Democrats make Medicaid center of Kentucky governor fight

Greg Nash

Kentucky Democrats want to make the state’s 2019 gubernatorial race ground zero in the battle over Medicaid expansion and work requirements.

Democratic challenger Andy Beshear’s campaign is looking to take a page from his party’s 2018 midterm win, highlighting health care to upset the Republican incumbent Gov. Matt Bevin, who recently polled as the most unpopular governor in the country.

Democrats believe Bevin is vulnerable because of his efforts to roll back health coverage by imposing work requirements and monthly premiums on Kentucky’s Medicaid expansion population.


Bevin also opposes ObamaCare and has praised efforts by congressional Republicans to try to dismantle it.

“I think Bevin has left himself wide open for attacks on health care. It’s a target-rich environment,” said David Turner, spokesman for the Democratic Governors Association (DGA).

Beshear, Kentucky’s attorney general, won the state’s Democratic primary late last month. He has positioned himself as a champion of ObamaCare and Medicaid expansion.

During an interview with Louisville Public Radio ahead of the primary, Beshear slammed Bevin’s attempts to revamp Medicaid.

“On day one, if not hour one, I would rescind Matt Bevin’s Medicaid waiver. I believe health care is a basic human right,” Beshear said.

Beshear also embraced ObamaCare’s protections for people with pre-existing conditions, something that might have been unthinkable for a red-state Democrat just a few years ago.

“I have a plan where we’re going to put the most important protections under federal law into state law. Protections I’m fighting for right now, like mandatory coverage for preexisting conditions, ensuring that companies can’t discriminate against women and charge them more than men for the same policy, and no lifetime caps,” Beshear said in the interview.

Democratic strategists said highlighting health care is one of the main keys for the Beshear campaign to pull off an improbable victory in a state that President Trump carried by almost 30 points in 2016.

Bevin is expected to lean heavily on his close relationship with Trump and will have the full support of the White House. He has already been using Trump’s name in campaign ads.


Senate Majority Leader Mitch McConnell (R-Ky.), who defeated Bevin in a 2014 primary, and is up for reelection next year, will reportedly help Bevin if needed.

Bevin has indicated he will focus his message on the economy. 

“While Andy Beshear brags about voting for Hillary Clinton, Governor Bevin continues to partner with President Trump to create over 50,000 jobs, and now we have the lowest unemployment in Kentucky history,” said Davis Paine, Bevin’s campaign manager. “The last thing Kentucky wants is to bring back the failed liberal policies of yesterday that are at the center of Beshear’s campaign for governor.” 
Campaign strategists said Beshear needs to focus the debate on “kitchen table” issues, and access to health care is one of the biggest. If he gets bogged down on social issues, Beshear is projected to be much more vulnerable to GOP attacks.

“Regardless of someone’s political ideology, they want someone who’s going to protect their access to health care,” said Jason Perkey, a Kentucky-based Democratic strategist, about the state’s voters.

“It’s a very difficult issue for the governor because he wants to remove something that people have and have gotten used to and taken advantage of in a way that’s made them healthier,” Perkey added.

The Beshear campaign said they are framing the campaign as “right versus wrong,” not “right versus left.”

“Medicaid is right for working families, and Bevin’s attempts [to roll it back] are wrong,” a campaign spokesman said.

Beshear is also leaning on the unpopularity of Bevin in the hope of attracting Republican voters. An April poll from Morning Consult found Bevin was the most unpopular governor in the country, and he won the recent GOP primary with only 52 percent of the vote.

In a memo, the DGA cited a December 2018 poll that found 65 percent of Kentuckians are opposed to Bevin’s plan to scale back Medicaid coverage.

For Beshear, the fight is also personal. His father, former Democratic Gov. Steve Beshear, expanded Medicaid under ObamaCare, resulting in more than 400,000 people who were able to get health coverage.

Beshear left office in 2015 because of term limits, and ever since Bevin won he has threatened to roll back expansion.

Bevin has said expansion is too expensive and has tried to impose work requirements, premiums and other changes to Medicaid that would result in up to 95,000 people losing coverage.

A federal judge has now twice blocked those measures from taking effect. After the first time, in July 2018, Bevin unexpectedly cut Medicaid dental and vision coverage for about 400,000 Kentuckians. He restored the coverage after a backlash. Bevin has threatened to end the expansion entirely if he doesn’t get the work requirements.

During the 2018 midterm elections, Democrats took control of the House and won red-state gubernatorial races by heavily focusing on the GOP attempts to repeal and “sabotage” ObamaCare.

Outside advocacy groups said that strategy should hold true for Kentucky.

“The biggest takeaway from 2018 is voters rejected the Republican and Trump war on health care. It resonated and going forward this year it will still be the case,” said Michael Feldman, spokesman for the pro-ObamaCare group Protect Our Care.

“Kentucky has always been this important symbolic state for the health law. There’s a lot of opposition, but once it kicked in, it’s one of the states that benefited the most,” said Jesse Lee, a senior adviser at the Center for American Progress.  

“That’s going to be the key, creating a bright contrast between someone who wants to help and someone who is dead set on hurting people.”

— Updated at 3:13 p.m. 

Tags Donald Trump Hillary Clinton Kentucky Kentucky gubernatorial election Medicaid expansion Medicaid work requirements Mitch McConnell
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