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With the American Health Care Act moving to the U.S. Senate, some New Hampshire Republicans are cheering as the bill makes its way through the legislative process. Yet, for some Trump supporters in the Granite State, especially in the North Country, they might not be too happy with its current version.

Despite still having some concerns about the AHCA, Gov. Chris Sununu said on Thursday that he was glad the bill passed the Republican-led U.S. House of Representatives.

“Failure to reform our health care system is not an option,” he said. “It is critical that we keep this conversation moving forward. My concerns with the AHCA remain firm and I expect that the United States Senate will take those concerns into consideration as they work to improve our nation’s health care system.”

Before the House passed the bill on Thursday afternoon, Sununu and 15 other governors sent a letter to House Speaker Paul Ryan reiterating their support for the Obamacare replacement and asked for states to have more flexibility when it comes to Medicaid.

It’s a similar letter Sununu signed on to earlier this year when the U.S. House tried to repeal and replace the Affordable Care Act the first time. In a Friday interview with the Concord Monitor, he applauded the passage of AHCA, but said he still had issues with the current version.

“I love the idea that Congress is taking action, the president is taking action,” he said. “They’re listening to the American people and they’re moving the ball forward. In it’s current form, I still have a lot of concerns, there’s no doubt. But we are moving it forward, and more important than anything is the need to reform the health care system right now that has failed the American people.”

It’s a different tone than he had in March, when he said the first version of the bill didn’t give states flexibility and would hurt New Hampshire’s expanded Medicaid program, which had bipartisan support.

“The bill that’s been proposed in Congress gives us concerns on a lot of different levels, to be very blunt about it,” Sununu said at a March press conference. “What I’m seeing in Washington gives me a lot of pause for concern to be sure, not just on the Medicaid expansion front, because that would drastically affect New Hampshire, but just on the mandates that are coming out of it.”

As expected, all of New Hampshire’s Democratic congressional delegation is opposed to the GOP-led plan. U.S. Reps. Carol Shea-Porter and Annie Kuster voted against the bill. Critics slammed the bill for potentially making millions lose health care and making it harder for people with some pre-existing conditions to find affordable insurance.

Some Granite State health care providers say more than 100,000 low-income New Hampshire residents could be at risk of losing health coverage under the AHCA plan. New Hampshire Hospital Association President Steve Ahnen said his organization was “deeply disappointed” that the U.S. House passed the health care bill.

“This bill is a significant step backwards on the commitment to ensure coverage and we cannot support it,” he said. “We will continue to work with Congress as this bill moves over to the Senate to ensure that any final legislation to repeal and replace the Affordable Care Act improves our health care system in a thoughtful and responsible way, rather than dismantling coverage for our most vulnerable residents.”

President Donald Trump campaigned aggressively on repealing Obamacare and lowering premiums. However, according to recent analysis, it appears premiums would significantly increase for older Granite Staters.

The Henry J. Kaiser Family Foundation, a nonprofit focused on health care, compared premium costs under the ACA and AHCA. For New Hampshire residents aged 60 or older who make $30,000, they could see their premium costs increase by 173 percent under AHCA. However, the same analysis also says younger residents in New Hampshire would pay less under the AHCA plan.

Many critics point out that the Trump-approved health care bill would negatively impact the people who voted for him. This holds up when using Coos County as an example.

Coos County overwhelmingly voted for Trump over Democrat Hillary Clinton by 52 to 43 percent, respectively. There is a large number of residents who are aged 65 and older in the North Country and the average household income is about $42,000, according to U.S. Census Bureau data. Those residents could fare worse under the AHCA plan than under the ACA.

In a Granite State Poll released Monday by the University of New Hampshire Survey Center, Trump’s approval rating in the state has remained steady at 43 percent. It’s the same rating he had in February. Republicans also still overwhelming approve of the president at 83 percent. Survey results from the North Country showed a statistically insignificant change.

It will be interesting to see over the next few months if residents in the North Country, especially those who voted for Trump, change their support. Nationally, it seems his base is sticking with him so far. Now, the U.S. Senate will now take over the AHCA bill and reports suggest the chamber will overhaul the legislation, making it different from the House version. The health care debate in Washington is far from over, leaving how it will ultimately impact New Hampshire a mystery for now.

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Pollsters were heavily criticized after the presidential election for completely missing the mark on their predictions. Across the country, they were scratching their heads, trying to figure out how they didn’t see Republican Donald Trump defeating Democratic challenger Hillary Clinton.

Even the University of New Hampshire Survey Center had to take a step back and figure out what went wrong for them. In their last Granite State Poll before the November election, they predicted an 11-point victory for Clinton. She actually won New Hampshire by four-tenths of a percentage point, 47.6 to 47.2 percent.

Their last survey also had Democrat Colin Van Ostern beating Republican Chris Sununu by 11 percent, 55 to 44 percent, for the governor’s office. Sununu beat Van Ostern by 2 percent.

For many political strategists in the state, these way-off predictions confirmed their suspicions that the UNH survey is a “bad poll.” Even WikiLeaks exposed that the Clinton campaign didn’t think much of them.

“As always, this poll doesn’t have a good history of accuracy so we need to take it with a grain of salt,” Clinton campaign manager Robby Mook wrote to Clinton about a recent UNH pre-primary poll May 5, 2015.

“The state of survey research is not static and there are a lot of technological changes and problems,” said UNH Survey Center director Andrew Smith. “We do an analysis after each election to look for biases that come into the surveys.”

Smith said he believes he found the reason why his numbers were so off during the election and he tweaked his methodology to reflect that in his most recent UNH poll released this week.

In his past polls, he would weight the sample based on age, sex, and region of the state, in addition to the number of adults and telephone lines within households.  Often pollsters will weight their samples to adjust for oversampling and undersampling of key demographics. For example, more women than men, and more older people than younger people, answer polls in the Granite State, Smith said.

Now, Smith added level of education into the mix.

“It’s a difficult variable to use and in the past it didn’t have that much political correlation when we used it, so it didn’t make a difference statistically,” he told NH Journal. “However, we saw that in this election, the percentage of people with a college education make a significant difference, and had we weighted it going into the election, we would have been dead accurate on all of the results.”

This election showed that Trump won the support of white, blue collar workers with some college education or less. He also over-performed in rural areas, while Clinton did better in more wealthy suburban areas.

Smith said he found that men with some college education, known as the Trump coalition, were not participating in the UNH surveys as much as they did when it came time to vote.

“It’s a new phenomena in New Hampshire politics,” he said. “Is it due to Trump? Probably, but it certainly made a difference in our polls. Hopefully, our methods are improved.”

The UNH Survey Center released four polls since February 10. The first one, released last Friday, was on Trump’s approval ratings in the Granite State, which found that residents are pretty divided on the president.

Forty-three percent of adults said they approve of the job Trump is doing as president, while 48 percent are disapproving of his performance, and 8 percent are neutral, the poll found.

These numbers are close to the national trend. The Pew Research Center released Thursday the findings of its survey, which found 39 percent approve of his job performance, while 56 percent disapprove.

Looking at the different regions of the state, his approval rating also varies. This is where it will be interesting to keep an eye on the UNH Survey Center to see if their new weighting of education level has an impact on the data.

In the Central/Lakes, Connecticut Valley, and Manchester area, his approval ranges from 32 to 39 percent. Along the Massachusetts border, on the Seacoast, and in the North Country, his approval rating is more positive.

Credit: UNH Survey Center

“It’s not surprising anymore,” Smith said. “Democratic political strength in the central part of the state and Connecticut River Valley is still there and Republicans have been strong in Massachusetts border towns and somewhat strong in the Greater Manchester area, like in Bedford.”

Smith said he found the political dynamics of the North Country interesting because that area is becoming more Republican. For years, it used to be an area of Democratic strength due to blue collar support for Democrats with union support.

“The character and self-identification of the people in the North Country is different than the rest of the state,” he said. “They have not been doing well economically and the Democratic Party has been having difficulty holding onto these blue collar people.”

As exhibited by Trump’s win, many of these blue collar workers in New Hampshire, and in other states across the country, lent their support to the president.

“All we are seeing right now is a group of people who are quasi-Republicans, who might not have participated in politics before, or turned out greater in number, but we’ll have to see how that plays out in the next several years,” Smith said.

The other polls released this week showed that the drug crisis is still the number one issue for residents in the state, Gov. Sununu has similar approval ratings at the start of his term as his predecessors, and all of New Hampshire’s congressional delegation have positive approval ratings.

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