That’s because the Trump administration is rewriting the disability eligibility rules, ostensibly to modernize the program, in ways that will make it even harder for aging blue-collar workers like Tincher to get benefits. Hundreds of thousands just like him would become ineligible for aid.

These changes would fall disproportionately on some of Trump’s most loyal supporters in red states. Most affected would be 50- to 60-year-olds without a high school or college education who have, for decades, toiled in physically grueling jobs, including coal mining, logging, and factory and construction work. The five states where the highest proportions of people rely on these benefits are West Virginia, Arkansas, Kentucky, Mississippi and Alabama. Unlike New York, California and a few others, these states do not have their own disability insurance programs for workers to turn to amid federal cuts.