FILE - In this Jan. 20, 2015 file photo, Sen. Shelley Moore Capito, R-W.Va., accompanied by Senate Majority Leader Mitch McConnell of Ky., speaks during a news conference on Capitol Hill in Washington. West Virginia likes to say it’s “Almost Heaven.” Less idyllic is the spot its Republican senator, Shelley Moore Capito, is in as she decides whether to back her party’s effort to bulldoze Democrat Barack Obama’s health care law. (AP Photo/J. Scott Applewhite, File)

MORGANTOWN, W.Va. | West Virginia Republican Sen. Shelley Moore Capito opposes the GOP health care bill that party leaders withdrew last week. She’s pushing to ease its Medicaid cuts and other provisions, but she’s in a tricky spot back home.

Donald Trump won last November in West Virginia by 42 points over Hillary Clinton. That leaves little doubt about the state’s support for him and the head start Capito should have when she runs for re-election in 2020.

But it’s also one of the poorest and sickest states, meaning it’s one of the most reliant on the Obama health care law. And repealing and replacing that law is a top Republican priority.

Capito says she didn’t go to Washington to hurt people. But she says Medicaid spending can’t be sustained.

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