “nothing personal, strictly business”


      1. albrt

        I agree with you that Obamacare sucks, but from the consumer end it is a better deal at $500 than $1200. I am surprised that nobody is bragging about bringing my monthly cost down by $500 or more. Seems like a big thing.

        1. Laura in So Cal

          What is happening locally is that provider groups are no longer accepting the lower cost HMO plans. If I sign up for one of these plans, providers are very limited and good luck getting in to see a doctor or NP. You basically need to buy a much higher priced PPO plan to get any real access.

          So many people have low – cost insurance, but can’t access any regular care. It would help cover emergency room visits etc. after the High deductible is met so it is essentially catastrophic care only, just like Yves notes in the intro.

  10. JonnyJames

    I just can’t take the “election” spectacle seriously. Once again, our “choice” is between two clownish, geriatric, cognitively challenged sociopaths. Have we reached the depths of kakistocracy yet? Apparently not.

    The fact that we have these two freaks to choose from is indicative of a dysfunctional, corrupt, collapsing society.
    It is painful to watch the slow-but-steady decay.

    I’m still waiting for Rod Serling to appear and say “You have entered The Twilight Zone.”

  11. chuck roast

    So, let’s see. NH has a population of around 1.4M people. Around 330K people bothered to turn out to vote.* Less than 25% of the pop. voted…let’s say 20% of the NH adults. I am tired of hearing the lameo opinions of 20% of the population. I would like to hear from the 80% of the population who were busy putting air in their tires on voting day.

    *I know, the Dems didn’t have a candidate. But didn’t the D-pols instruct the populace to vote for Nikki in order to ‘save our democracy’?

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