Where Trump support and Obamacare use soar together

Updated 4:22 AM ET, Tue January 24, 2017

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Hyannis, Nebraska (CNN) -- Deep in the Sandhills of rural Nebraska, where a two-lane highway curves between prairies and grass-covered dunes, there is a county full of surprises.
It's home to Hyannis, a small village without stoplights, where fresh hot coffee is free, everyone waves and, in 1931, a news report named it "The Richest Town in America."
Cattle are king and far outnumber people in this county, small children ride horses as comfortably as they walk, and John Wayne's loyal stunt man grew up here, ranching. Roping competitions and pie socials help neighbors in crisis, and people make extra cash selling truckloads of dead coyotes to fur traders.
Life in Grant County, population 641, could not be more different than the gilded Big Apple existence long enjoyed by President Donald Trump. Still, it ranked among the top counties in the country supporting him in November; he got more than 93% of the votes here. And yet Grant holds another distinction: It's the county with the highest percentage of Obamacare enrollees in the nation.
One in three residents, or 33% of the under-65 population, bought insurance on Obamacare exchanges, official data from a year ago show. The national average is just 5%, which raises the question: In a place so tied to the Affordable Care Act, why would people back the man who vowed to repeal it? Wouldn't that seem a vote against the community's own interests?
    "People may think we're slow," explains one man, "but we're not stupid."
    In their world, one they feel is overlooked by those in big cities or on the coasts, their actions make perfect sense. You can't possibly understand, they say, unless you've lived here. I set out to try.

    Breaking the news

    Just mention politics to a group of men unwinding over gas station coffee and the insults come fast and fierce, political correctness be damned.
    "The black bomb" is how one rancher describes Trump's predecessor. "This guy came out of the sewers of Chicago. How could he be good?"
    The rancher's not about to give his name to someone with the "Clinton News Network" -- what he calls CNN -- but he and his friends are happy to rail against the former administration. Obamacare is right up there on the list of things gone wrong, they say.
    The hands they extend for shakes are rough and callused, symbols of how hard people here work. They are self-sufficient and don't like being told what to do any more than they like taking handouts. They take care of themselves, and each other, and don't need government stepping in to muck things up.
    That their county leads the nation in Obamacare enrollees is news to everyone I meet.
    "If they're on it, they're not saying," one man theorizes. People are on it only because the government "put a gun to people's heads," offers another. And just because they're on it, they warn, doesn't mean they like it.

      No other choice

      Walking through Hyannis, the county seat, I hear stories of skyrocketing premiums, deductibles that can't be met and brewing resentment. If people don't want to pay the penalty for not having insurance, which is taken out of the tax refunds they rely on, they're trapped.
      What they tell me might give pause to Obamacare experts, who say the Affordable Care Act is complicated, is hard to navigate and often leaves people misinformed about costs and choices. But these are the experiences and perceptions of how the law has played out in Grant County.
      Why some Nebraskans hate Obamacare

      Less choice. Higher premiums. Ideological opposition. These are some of the reasons so many rural Nebraskans may not be happy with their insurance under Obamacare. But there's also evidence the Affordable Care Act has helped rural communities like Grant County -- gains that could be erased with a repeal.


      Some have appreciated newfound coverage: With it, they were able to take care of longstanding problems, like the woman with a prolapsing uterus who could finally have a hysterectomy. But most people I meet complain that they're on Obamacare only because they have no other choice.
      Unless they work for the school, the county, the railroad or the electric company -- and the vast majority of people in cattle country don't -- these aren't Americans fortunate to be covered by an employer's insurance plan.
      Some might have been so lucky in the past, but that luck ran out when the Affordable Care Act came in, they say.
      Ginger Fouse curates the Grant County museum in the county courthouse. She's rushing to make a doctor's appointment in Alliance, 60 miles away and home to the closest hospital. Before she goes, she makes her feelings about Obamacare clear: "Nothing but horseshit."
      Fouse's husband is a ranch hand, and they used to get coverage through the ranch. But once Obamacare hit the scene, she says, the rancher believed everyone could take care of themselves. Only problem is, Fouse says, she and her husband can no longer afford the premiums. So they're now covered by nothing.
      "We're not going to quit eating to pay insurance," she says before heading out the door.
        Ellen White, a museum volunteer, steps in to introduce me to the area she's always called home.
        She shows off aged photographs: the old town hall where they used to dance, images from the 1949 blizzard that wiped out cattle and snapshots from the first old-timer rodeo.
        Ellen White, 69, volunteers at the county museum and speaks proudly of the history and work ethic that shaped her and others. "We've gotten along in this world without anyone telling us what to do," she says.
        A man's barbed-wire collection is on display, as is memorabilia from the deceased military doctor who delivered White and countless other locals.
        The highlight, though, is a collection of keepsakes from the late Chuck Hayward, who took his horses to Hollywood and worked as John Wayne's stuntman. Included are action shots, the saddle Hayward used while filming in Afghanistan and wooden stirrups from a shoot in Chile. There's also a saddle said to have been used by Wayne himself during the filming of "True Grit."
        White, 69, describes a time she wishes younger generations would appreciate. She grew up on a ranch south of Ashby, an unincorporated community just west of Hyannis. She, like so many others, rode a horse to her country school.
        She had three older brothers, and if they told her she couldn't do something, she proved she could. She was able to drive a team of horses by age 5 and helped milk 12 to 15 cows every morning and night.
        Life was tough, but it made people who they are. They worked for everything they had.
        Sometimes she watches HGTV and is stunned by house hunters shopping for $500,000 homes.
          "They'll pay on those houses forever and ever," she says. "We didn't buy anything unless you could pay cash for it."
          It's that sort of responsibility and practicality that courses through this ranching community's veins.

          Assessing life here

          Roughly 150 ranches dot the county, most of them passed down through families. It's an area where the first homesteaders arrived in the 1880s, tried to farm and failed. The sandy soil worked against them but proved a sweet spot for cattlemen, who snatched up tracts of land.
          The ranches are private and sit far off the main roads, in some cases miles off, and are impossible to assess by driving past. Ask a rancher about the size of his land or his herd, and he'll keep those numbers to himself.
          The question is uncouth, explains Dan Vinton, a lifetime rancher and longtime county commissioner; it's like prying into a person's salary.
          "We have enough grass to feed the cows," says Vinton, 66. "We have enough cows to take care of the grass."
          Dan Vinton, a lifetime rancher and longtime county commissioner, knows that this life isn't for everyone. "It's pretty hard for the city person to adjust to the country lifestyle," he says. "You can't just jump into your car and go to Walmart."
          Over chicken-fried steak in the Hyannis Hotel Restaurant, one of a handful of businesses on Main Street, Vinton and fellow Commissioner Tom White -- who worked in the feed business and is married to Ellen, the museum volunteer -- regale me with their own stories of growing up in Grant County.
          They didn't have electricity till the 1950s, got up and went to sleep along with the sun and like to say they "had running water because you had to run and get it." They took Saturday night baths in the same water used by their siblings.
          "We didn't know we were stinky little buggers because we all smelled the same," White, 71, says with a laugh.
          Life here has always made sense to them, no matter the challenges. When White needed chemo and radiation to treat cancer a couple months back, he and his wife simply rented an apartment near the hospital in Scottsbluff, more than 100 miles away, for five weeks. They'll travel to Denver for his upcoming surgery.
          They aren't city folk and don't want to be. Vinton drives that point home when he admits he and his wife have cell phones only so they can find each other when they get separated in the Walmart, which is well over an hour from home.
          Vinton's son works at the family ranch and is on Obamacare. His folks and the Whites aren't on it themselves, but they look forward to the day when it's abolished. They hear people complain about rates rising and call the program "ridiculous."

          Not wanting to be dependent

          A 31-year-old woman sits in the restaurant beside her towheaded boy. To her, Obamacare is maddening, and she unleashes her frustration.
          She's a college grad who does her research. When she and her husband got married, they picked out a policy and were happy. But then, Obamacare changed everything.
          They could no longer afford the private plan they liked. The number of companies she could choose from on the Obamacare exchange dwindled; only two choices exist today. They switched to one company only to see it get absorbed by another. They watched their premiums and deductibles increase, along with out-of-pocket expenses. They've been on four plans in two years.
          She's married to a rancher, and in ranching, it's hard to estimate how much a person will earn each year. When cows sell high, ranchers do well. But, as in any market, the numbers fluctuate. One year, her family might make $20,000; another $50,000, she says. Financial uncertainty makes planning a crapshoot.
          A stunning thing happened, though, when she got pregnant with her son. Suddenly, she was told she qualified for Medicaid, a notion that made her Republican head spin.
          "I want to be responsible for myself. I don't want to be dependent," says the woman, who didn't want her name used. "But you priced me out of what I did to take care of myself and forced me into government assistance."
          Pregnancies only last so long, though, and she doesn't meet the Nebraska Medicaid qualifications for parents. That means she's back to fretting about what this year's premiums will be.
          "I have to get knocked up," she says, half joking, half disgusted. "Mama needs dental care."

          Fans turned foes

          Across the street in the grocery store, I spot Clarissa "Casey" Sanchez working behind the counter. She was a fan of Obamacare at first.
          Paying $50 a month for herself was both doable and a source of comfort for the 30-year-old employee.
          But then she got married. With their combined gross incomes, she says, her monthly premium jumped to more than $600, and they make too much to qualify for Medicaid. Her husband has his own private policy, but she says she can't join it because she's pregnant. He bought the low-premium policy before Obamacare, and it doesn't include maternity coverage.
          Sanchez is determined to take care of herself but feels punished for trying. She's 13 weeks pregnant, scared and crossing her fingers.
          "I'm going without insurance and hope Trump does something quick," she tells me.
          Nearby, working at a cash register, Julie Braun, 36, chimes in: "I got married to get off Obamacare."
          Julie Braun, 36, says she was so disappointed in Obamacare that she got married to get off it.
          She, too, once enjoyed low premiums -- just $30 a month -- only to see them soar. She needed two ankle surgeries last year, and with a high deductible, copays, therapies, braces and boots -- which aren't covered -- she says she's staring down a $20,000 bill she can't pay. She makes $9 an hour and even with her husband's salary plans to file for medical bankruptcy.
          Though Braun and her husband had intended to marry at some point, they moved up their wedding date by a couple years. He teaches in the school and has good benefits, and that was all she needed to rush down the aisle.

          'A scam and racket'

          People here say they've had it with Washington and "mealy-mouthed politicians," the sort who speak pretty but say nothing, one local explains. This is why they backed Trump en masse. They like that he has a business record and trust that he can do better by them.
          "The man didn't get rich as he is by being stupid," says one man who refuses to give his name but pulls me aside to tell his own story.
          He's 50 and has never paid for health insurance. He calls the health care system "a scam and a racket." When he had a cracked tooth not long ago -- the first dental problem he'd ever had -- the dentist told him it would cost more than $4,000 to fix. "For one tooth!" he exclaims.
          So he looked at the dentist and asked how much it would cost to pull out all his teeth and give him fake ones instead. It was half the price, so he came back with his checkbook and had every tooth yanked.
          He now says he's facing a stiff penalty for not having insurance, which enrages him.
          "I pay for my own medical, and now I have to pay for someone else's?" he says. "Don't get me wrong; I want to do my part. But when does my part stop?"

          'Garden of Eden'

          The Sandhills Oil Company gas station -- just "the station" to locals -- is a popular gathering spot where people gab over coffee.
          Robin Jameson, 56, sits in the corner office. She moved here to oversee the station, one of several in a family business portfolio.
          "It felt like home immediately," she says. She likes how people watch out for one another, donating propane and groceries to those in need, and she gives back in her own way.
          An old rancher strolls into her office, seeking help deciphering a credit card bill. Retired ranchers down the road visit whenever their grandson competes in out-of-town rodeos, so she can set them up on a computer to watch the live-stream.
          Woody Thompson sits in the station and over coffee talks about his "Garden of Eden."
          One of the regulars at a station table is Woody Thompson, 76. He landed in this area more than 60 years ago, when he came out of the Dust Bowl looking for work. He says he was brought here by "a drunk and a horse thief."
          For decades, he worked on ranches. It's been a life rich in independence and great neighbors, the sort who once kept reselling a white leghorn rooster to raise money for a friend dying of brain cancer. These qualities made even the toughest days worthwhile. Digging harnesses out of snow drifts, riding miles and miles in 30-below temperatures, the winter of '78-'79 when the ground never saw less than 3 feet of snow -- he wouldn't take back his time here for anything.
          "It might not be heaven, but it's the Garden of Eden," Thompson says.
          A heart problem eventually took him away from ranching. Twice a month, he drives 70 miles south to see his Denver cardiologist, who meets him in Ogallala -- the nearest town on the nearest interstate. (Locals like that the interstate runs through flat Nebraska, allowing them to keep their hills to themselves.)
          Thompson, who moved to Hyannis 15 years ago, hands over one of his business cards. He's now a traveling rep for a company that performs castrations. With a couple golf balls in a bag, he demonstrates how they're done.
          Like so many people in this county, he says that Trump's business know-how spoke to him -- even if he doesn't suspect that he'd like the guy personally.
          "I have three daughters," Thompson says. "If Megyn Kelly had been my daughter, I would have beat the hell out of him."

          Respecting the law

          A couple blocks uphill, in the old courthouse, I find Christee Haney. She's in her second term as county clerk and keeps official records in the same books and logs used by clerks in the late 1800s.
          When she was elected seven years ago, it was to fill multiple offices. In an area as rural as this, she's more than the country clerk. She's also the county assessor, the registrar of deeds, the clerk of the court and the election commissioner.
          Party registration doesn't dictate votes here, where 81% of registered voters cast ballots in November. She has 40 registered Democrats, she says, but only 20 people voted for Hillary Clinton. Haney's cousin is one example; she's a Democrat who voted for Trump and refused to back Obama, whom she never trusted.
          Haney, 54, considers the high rate of Obamacare enrollment in Grant County and offers this: People are abiding by the law, simple as that.
          "It's a matter of respect out here, and that's what we've all taught our kids," she says.
          Christee Haney, the Grant County clerk and more, writes in the same logs used in the late 1800s.
          The K-12 school in Hyannis, which serves several counties and has fewer than 150 students, is a source of pride here. The teacher-to-student ratio is 1-to-9, the principal tells me. Students are more than cowboys and cowgirls: They test above the national average, are given their own laptops, flourish in the arts and play sports that draw the community together.
          Parents who've raised kids here brag about them getting scholarships; one proud dad says his daughter turned down Stanford, MIT and Yale because she wanted to be a Cornhusker. She graduated from the University of Nebraska with perfect grades.
          People here may not have what big cities offer, but that suits them. When Haney takes a day to run errands in Ogallala, population 4,570, she finds the traffic and all the people exhausting.
          She and others here prefer this quiet life with wide-open spaces and fewer stresses. They aren't facing a drug epidemic and don't worry about crime. They leave their keys in the ignition and don't lock their doors. They don't have a homeless problem and don't fret about unemployment. If anyone wants to work, there's work to be had.
          The folks in Grant County wish people elsewhere would take responsibility in their own lives and stop blaming others for their problems.
          "People on welfare in big cities make more money not working than we do working," says one woman. She's not the only one I meet who believes this.

          Not wanting to go without

          In a small house on the north side of the tracks, where the railroad carries coal from Wyoming and Montana, Terry Keys feeds and burps his 3-month-old son, Deacon.
          The baby shouldn't be this old. He was born two months early, when severe preeclampsia sent Terry, 34, and his wife, Trish, on an emergency trip to Lincoln at the end of October. Trish and Deacon had to stay there for a month until it was safe to bring the baby home. Terry, who helps drill and service wells, drove more than 300 miles each way to join them on weekends.
          Trish, the village's 37-year-old salon owner, curls up in the chair beside her husband and son and recounts an odyssey she's still processing.
          The couple, both Trump supporters, had been uninsured when Obamacare came along. The first year, they paid a penalty of $90. But fearing the prospect of steeper fines, they signed up. With the Affordable Care Act, they could purchase what had previously evaded them for about $150 a month.
          "It was reasonable, and we didn't have insurance before," Trish says. It helped them, she says, until it didn't.
          Trish Keys, with 3-month-old Deacon, is fighting to untangle how she ended up with a $104,000 medical bill for her son, who was born two months early.
          She'd been told their policy would cover Deacon and the exorbitant neonatal intensive care expenses for the first 30 days of his life "no matter what." But she says the insurance company stopped the family's policy without notice. Trish and Terry found out only when they stepped into a pharmacy in Lincoln for flu shots and were told they had no coverage.
          A panicked phone call later, she was told they qualified for Medicaid and should apply, which meant a flurry of paperwork and bureaucracy. After the trauma of having a preemie and being stuck in a city far from the world she knows, Trish came home to the stress of fighting a $104,000 bill. She still isn't sure who's responsible -- Medicaid or the insurance company -- and only knows she and Terry won't be able to pay it.
          "There has to be a simpler way. I feel like they've overcomplicated everything," she says.
          "It's mind-boggling to me," she says before turning her gaze to her son, who finally weighs 9 pounds. "Now that this has happened, you don't want to go without insurance."
          She hopes to still be able to afford it. And like others in this remote heartland county, she trusts that her new president won't let her down.