I actually live in a flyover state. Democrats fly over it because the residents would vote for a dead dog over a democrat. Republicans fly over because there is no need to waste fuel and add costs by going someplace where you've always won. And thanks to the electoral college - I really don't count. 35% of the residents of my state did not vote for Donald Trump, but if you look at the only votes that matter - 100% of the residents voted for him.
The thing about flyover states (speaking as a resident of one of those states that has never even been to elitist NYC) - they don't seem to mind about promises made and not kept. For 10 years here, every office, from dog catcher to Senator to Governor, has run against "Obamacare" 10 long years their Republican candidates have promised to do something to help them...they've pointed out how much they have to pay in premiums...they've pointed out how high their deductibles are. And for 10 years...their representatives have done notihng. The president they voted for in 2016...who promised them a "really great" healthcare plan that would "cover everybody" and "cost so much less"...didn't deliver. Indeed...he saw their pain...he saw how much they are paying in premiums...he saw their high deductibles...and he pretty much said "we aren't doing anything until after the 2020 election....maybe even longer until they can get enough Republicans in the Senate to get those magical 60 votes they need to repeal Obamacare. In the meantime, the tax cut saved you enough money that you can buy an extra jar of Vaseline to make what they are doing to you feel a little better.
Flyover state residents apparently bought the "it has to be repealed to be fixed" argument. But "Obamacare" already covers people with preexisting conditions AND families until the kids are out of college. So instead of addressing the parts that it DOESN"T have...they just kick then can down the road year after year after year and are happy to just ***** about how much healthcare costs them.