On Thursday, House Republicans postponed a vote on their proposed health care bill to replace the Affordable Care Act after it became clear they didn't have the votes to pass it.
The White House reacted to the delay with an ultimatum: Vote for the current GOP health care replacement plan, or leave the Affordable Care Act in place and suffer the consequences.
Replacing the Affordable Care Act (ACA) has long been a goal of the GOP -- but getting rid of Obamacare may actually hurt the voter base that helped put them in power.
In California, it was largely rural counties that voted to elect Donald Trump president. Trump made repealing the ACA one of his key campaign talking points. But Dr. Anthony Iton with the California Endowment says those counties are among those with the most to lose should the ACA be repealed.
“There are 25 counties that voted for President Trump," Iton says. "And 23 of those 25 counties have rising white mortality rates.”
Iton says people in those counties are dying of drug overdoses, alcohol-related illnesses, suicides and accidents. And he says many of the underlying causes of those premature deaths can be treated with services currently offered through the ACA, like mental health care and substance abuse treatment.
"Those are the things that are in jeopardy right now of being essentially withdrawn from these populations, particularly in rural areas where there’s a relatively thinly stretched health care delivery system," he says.
Rural Sierra County voted overwhelmingly for Trump in November. Supervisor Lee Adams, a Democrat, says nearly a third of the county's 3,000 residents are enrolled in Obamacare.
“I think most are hoping for the best, and until the shoe drops they still are hopeful that everything is going to be fine," he says.
But Adams says a repeal of the ACA could have a significant negative impact on the county, where the economy has been struggling and about 14 percent of the population live below the poverty line.