• The Affordable Healthcare Act (ACA) allows States to expand Medicaid.

  • Democratic States accepted the Medicaid expansion. More people got healthcare.

  • Several Republicans States refused to expand Medicaid. As a direct consequence, rural hospitals shut down. Rural voters facing hospital shutdowns blamed Democrats

https://link.springer.com/article/10.1007/s11109-024-10000-8

The conclusion of this paper is simple. Americans shouldn’t have democracy. It’s a system too difficult, too complex for them. They need something like the Chinese CCP.