Democrats have already been pursuing policies that are much better for the white working class than anything the other party has to offer. Yet this has brought no political reward...Take, in particular, the case of Clay County [Kentucky]...Independent estimates say that the uninsured rate fell from 27 percent in 2013 to 10 percent in 2016. That’s the effect of the Affordable Care Act, which Mrs. Clinton promised to preserve and extend but Mr. Trump promised to kill...[but] Mr. Trump received 87 percent of Clay County’s vote. - Paul KrugmanIf Krugman is really this shocked that Democratic governance doesn't get more credit for Obamacare, he should just consult his own writing on the topic back in 2009:
The screamers on talk radio and Fox News would have you believe that the plan is to turn America into the Soviet Union. But the truth is that the plans on the table...relies on private insurance companies, using a combination of regulation and subsidies to ensure that everyone is covered.My guess it that when Krugman sold Obamacare to the public as a market-based program rather than a government program, a lot of voters believed him. Liberal technocrats deliberately designed Obamacare in a way that would minimize the government's role (so as to preserve capitalism) and obscure it (so as to make it politically acceptable to capitalists). They then promoted it accordingly, insisting that it was not some Soviet-style Big Government initiative, but rather a modest tweak that ultimately "relied on insurance companies". So naturally, when private insurance became more accessible and affordable, the people of Clay County credited private insurance companies rather than Democratic governance.
This dynamic is one of many simple reasons why the liberal capitalist technocracy that Paul Krugman is so fond of can't get no respect among the general public. On one hand, Democrats want voters to appreciate all of the benefits they get from the government - but on the other hand, Democrats are terrified of doing anything in our economy that might look like a government intervention into capitalism. The result is what Cornell government professor Suzanne Mettler calls The Submerged State:
Americans often fail to recognize government’s role in society, even if they have experienced it in their own lives. That is because so much of what government does today is largely invisible...The submerged state obscures the role of government and exaggerates that of the market. It leaves citizens unaware of the source of programs and unable to form meaningful opinions about them.Incidentally, in 2007, Paul Krugman understood this problem perfectly well:
Still, why all the complexity? The smart, well-intentioned economists who devised the plan think they’re being more politically realistic than single-payer advocates — that it’s necessary to placate the insurers. But that’s what Bill and Hillary Clinton thought, too — only to find that their plan’s complexity confused the public...The alternative to this, of course, is bold and blatant socialism. When the government just hands health care directly to voters - rather than trying to launder it through an elaborate system of tax breaks and indirect regulatory maneuvers and so on - voters will know who to thank. Krugman gets that Hillary Clinton's political ambitions have been thwarted in the past when a heath insurance "plan's complexity confused the public," so he shouldn't be surprised when she fails again for the exact same reason.