The GOP fought tooth and nail against Medicaid expansion as part of Obamacare. Many red states opted not to allow the income limit for adults without children (yes, including Florida, Texas, and Mississippi) to increase, thus allowing million to go uninsured or underinsured even though the Federal government subsidizes the cost. Even before the House went red even if every single Democrat voted for expanded healthcare (which they likely would) the filibuster doomed the chances of that happening. At a state level PA only opted into Medicaid expansion after Wolf took office, and within a few years 300,000 Pennsylvanians who were otherwise uninsured became eligible for Medicaid. The overall nightmare that is US healthcare will never improve unless half of the people in charge realize that access to healthcare isn’t a handout, it’s an investment in a stronger, healthier population but of course to fund it all their rich friends would need to pay higher taxes.