OPINION: Kentuckians on Medicaid voted against their own interests, and the Democratic base wasn't motivated

By Cheyene Miller
University of Kentucky School of Journalism and Telecommunications

Back in 2004, journalist and historian Thomas Frank wrote the political book “What’s the Matter with Kansas?”

Frank explores a political landscape historically dominated by left-wing [opulist movements, until conservatives started using social issues like abortion and gay marriage to appeal to the working class.

In doing so, Republicans were able to sway middle class and low-income citizens to vote against their own economic interests.

He argues the political discourse in America’s heartland has moved from discussion of economic mobility and opportunity to culture war issues, which are based in perceived anger toward “liberal elites.” Eleven years later, Kentucky has become the new face of this phenomenon.

Prior to the Nov. 3 gubernatorial election, Kentucky was known as the only Southern state where Democrats dominate most levels of government. But with Republican candidate Matt Bevin’s victory over Democrat Jack Conway, Kentucky might be the new Kansas.

During the campaign Bevin spoke against raising the minimum wage, advocated dismantling the state’s online insurance market Kynect, and posited restructuring the Medicaid expansion. And yet Bevin’s largest amount of support came from the most impoverished areas of the state which have high numbers of Medicaid recipients.

Polls consistently had Conway ahead of Bevin throughout the race, and yet Bevin defeated Conway by nearly nine percentage points. Political experts have suggested several reasons for how this happened, such as low interest among Democratic voters and conservatives being less likely to participate in polls.

Another likely reason is that religious conservatives, which make up a huge voting community in Kentucky, were motivated by the situation surrounding Rowan County Clerk Kim Davis.

The escapade involving Davis and her refusal to issue marriage licenses in wake of the U.S. Supreme Court’s decision to legalize same-sex marriage received national attention, and Bevin showed support for Davis’ cause, turning a relatively insignificant issue into a culture war issue on which many conservatives base their votes.

Bevin’s victory should serve as a wakeup call to those on the left and even the center. The Democratic base was not motivated in this election, and the party paid the ultimate political price on Election Day. Regardless of whether or not they are justified in their sentiment, much of working class America is angry, and Republicans have proven to be more capable of capitalizing on the emotions of the citizenry and turning them into victories.

Cheyene Miller is the managing editor of the Kentucky Kernel, for which he wrote this column. It also appears at http://kykernel.com/2015/11/19/kentuckians-voted-against-their-own-interests/.

Here are the candidates' positions on several issues

This post may be updated with summaries of other issues.

ECONOMY
     Democrat Jack Conway and Republican Matt Bevin's economic positions adhere in large part to party orthodoxies. Bevin plans to make the Bluegrass more competitive by passing "right to work" legislation, which would outlaw labor contracts that require workers to pay union dues or fees. Conway's plan to bring more jobs to Kentucky primarily focuses on education. He plans to align job-training programs to the needs of employers and plans to work with schools to improve graduation rates. Conway wants an increase in the minimum wage to $10.10 an hour. Bevin opposes that idea, and his running mate, Jenean Hampton, said an increase to minimum wage would be "disastrous." Independent Drew Curtis favors the increase and says he will look at policies in other states and bring the successful ones to Kentucky, hoping to bring a "tech boom" to the Bluegrass by focusing on technology training. –Ben Johnson

EDUCATION

     Republican Matt Bevin says Kentucky needs to back out of the nationally adopted State Common Core Standards because they “doesn’t adequately address the diverse needs” of the state. Bevin also wants to guarantee school choice, including charter schools and tax credits for private education, and has said families who home-school their children should have access to the same public amenities provided to kids who attend state-funded schools. He favors outcomes-based funding for higher education, with emphasis on producing degrees that will help the economy.

     Democrat Jack Conway wants to expand early childhood education, first to 3- and 4-year-olds in homes with incomes up to 138 percent of the poverty level, with a goal of 200 percent. He supports Common Core and opposes charter schools and tax credits for private education. He says he would look at outcomes-based funding but wants to maintain a level playing field for universities.

     Independent Drew Curtis wants to expand early-college programs in high schools and says a budget cut to education is one of the last things he would recommend. However, he also says solving Kentucky’s pension problem is one of his first priorities, so education funding issues would have to wait at least a year. –Kevin Erpenbeck

DRUGS

     Drug abuse is a growing problem for Kentucky, which has the nation’s third highest death rate from drug overdoses.  The number of heroin overdoses has tripled in the last three years alone. There are limited treatment options available, with only one-tenth of the treatment beds needed. Here is how the three candidates for governor say they will deal with that problem:

     Democrat Jack Conway notes his history of fighting drugs as attorney general. He supports the local-option needle exchange program and calls for more education and treatment but has yet to provide a solution on how he will pay for that. He opposes legalizing marijuana for medical purposes and says people on Medicaid should be tested for drugs only with probable cause.

     Republican Matt Bevin says he would randomly drug-test Medicaid recipients but otherwise has talked less about the state’s drug abuse crisis than Conway. He says the key is intervening earlier and creating better economic opportunity. He says the state spends too little on behavioral health and supports legalizing marijuana for medical purposes.

     Independent candidate Drew Curtis supports decriminalizing addiction. He suggests copying Massachusetts’ program on tackling opiate addiction if it proves successful. –Megan Ingros

GAMBLING

     Expanded gambling, an issue that could have an impact on the state’s economy budget, is viewed with differently by all three candidates but isn’t a strong point of focus for any of them.

     Democrat Jack Conway favors a referendum on the issue and says the time could be right for it, to create revenue for the horse racing industry, pensions and early childhood education, since bond-rating agencies have said the state needs a dedicated revenue stream to shore up its pensions.

     Republican Matt Bevin stands on the opposite end of the spectrum. During an Oct. 6 debate, he rejected gambling as a possible solution to any of Kentucky’s problems. “I don’t think it’s the solution to what ails us financially in this state,” he said.

     Independent candidate Drew Curtis stands right in the middle. While not much more enthralled by the idea of expanded gambling than Bevin, he hasn’t been willing to completely dismiss it just yet. “Our pension system is in dire shape, so we must consider all options,” Curtis told WFPL Radio. –Jerry Seale

HEALTH CARE AND INSURANCE

     In regard to Medicaid, the federal-and-state-funded health insurance for lower-income people, Democrat Jack Conway wants to stay where we are right now and Republican Matt Bevin does not.

     Conway wants to keep the Kynect health-insurance marketplace and the expansion of Medicaid to people with incomes up to 138 percent of the federal poverty line, saying he believes the state-funded study that shows the expansion is paying for itself by adding so many people to the health-care system that enough jobs and tax revenue will be created to cover the state’s cost – starting at 5 percent in 2017 and rising to the federal health reform law’s limit of 10 percent in 2020.

     Bevin scoffs at the study, saying the expansion is unsustainable, and says he would apply for a federal waiver to change it to a program in which some people pay premiums, co-payments, deductibles or health savings accounts. He also wants to use the federal exchange and abolish Kynect, which is funded by a 1 percent fee on all health-insurance policies sold in the state. The federal exchange charges 3.5 percent on policies it sells.

     Independent candidate Drew Curtis is against abolishing Kynect and wants to stand and watch what happens with the Medicaid expansion. He says it seems likely to pay for itself in the near term. –Lauren Allen

SMOKING BAN
     Democrat Jack Conway favors a statewide ban on smoking in public places. Republican Matt Bevin says local communities should decide the issue for themselves. Independent candidate Drew Curtis favors a ban that exempts cigar bars and other establishments related to smoking. –Al Cross

TAXES
     Republican Matt Bevin calls for comprehensive tax reform that includes reduced income-tax rates on businesses and individuals and repeal of inheritance and inventory taxes.
     Democrat Jack Conway endorses bipartisan tax reform that would not increase overall revenue. He has called for ending the inventory tax.
     Independent Drew Curtis wants to change income-tax brackets to percentages of income, not dollar amounts, to adjust to inflation, and supports "an across-the-board reduction in exemptions, with the goal to elimimnate as many as possible over the next decade." –Al Cross 

Fate of health coverage through Medicaid expansion and Kynect could rest on the outcome of the election

By Cheyene Miller and Anthony Pendleton

University of Kentucky School of Journalism and Telecommunications

            The fate of health coverage for about half a million Kentuckians could rest on the outcome of the Nov. 3 election for governor. Democrat Jack Conway wants to stick with the state’s embrace of federal health reform while Republican Matt Bevin does not.

            Gov. Steve Beshear expanded the Medicaid program and created an online insurance market known as Kynect. Between the 400,000 in the expansion and 100,000 private insurance plans purchased on Kynect, the percentage of people without health insurance dropped more in Kentucky than any state in the nation, from more than 20 percent to just over 9 percent, according to the Gallup Poll.

            Kentucky was the only Southern state to create its own insurance exchange, and one of only two Southern states to expand Medicaid, along with Arkansas.

Beshear is on his way out of the governor’s mansion, however, and his possible successors have two drastically different stances on the Patient Protection and Affordable Care Act, also known as Obamacare.

Conway’s stance throughout the race has been to keep what is arguably one of the greatest accomplishments of his fellow Democrat, while Bevin has promised to dismantle Obamacare in Kentucky, albeit with an inconsistent stance on the Medicaid expansion.

Bevin told reporters in February that he would immediately end the expansion, but in July he denied saying that and started talking about seeking a federal waiver to receive Medicaid money in a grant and create a system resembling Indiana’s, in which Medicaid beneficiaries pay premiums to get better benefits.

“We can’t afford the current structure as it exists,” Bevin said in September. Beshear questioned Bevin’s knowledge of the system, and said the non-partisan Congressional Budget Office found that such waiver plans “will likely cost more than the expansion as we have implemented it in Kentucky.”

Bevin has said a waiver might allow Medicaid to offer some help to people with incomes above 138 percent of the federal poverty level, perhaps by helping them with health savings accounts.

Before the expansion, only Kentuckians with household incomes at or below 69 percent of the federal poverty level qualified for Medicaid. The expansion doubled that to 138 percent of poverty.

The federal government is paying the full cost of the expansion through 2016, at which point Kentucky would start paying 5 percent of the cost, rising in yearly steps to the law’s limit of 10 percent in 2020. By the 2020-21 fiscal year, the expansion is expected to cost the state $363 million a year.

A state-funded study by Deloitte Consulting predicted in February that the expansion will generate enough jobs and tax revenue to pay for itself through 2020, but Bevin has called the study “nonsense.” Conway has cited the study in saying he supports the expansion but would monitor its costs.

In his speech at the Fancy Farm Picnic in August, Conway said Kentuckians should vote for a candidate who “understands that the truly Christian thing to do is to say that we are our brother’s keeper and health care for our people makes us a healthier and better society.”

            The candidates are playing to their bases Bevin by taking a stance against Kynect and the Medicaid expansion, and Conway by following the footsteps of Beshear in supporting it, University of Kentucky political science professor Stephen Voss said.

“They’ve already managed, without saying very much, to give that basic signaling that each side wanted to hear from them,” said Voss, adding that both candidates are also doing their best to remain vague when discussing health care: “For both candidates, delving more deeply into the specifics is fraught with risk.”

Bevin has been more consistent with his stance on Kynect, saying he would "facilitate the transition of enrollees" onto the federal exchange as he dismantles Kynect. In September, Bevin said he would consider a suggestion from Republican state Sen. Ralph Alvarado to keep Kynect operating and finance it by expanding it to other states, but he was skeptical of the idea.

            Lexington-based litigation attorney Douglas McSwain, who specializes in constitutional and health-care law, said Kynect is one of the reform law’s biggest success stories nationwide. “The main issue is that health-care reform has been a very good success under the Beshear administration,” McSwain said.

Kynect is funded by a 1 percent assessment on all Kentucky health-insurance policies, while the federal fee is 3.5 percent on policies sold on the exchange.

Independent candidate Drew Curtis has said the state can probably afford the first round of expenses from the Medicaid expansion, and should leave it and Kynect “alone as it is” until the state sees the long-term effects. “You can’t drop a massive system change on people, and (then) do it again in two years,” he said.

Kynect Director Carrie Banahan has said that Kynect would cost at least $23 million to dismantle and that most of the seven insurance companies using it would probably not go to the federal exchange.

            Whoever is elected governor will likely have many obstacles on his plate regarding health care, since Kentucky is one of the least healthy states. According to America’s Health Rankings, Kentucky is 47th in overall health, with major issues facing the state including high rates of smoking and preventable hospitalizations. Kentucky also ranks first in the nation for lung cancer deaths, according to the federal Centers for Disease Control and Prevention.

Cheyene Miller and Anthony Pendleton are journalism seniors at the University of Kentucky. They wrote this story for the Covering the Governor’s Race course being taught by Associate Professor Al Cross and Journalist in Residence John Winn Miller.

Bevin turns up the heat, during debate and afterward

By Matthew Young
University of Kentucky School of Journalism and Telecommunications

In a governor’s race that has been conspicuous for its relative silence, Republican Matt Bevin is turning up the heat on Democrat Jack Conway.

Matt Bevin and Jack Conway
(Lexington Herald-Leader photos)

Content for weeks to ride the wave of conservative anger and frustration over County Clerk Kim Davis’ fight against gay marriage in Rowan County, Bevin is now aiming directly at Conway, the two-term state attorney general.

The most spirited attack came in Tuesday night’s Bellarmine University debate when Bevin called Conway, in no uncertain terms, a liar.

That came after Conway accused Bevin of saying he would like to see the road fund in Kentucky – in dire need of cash – drained all the way to zero, then have it audited. Bevin’s anger was palpable in his response:

“First of all, so much of what comes out of your mouth, Jack, is absolutely made up. I have never once called for letting anything go to zero and then auditing it. You literally make lies up on the fly. So I would challenge those of you watching, check carefully with the facts.”

The Conway campaign later cited a Beattyville Enterprise article from last year’s U.S. Senate primary in which Bevin said government public-works projects have "served their purpose," but could not provide any evidence that Bevin wanted the highway fund to fall to zero.

Bevin lashed back at several attacks.

He is still fighting off claims that he was delinquent on taxes, something fact-checkers largely cleared him of early in the Senate primary against Sen. Mitch McConnell.

A recent Conway ad shows Bevin saying the Farm Bill was “an insult to farmers.” The screen then splits and shows him saying that was “a misrepresentation of what I said.”

Bevin has a case, since the “insult” he spoke about was the bill’s longstanding non-agriculture provisions, and the money it funneled to big agribusiness.

The ad also says Bevin told one group that early childhood education “after the age of nine serves no purpose,” then shows him denying that he opposes early childhood education.

While Bevin has said Head Start’s benefits to children disappear after the third grade, Head Start and early childhood education are not exactly the same.

More clearly, Bevin has backtracked on the expansion of Medicaid in Kentucky to include more than 400,000 people. After he said he would end the expansion, and Conway accused him of being callous, he denied saying he would end it and said he would seek a less expensive alternative, like Indiana’s.

The frustration seems to have taken its toll on Bevin. Tuesday night’s debate was not the only time he directly attacked Conway.

In an interview with Kentucky Public Radio, Bevin told host Ryland Barton, “Jack Conway supports the idea of bankrupting the coal industry.” Conway notes that he is the only Democratic attorney general who has sued to block the Obama administration’s regulation of greenhouse gases from coal-fired power plants.

While Bevin may lack evidence to back up this attack, it suggests he will keep up the heat as the race heats up.

Perhaps the most personal attack from Bevin was about race.

Bevin, who has adopted four black children from Ethiopia and chose Jenean Hampton, a black conservative activist, as his running mate for lieutenant governor, used race to question a lack of action from Conway on Gov. Steve Beshear’s appointment to university boards.

“I would question whether or not it's racially motivated that our governor and attorney general have no qualm with, even though its statutorily required, having no blacks on the University of Louisville board,” he said in the debate. Conway has said he would correct that.

Returning to his favorite argument, about the Rowan County clerk’s stand against gay marriage, and Conway’s non-appeal of a ruling that led to the Supreme Court’s legalization of it, Bevin said, “We have an attorney general who is once again turning a blind eye. We’re quick to put a Kim Davis in jail for not doing her job; we tell her to quit or do her job. We have an attorney general that repeatedly does not do his job, and a governor in the same boat. We cannot have a double standard in this state."

Conway replied that the law gives him discretion not to appeal, an appeal would have been futile and wasteful, and “the good-paying jobs of the future” will come to states that are inclusive. “I think Kim Davis went to jail because she defied a federal court order. I have sympathy for her, but we are a nation of laws.”

Matt Young is a student in Covering the Governor's Race, a course in the University of Kentucky School of Journalism and Telecommunications, taught by Journalist In Residence John Winn Miller and Associate Extension Professor Al Cross.

Bevin and Conway clash at Farm Bureau forum

By Anthony Pendleton
University of Kentucky School of Journalism and Telecommunications

Gubernatorial candidates Matt Bevin and Jack Conway attacked each other's character and accused each other of being liars at the Kentucky Farm Bureau "Measure the Candidates" event in Louisville July 23.

The event, labeled as "a forum, not a debate" in a press release, felt more like a debate due to all the back-and forth attacks. The two also disagreed on issues such as Medicaid expansion, and debated other issues such as public-private partnerships and tax breaks.

One of the more important topics was the lack of high-speed Internet service in rural Kentucky. Both candidates agree that it needs to be expanded to those areas. Conway says he supports public-private partnerships, paid for partly by the government and partly by business, in order to bring broadband to those counties.

A public-private partnership was made in December between the state and Macquarie Capital, an Australian financial services group, to achieve that goal. Conway, a Democrat, accused Bevin, a Republican, of being against public-private partnerships.

Bevin denied the accusation, saying he’s a “strong proponent of it.” Bevin added, “We need to be very mindful of the way in which we enter into these and who is actually ultimately gonna pay for them.”

Another big issue was the topic of Medicaid, a federal-state program that funds health coverage for low-income people. According to Conway, “about 350,000 new people” signed up for Medicaid once it was expanded, through additional funding from the Patient Protection and Affordable Care Act, to people with household incomes up to 138 percent of the federal poverty level, bringing the total to 1.2 million Kentuckians.

“I agree too many people are on Medicaid. We need a healthier economy so that we get people off Medicaid,” Conway said. He said Bevin would eliminate the state’s Medicaid expansion on his first day in office, which would be "callous."

Bevin denied the accusation, calling it an “absolute lie.” However, Bevin said at a press conference in February that he would eliminate the expansion: “No question about it. I would reverse that immediately.”

UPDATE: On July 28, at a state Chamber of Commerce forum, Bevin said he wouldn’t end the expansion but would transition to a modified program, perhaps like Indiana’s, which state Senate President Robert Stivers had mentioned as an alternative the day before.

On the issue of "tax expenditures," which are tax credits, deductions, and exemptions, both candidates said they support continuing them for Kentucky’s farmers. Conway again accused Bevin of lying, saying that Bevin had said he would eliminate all tax expenditures.

Bevin denied the accusation, saying he’s not opposed to all of them. “We need to look very closely at them,” he said. ”There’s many of them that, frankly, make good sense. . . but there are many that don’t,” he added.

However, at a forum hosted by the Jessamine County Republican Party in April, Bevin said, “We have gotta get rid of what are called ‘tax expenditures’ in the state of Kentucky. Tax expenditures are Frankfort-speak for ‘loopholes’ that cost the taxpayers $10 billion a year.”

The two threw out numerous attacks. Bevin trivialized Conway’s time as a private-sector attorney, saying Conway only worked “for maybe five or six years total, in your entire life, in between political jobs, when you’ve lost an office and your dad’s hired you for a little while.”

Bevin also told Conway,. “You’ve been very strongly supportive of President Obama time and time and time again.”

They also bragged about their accomplishments. Conway mentioned how he and other attorneys general sued the Environmental Protection Agency over coal regulations, while Bevin brought up his achievements as a small business owner.

In his closing remarks, each candidates said the choice in the election is a question of trust. Bevin said he would govern as a Christian. “I’m running for a civic office, but I am unapologetic about the fact that my Christian faith defines my decision-making process. . . I will bring those Christian principles and that mindset to Frankfort.”

Conway said Kentuckians would "vote for the attorney general who has stood up for them the last seven and a half years," and noted that Bevin has refused to release his tax returns. "Yeah, who do you wanna trust the future to? Someone with a record of accomplishment? Or someone that the McConnell people have called ‘an East Coast con-man’ who is the number-one tax delinquent in his hometown of Connecticut?” Bevin, who ran against U.S. Sen. Mitch McConnell in last year's Republican primary for senator, said later that he never lived in Connecticut.

This was the second public meeting of the two candidates. The first was June 19 at the Kentucky County Judge-Executive Association/Kentucky Magistrates and Commissioners Association joint summer conference in Louisville, but they spoke back to back and had no interchanges.

Independent candidate Drew Curtis, Lexington resident and creator of the news aggregator Fark.com, wasn’t invited to either event or the Chamber forum.

In a press release, Curtis expressed his dissatisfaction with the two candidates. “Bevin is a Tea Party extremist and Conway is trying so hard to get Republican swing voters that he was actually quoting Reagan. If Kentucky voters want a real change in Kentucky, they need to vote for a candidate who looks at facts first, not party politics.”