There's a pretty clear answer to this question almost every single time it's asked... the people who benefit are wealthy and the people hurt are poor. The latter structurally lack the ability to fight it or lobby their congresspeople to change the law to help them. Until a mass movement steps forward to say "no, we will not tolerate this", nothing can possibly change. We have no recourse but each other and collective action.
And it's not necessarily true among those who do vote either:
https://krugman.blogs.nytimes.com/2007/09/24/bubba-isnt-who-...
It's an old article and I don't doubt that 2016 has messed with the numbers, but the narrative of poor rednecks screwing themselves over every election is largely unfounded and smacks of classism.
It will take something like the union/wildcat teachers' strikes, that forced Republican majorities with unified control of state governments to raise wages and increase funding, to do anything about healthcare or the many other structural challenges we face as a nation.