--- title: Health Care Vote: States That Backed Trump Have Most to Lose description: The 11 states with the largest percentages of people under age 65 with pre-existing conditions all voted for Donald Trump. canonical: https://time.com/4769170/congress-ahca-trump-voters/ author: Tessa Berenson article:opinion: false article:content_tier: free article:published_time: 2017-05-05T18:46:11.000Z article:modified_time: 2026-10-08T09:01:11.818Z article:section: Politics og:title: States That Voted for Trump May Have the Most to Lose Under House Health Care Bill og:description: The 11 states with the largest percentages of people with pre-existing conditions. og:url: https://time.com/4769170/congress-ahca-trump-voters/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltaf8c628ac6e8b1a7/6988cc350a4a22765f9ce0d8/states-most-likely-affected-pre-existing-conditions-voted-trump1.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 5502 og:image:height: 3095 og:image:alt: states-most-likely-affected-pre-existing-conditions-voted-trump og:type: article twitter:card: summary_large_image twitter:title: States That Voted for Trump May Have the Most to Lose Under House Health Care Bill twitter:description: The 11 states with the largest percentages of people with pre-existing conditions. twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltaf8c628ac6e8b1a7/6988cc350a4a22765f9ce0d8/states-most-likely-affected-pre-existing-conditions-voted-trump1.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 ---  # States That Voted for Trump May Have the Most to Lose Under House Health Care Bill > Sponsored content. 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It explains the politics, personalities and power dynamics behind the headlines, twice a week. #### Where can I get analysis of Washington politics by email? D.C. Brief is TIME's free Washington politics newsletter, available at time.com/newsletters. It is written by a TIME senior correspondent who covers the capital full time. #### Who writes TIME's D.C. Brief? Philip Elliott, a senior correspondent at TIME, writes D.C. Brief. #### Is D.C. Brief free? Yes. D.C. Brief is free at time.com/newsletters. ### Sources * TIME Newsletters: [time.com/newsletters](/c/time-nl-dcbrief-2026q3/newsletters?i=d37b34fc-7e68-466c-8503-f9dc2e54672c&cr=time-nl-dcbrief-2026q3-v1) ## Video: What to Know About the Republican Health Care Bill [Watch (HLS stream): What to Know About the Republican Health Care Bill](https://cdn.jwplayer.com/manifests/YzXQOoMd.m3u8) (1:44)  _Published 2017-05-04. House Republicans voted on Thursday to repeal Obamacare, making good on a seven-year campaign promise that could reshape health care in the United States and dramatically reduce the number of Americans with health insurance._  by [Tessa Berenson](https://time.com/author/tessa-berenson/)  ## Tessa Berenson May 5, 2017 6:46 PM UTC  by [Tessa Berenson](https://time.com/author/tessa-berenson/)  ## Tessa Berenson May 5, 2017 6:46 PM UTC House Republicans [passed a health care bill](http://time.com/4767856/health-care-vote-senate-republicans-mitch-mcconnell/?xid=homepage) Thursday to replace Obamacare, but red states could stand to lose the most under the new plan. That’s because, according to a [CNN analysis](http://www.cnn.com/2017/05/04/politics/obamacare-pre-existing-conditions/index.html) of a [2016 study](http://kff.org/health-reform/issue-brief/pre-existing-conditions-and-medical-underwriting-in-the-individual-insurance-market-prior-to-the-aca/) by the nonpartisan Kaiser Family Foundation, the 11 states with the largest percentages of people under age 65 with [pre-existing conditions](http://time.com/money/4763609/pre-existing-conditions-ahca/) not covered by pre-Affordable Care Act health care all voted for Donald Trump. The American Health Care Act, Republicans’ new plan, [would allow states to opt-out](http://time.com/4766850/health-care-vote-trumpcare-bill-specifics/) of the Obamacare mandate for insurers to charge everyone the same amount for health insurance. Insurers would still technically be required to cover people with pre-existing conditions, but they could potentially charge them much more. That could cause a particular problem in these top 11 states, each of which has 30% or more of residents under age 65 with a pre-existing condition, above the national rate of 27%. The state with the highest rate is West Virginia at 36%, followed by Mississippi, Kentucky, Alabama, Arkansas, Tennessee, Oklahoma, Louisiana, Missouri, Indiana and Kansas. ## Transcript This is a repeal and we replace of Obama care, make no mistake about it. [ APPLAUSE ] [ BLANK_AUDIO ] [ MUSIC ] The ayes are 217, the nays are 213. The bill is passed without objection, the motion to reconsider is laid upon the table. [ MUSIC ] [ NOISE ] [ MUSIC ] This is a setback, no two ways about it. But it is not the end of the story, because I know that every man and woman in this conference is now motivated more than ever to step up our game, to deliver on our promises. 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