by David K. Jones
Republican Matt Bevin’s dominant victory in Kentucky’s gubernatorial race is a blow for Obamacare, but is probably not as damaging as it seems. Kentucky will become a test case for what happens when a newly elected conservative comes into office after promising to undo the Affordable Care Act’s (ACA) coverage expansions: Bevin is likely to quickly confront the practical and political realities of taking away insurance from 400,000 people. Republicans in DC might learn from either his softening or the ensuing mess following cuts and could well think twice before trying to repeal the ACA nationally.
What Happened
Attorney General Jack Conway (D) led in the most recent polls and was expected to win this race. Kentucky has had a Democratic governor in 40 of the last 44 years. Bevin was not an especially strong candidate, winning the Republican nomination by just 83 votes after being soundly defeated by Mitch McConnell in the 2014 Senate primary.
Obamacare was a major issue throughout the campaign because Kentucky has been the poster child for ACA implementation. Mitt Romney won the state by 22 percentage points in 2012, but it was still the only state in the southeast to build its own exchange and to expand Medicaid. President Obama praised Democratic Governor Steve Beshear during his 2014 State of the Union speech, inviting him to sit in the First Lady’s box.
The launch of Kynect, the state’s exchange website, went smoothly while the federal website healthcare.gov was riddled with problems. The state expanded Medicaid and more than 400,000 people signed up. These factors combined to make Kentucky the state with the second largest decrease in the proportion of residents without insurance, decreasing from 20.4 percent in 2014 to 9 percent in 2015.
However, this progress is particularly vulnerable in Kentucky given how the ACA was implemented by Governor Steve Beshear. He could not convince the legislature to create an exchange or expand Medicaid, so he did both using executive powers. As a result, Bevin does not need a legislative vote or a prolonged fight to undo these core elements of the ACA. He can get rid of them with the stroke of a pen.
This is exactly what Bevin has said he would do. His campaign website calls for immediately “freezing and disbanding” the state’s exchange website, instead transitioning to healthcare.gov. He said early in his campaign that he would reverse the Medicaid expansion immediately
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