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 Ms. Hurd, 30. And the people who work hard and struggle for every penny barely end up surviving. ... President Trumps 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, Mr. 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 the election of President Trump. 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 support are those that everyone benefits from, Social Security and Medicare.
They are also likely helping fuel the renewed Democratic push for a single-payer system, or at least one that provides broader access to government health insurance.
Democrats have begun to recognize the political costs of playing into the narrative that they only care about the poor, said Joan C. Williams, a professor at the University of California Hastings College of Law and author of a recent book, White Working Class: Overcoming Class Cluelessness in America.
Many Republican states plan to start requiring many Medicaid recipients to work, volunteer or take job-training classes. Along the same theme, Mr. Trumps new budget proposal would make it harder for the so-called able-bodied poor who dont work to receive food stamps and public housing.
Such proposals reflect a very American view that only those who are severely disabled or struck by tragedy deserve government assistance, and that anyone else who gets it is shirking, said Mark Rank, a professor of social work at Washington University in St. Louis.
Our social safety net is, in general, the weakest of any of the Western industrialized countries because we have these kinds of views, Mr. Rank said. ... Ms. Hurd remembers watching a documentary about people signing up for Obamacare coverage last year and bristling when someone who got a big subsidy gushed about the low price.
I was like, Its not expensive for you because everybody else is paying for it, she said. ... For Ms. Hurd, health care has been something to avoid since she and her husband got the marketplace plan shortly after Harrys birth last year. (Before that, she had a job with benefits but quit because of her difficult pregnancy.) She went to an urgent care clinic for a throat culture last fall because unlike at her primary care practice, she could find out the cost, $150, upfront. And when Harry was up all night sobbing with a fever recently, she hesitated briefly before seeking medical help, again at urgent care.
Thats ugly, she said. I hate that I, even for a moment, considered waiting it out to save money.