So, they want to cut Medicaid, the US subsidy for healthcare for the poor, even harder then the mainstream of the party is willing to.

https://www.semafor.com/article/05/15/2025/democrats-plot-a-midterm-comeback-fueled-by-republicans-medicaid-cuts

Democrats plot midterm comeback over GOP Medicaid cuts

https://apps.npr.org/2024-election-results/west-virginia.html?section=P

Trump won every county in West Virginia.

https://www.cookpolitical.com/vote-tracker/2024/electoral-college

He had the highest percentage share of the popular vote there aside from Wyoming, the other big coal state, with a 41.9 percentage point lead over Harris in the popular vote.

And we already had one term of Trump:

https://qz.com/1960354/trumps-promise-to-put-coal-miners-back-to-work-was-a-failure

In 2016, Republican presidential candidate Donald Trump made a promise to coal miners at a rally in West Virginia. “For those miners, get ready because you’re going to be working your asses off,” he told them, wearing a white hard hat. “We’ll be winning, winning, winning.”

After four years of the Trump administration, coal has been losing, losing, losing. Not that Trump can take the blame (or the credit). Dismal economics have been inexorably displacing coal as the fuel of choice in the US and around the world. Trump made some attempts to stop the bleeding—easing air pollution laws and propping up ailing plants—and in 2017, falsely claimed those efforts were working. “We are putting the coal miners back to work, just as I promised,” he said.

https://wvmetronews.com/2025/05/01/medicaid-cuts-would-hit-wv-harder-than-most-states/

West Virginia is heavily dependent on Medicaid. According to the Kaiser Family Foundation, 28 percent of the state’s population—about 500,000 individuals—are covered by Medicaid. That’s the fifth highest per capita rate in the nation.

“Not only did you not get your promised coal boom, but he took your healthcare away to boot.”