Trumpcare, the budget office tells us, would cause 23 million people to lose health insurance, largelybr through cuts to Medicaid — remember, the program that benefits almost a third of West Virginians.br Now, to be fair, the Trump budget would protect West Virginians from the ravages of the estatebr tax, which affects around 20 — that’s right, 20 — of the state’s residents each yearbr Beyond that, more than 4 percent of the population, the highest share in the nation, receives Social Security disability payments, partlybr because of the legacy of unhealthy working conditions, partly because a high fraction of the population consists of people who suffer from chronic diseases, like diabetics — whom Mick Mulvaney, Trump’s budget director, thinks we shouldn’t take care of because it’s their own fault for eating poorly.br It would also lead to soaring premiums — we’re talking increases on the order of 800 percentbr — for older Americans whose incomes are low but not low enough to qualify for Medicaid.br Partly, presumably, they supported Trump because he promised — falsely, of course — that he could bring back the well-paying coal-mining jobs of yore.br Maybe he would take benefits away from Those People,br but he would protect the programs white working-class voters, in West Virginia and elsewhere, depend on.