Candidates for Ky. governor keeping health care at arm’s length

Published 12:46 pm Thursday, September 19, 2019

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By Al Cross
Guest columnist

The race for governor has begun in earnest, with both sides using scare tactics. But both sides also seem scared of saying the wrong thing about the most important issue to voters — health care.

Yes, health care. That may have been the most surprising news of the week, in the Prichard Committee’s release of its poll, taken in June.

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Asked which issue “should be the top priority for your elected officials in Kentucky to address,” 32 percent chose health care. Jobs and the economy got 24 percent, K-12 public education 20 percent, infrastructure 12 percent, public safety 6 percent, and postsecondary education 3 percent.

The poll didn’t mention drug abuse; many voters may think of that as a health issue, which it is; or maybe they finally understand that Kentuckians, collectively, have some of the poorest health in the nation.

Health is a broad issue, but on it, both sides have a narrow focus.

Democrat Andy Beshear is fixated on insurance for pre-existing conditions, the most popular feature of the Patient Protection and Affordable Care Act, better known as Obamacare.

But the most significant aspect of Obamacare is the 2014 expansion of the federal-state Medicaid program under Beshear’s father, then-Gov. Steve Beshear, which reduced the percentage of uninsured people in Kentucky more than in any other state.

When Matt Bevin was seeking the Republican nomination in 2015, he said he would abolish the expansion because the state couldn’t afford its 10% share of the cost. But after he won the primary, he apparently realized that would be politically risky, because the expansion gave hundreds of thousands of Kentuckians their first health insurance. He said he would seek a waiver of Medicaid rules to require people in the expansion to have “skin in the game” through deductibles and co-payments, and to work or volunteer 80 hours a month to qualify for vision and dental benefits.

When he became governor and proposed the waiver, he went farther, also calling for childless people in the expansion to work, volunteer or go to school, and report their activities monthly, to stay in Medicaid. A federal judge in Washington has blocked the plan; an appeals court will hear the case Oct. 11 but isn’t expected to decide it before the election.

The issue is highlighted in the latest TV attack from the Republican Governors Association. Its first half shows angry images of liberal Democrats in Congress proposing more government control of health care, a scary prospect to most viewers. Then it jumps to a separate issue and says “Beshear supports giving taxpayer-funded health benefits to people who CAN work but choose not to.”

That echoes Bevin’s July statement that “hundreds of thousands of people” on Kentucky Medicaid “could be going to work, should be going to work, and choose not to go to work.” But a study by experts hired by his administration, doing this research on their own time, estimated that only about 48,000 now on Medicaid wouldn’t meet the proposed requirements, and that they are about 36 percent of those who would be subject to the work rules.

Beshear has said he opposes the work requirements, but in responding to the Republican ad, he didn’t mention them or even defend his father’s expansion of Medicaid to the working poor. He probably knows that most Kentuckians support the idea of able-bodied people working in return for government aid. Most may not realize that Medicaid isn’t like welfare or food stamps; you just get your health bills paid.

But if the work idea is so popular, why isn’t it in Bevin’s own ads? He may be uncertain about how the whole health-care issue will play and is allowing the RGA to raise it with TV viewers. He’s surely polled it, and polling after the ad has had time to sink in may give him a better idea of how to handle the issue.

What University of Kentucky political science professor Stephen Voss said about health care in the 2015 race remains true: “For both candidates, delving more deeply into the specifics is fraught with risk.”

A surer strategy is to associate Beshear with the national Democratic Party, which has moved leftward, away from most Kentucky Democrats. That’s what the RGA has been doing since the May primary. But Beshear is also trying to scare voters, with his latest ad saying Bevin’s “education cuts” could leave some communities without schools.

At a press conference, Bevin was right to call that a scare tactic, but he was wrong to disparage Courier Journal reporter Tom Loftus for questioning his assertion that school funding is at a record high. Not with inflation, the fact behind the question my former colleague never got to complete because Bevin went off on him. Once again, the governor was his own worst enemy.

Al Cross (Twitter @ruralj) is a professor in the University of Kentucky School of Journalism and Media and director of its Institute for Rural Journalism and Community Issues. His opinions are his own, not UK’s.