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Donald Trump woke up today tweeting about Fox and Friends‘ TV ratings. That was a safe topic, well within his bunkered comfort zone – because he ertainly wasn’t going to tweet about his latest political humiliation.

It happened last night in deep red Oklahoma – the second time in recent weeks that Oklahoma has humiliated him. The first time, you’ll recall, was when he was greeted by a two-thirds empty arena in Tulsa. And now, at a time when Trump is trying to kill Obamacare in the U.S. Supreme Court, the voters of Oklahoma have decided to enshrine an expansion of Obamacare in the state Constitution.

Amidst all the evidence that Trump is in political (and mental) decline, last night’s ballot initiative probably belongs in the top 10. In case you were wondering whether it seems politically loony for a “president” to target Obamacare during a raging pandemic to which he has surrendered, the results in Oklahoma expose his stupidity.

It’s amazing what can happen when knee-jerk ideological hatred of Obama’s signature achievement gets trumped by the facts of real life. When people desperately need health insurance, they’ll seek out what’s available. And if red-state voters feel it’s imperative to thumb their nose at Trump – and, in Oklahoma, to defy resistant Republican state lawmakers – they’re willing to do it.

Under Obamacare, states can cover low-income citizens via an expansion of Medicaid. But most states run by Republicans have predictably refused to approve that expansion. So last night, Oklahoma became the fifth Republican-run state (joining Maine, Nebraska, Utah, and Idaho) to take the decision away from the stonewalling lawmakers and endorse Obamacare expansion at the ballot box.

“In an election year that will be focused on health care, Oklahomans just delivered the first big win,” says Jonathan Schleifer, executive director of The Fairness Project, which helped the ballot campaign. “Voters in a deep red state became the first in the country to put Medicaid expansion in their state constitution to protect it. Americans are tired of politicians ignoring the problem or worse, trying to take their health care away. Americans aren’t going to stand for that type of approach anymore.”

Trump, at this point in his benighted reign, doesn’t have many moves left, and if he thinks his umpteenth attempt to kill Obamacare is a political winner that will reverse his plummet, then he clearly doesn’t know how to read tea leaves. Ten years after Obamacare’s passage, the law that covers 20 million people is more popular than ever before. Indeed, the historic 2018 blue wave that drowned the House Republicans was powered in swing districts by support for Obamacare. Trump and the GOP fatally ignored what the polls were telling them; in late October, the Fox News poll reported that 54 percent of likely midterm voters endorsed Obamacare – and that Obamacare was 10 points more popular than Trump.

And now, as evidenced by the Oklahoma results, even the majority of voters in that conservative bastion recognize the value of covering 200,000 impoverished citizens – especially since 90 percent of the expansion tab will be paid by the feds. In the midst of a national health emergency, scary “big government” suddenly seems essential. Which is what happens when ideology collides with reality.

One of Oklahoma’s Yes voters, Christine McIntyre, summed it up perfectly while speaking to a local reporter: “Part of me would vote ‘No,’ but I have an adult son (who) makes borderline poverty income that doesn’t qualify for Medicaid, and he doesn’t have health insurance, and because he doesn’t have health insurance, it affects his family, and upsets me. So, I voted for it even though personally, I probably wouldn’t have. I don’t know how I would say ‘No'” to her son.

The new Oklahoma constitutional amendment requires the resistant Republican governor and Republican lawmakers to expand Obamacare by next summer. That leaves only 13 states in the No camp – which is a shame for the folks who live there, because studies show that the mortality rate is lower in the states that have expanded Obamacare.

You’ll undoubtedly be shocked to learn that the naysaying 13 were all red states in the 2016 presidential race. But we’ll see what happens on Aug. 4 in red Missouri, which will vote that day on whether to enshrine Obamacare expansion in that state’s constitution as well. Trump won Missouri last time by 18 points, but this time people’s lives hang in the balance. Oklahoma just demonstrated how nuts it is to imperil people’s coverage in the midst of a pandemic. Health care is on the ballot this summer, and the stakes could not be higher.