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SNL Blogs
Wednesday, November 04, 2015 1:28 PM ET
Upset in Kentucky governor's race may have far-reaching effects on health
care
By Matt Blumenfeld
A surprising gubernatorial victory by a Tea Party-supported candidate could change the health care landscape across the state of Kentucky and dealt a
major blow to a fledgling Democratic political narrative.
Republican businessman Matt Bevin on Nov. 3 scored a big win over former state Attorney General Jack Conway, defeating his Democratic rival by a 53%to-44% margin. The victory came as a major shock to political insiders as Bevin has never held office and was beaten handily by Sen. Mitch McConnell in
their 2014 Republican primary battle. Bevin also trailed in every nonpartisan public poll in the weeks leading up to Election Day — even an internal poll
released by his own campaign showed him behind by three points as of mid-October.
Over the course of the campaign Bevin sought to nationalize the race and make the contest more or less a proxy fight over President Barack Obama's
agenda. Bevin repeatedly tied Conway to Obama and pledged to root out "Obamacare" in the state by closing down Kentucky's health care exchange, called
Kynect. Reforms put in place by the Affordable Care Act, including the creation of Kynect and the expansion of Medicaid, has been a success when
measured in terms of lowering the uninsured rate. According to The Courier-Journal of Louisville, the state's uninsured rate has tumbled to less than 9%
from 20.4% since the ACA's implementation.
Just before the polls opened, outgoing Kentucky Gov. Steve Beshear, a Democrat, predicted that running on health care reform would be a "political winner."
Residents "came out of the woodwork in droves" to find out more about obtaining health coverage after the ACA went into effect, Beshear told The
Washington Post. Democrats hoped the Kentucky election would be a test case for proving that embracing the health law could vault them to victory
elsewhere, a notion that Beshear heartily promoted prior to the stunning result.
"In 2016, I predict the Democratic nominee will make this a major issue and will pound the Republicans into the dust with it," he told the Post.
That prospect now seems much dimmer after Bevin's victory. But what might happen to the hundreds of thousands of Kentuckians who either qualified for
Medicaid or signed up for policies through Kynect remains quite uncertain. Thanks to unique powers the Bluegrass State governor holds, Beshear did not
need approval from the state Legislature to move forward with Medicaid expansion or a state-based exchange. That means Bevin could make sweeping
changes as soon as he moves into the governor's mansion. Though he campaigned strongly against "Obamacare" and has not backed down from his
promise to kill the state exchange and move residents onto a federal one, Bevin has tweaked his thoughts on Medicaid. Bevin's latest position would see the
state ask the federal government for a waiver that would allow for a reconfiguration of the program and reduce eligibility.
Shuttering the state exchange probably will not have a major practical impact, a senior vice president of the Kaiser Family Foundation told Business Insider.
Even if and when Kynect is closed, residents will still be able to shop for coverage through Healthcare.gov.
Changing Medicaid would have far greater ramifications, but whether the governor-elect will be able to follow through with his plans is another question.
Though he will not have to tangle with the divided state Legislature — Republicans control the Senate, while Democrats have a majority in the House —
Bevin will have to deal with an Obama administration that might not be keen on changing how Medicaid operates in Kentucky. Other states came to
arrangements that conditioned Medicaid expansion on the state being allowed to charge small premiums. But since Medicaid expansion is already in place in
Kentucky, Obama's administration is not likely to look favorably on any tweaks in that direction, The New Republic pointed out.
Bevin could still kill the expansion altogether, but that move would come with great political risk — more than 400,000 Kentuckians enrolled in Medicaid after
the program was expanded in the state.
Source: S&P Global Market Intelligence | Page 1 of 1