GOP will pretty much hold on to ALL the regular voters through 2020, 2024. Jan 2021 people on Medicaid start dying.
Nov. 2020 — Presidential election
By now, some pain may have kicked in for some Americans. Some who were formerly eligible for tax credits for individual market insurance premiums — that is, those between 350 and 400 percent of the federal poverty level — will no longer be eligible.
The cost-sharing reduction payments that benefit lower-income people on the exchanges will also end. That could lead to lower-income people paying premiums near where they are now, but also having much higher deductibles, the CBO reported this week. In other words, health care would be more expensive for many lower-income people in the individual markets, so many may simply choose not to purchase insurance.
And the amount the federal government spends to reimburse states for Medicaid will be dropping by then. If states want to maintain current levels of coverage, they will have to spend more and more of their own money. Otherwise, as the CBO wrote, states would cut spending in a number of ways:
"...cutting payments to health care providers and health plans, eliminating optional services, restricting eligibility for enrollment through work requirements and other changes, or (to the extent feasible) arriving at more efficient methods for delivering services."
Furthermore, some older Americans would by now paying more for their health insurance, though some younger Americans could be seeing smaller premiums.
But then, the number of people on the exchanges in the first place is small — around 6.4 million right now. If people on the exchanges are getting less care for more money, and if it affects their votes (that is, if those people vote), it may not be a huge bloc of voters. And the effects of these changes may be slow in coming.
"Those changes do start in 2020 and could be a problem for the election [for Republicans], but I think those market effects would be more gradual," said Caroline Pearson, senior vice president for policy and strategy at Avalere Health.
(But then, once again, all of this is contingent upon people pinning negatives and/or positive to Republicans.)
January 2021
Medicaid expansion starts to roll back: matching rate for the expansion population starts to decline
"Trigger laws" start going into effect, ending Medicaid expansion altogether in some states
NPR
The healthcare effects will not turn the 2018 or 2020 elections. But by then Trump himself will have become TOXIC.
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Said Peter...what you're requesting just isn't my bag
Said Daemon, who's sorry too, but y'see we didn't have no choice
And our hands they are many and we'd be of one voice
We've come all the way from Wigan to get up and state
Our case for survival before it's too late
Turn stone to bread, said Daemon Duncetan
Turn stone to bread right away...