I imagine in terms of medical care access and affordability or welfare stimulus, practically negligible, but in terms of CDC funding, science literacy, public policy, and general preparedness, it would be a whole lot better put together.
So I'd say... 10% fewer deaths? 200K vs. 220K deaths sounds about right.
A random county in bumfuck idaho really doesn't matter. However most counties will adhere to the state, who will mostly adhere to the feds. You'll find differences amongst municipalities, sure, but with something like a pandemic going on, ignoring federal guidance would put you in the minority
It's not some random bumfuck county in Idaho, it's any office held by Republicans across the entire country