Health Care

What Kentucky's Obamacare Success Might Mean in 2014


What Kentucky's Obamacare Success Might Mean in 2014

Photograph by Luke Sharrett/The New York Times via Redux

If you want to see how the success or failure of the Affordable Care Act might shape the nation’s future electoral battles, watch Kentucky.

The state’s health-insurance exchange, Kynect, stood out for having worked smoothly in the week after most other marketplaces opened around the country with glitches and delays. The Bluegrass State happens to be home to two Republicans who serve as some of Obamacare’s biggest foes in the U.S. Senate: Mitch McConnell, the minority leader up for reelection next year, and Rand Paul, the libertarian Tea Party ally eying a run for the White House.

Behind Kentucky’s exchange is Governor Steve Beshear, a second-term Democrat who decided to build the exchange over the objections of state Republicans. Beshear argued in a New York Times op-ed last month that Kentucky’s “horrendous” health status meant the state urgently needed the Affordable Care Act to help expand insurance coverage to 600,000 people. He also took a jab at “naysayers” who “pour time, money and energy into overturning or defunding the Affordable Care Act.” McConnell and Paul hit back last week, writing in their own op-ed, “Obamacare might sell in New York, but Kentuckians aren’t buying it.”

The problem for the Republicans, though, is that Kentuckians are buying it—in fact, the Kentucky exchange has, so far, enrolled more patients than any other. By Monday afternoon, 6,946 families had enrolled in plans through Kynect and the website had handled 3.1 million page views, according to the governor’s office. Soon after the launch, Beshear was talking to CNN’s Sanjay Gupta and MSNBC’s Chris Matthews, making the red-state governor a visible public face of Obamacare.

Kentuckians aren’t particularly ideological, says Stephen Voss, an associate professor of political science at the University of Kentucky. Despite Rand Paul’s Tea Party ties, Voss says, the conservative movement hasn’t been strong in the state, and most voters are practical. “Moderate, technocratic Democrats have done very well here, and will continue to do so,” he says. Registered Democrats actually outnumber Republicans in the state, but Kentucky has gone red in every presidential race since 2000.

So will Obamacare’s apparent early Kentucky success—and it is early—translate into electoral victories for Democrats? Voss is doubtful. Even if people have favorable impressions of Kynect, “You’re still talking a relatively small impact, compared to the vast number of people who are going to get a vague impression through a bit of TV news coverage,” he says. And McConnell’s Democratic challenger, Kentucky Secretary of State Alison Lundergan Grimes, hasn’t exactly embraced the health-reform law.

Beshear, who is ineligible to run for a third term as governor in 2015, might have the most to gain politically. “Here you’ve got a moderate Democrat—in a state highly favorable to Republicans in national politics—who was willing to fight for a national Democrat’s policies and pulled off an impressive technical success of a sort that lots of people are failing to do,” says Voss. “This guy who looked as though he was about to leave the stage and maybe even retire, his stock has shot up.”

John_tozzi
Tozzi is a reporter for Bloomberg Businessweek in New York.

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