As Obamacare spreads in Kentucky, the state remains conflicted about it and other forms of government help

Even as Obamacare coverage spreads in Kentucky, more widely than in almost any other state, the commonwealth remains conflicted about it and other forms of government aid — creating a political battle that is likely to continue at least until the November 2014 elections, and perhaps into the governor’s race in 2015.

The federal health-reform law and its presidential namesake have been the centerpiece of the U.S. Senate race, with Republican Sen. Mitch McConnell railing against it, primary challenger Matt Bevin saying McConnell hasn’t done enough to dismantle it, and likely Democratic nominee Alison Lundergan Grimes keeping mostly mum as she waits for the political landscape to settle.

McConnell’s Kentucky strategy is part of a national game plan, in which “Republicans are launching a class war with racial undertones—and hurting the poor whites they’ll need to win in 2014,” the respected, non-partisan National Journal said in a cover story in its weekly magazine over the weekend, reported from Louisville by political writer Beth Reinhard. It is titled “Return of the Welfare Queen,” a trope popularized by Ronald Reagan.

Reinhard first looks beyond Kentucky, noting that “25 Republican-led states have — astoundingly” rejected expansion of Medicaid under the law. “To justify this unprecedented rejection of federal relief, these governors and state lawmakers say they just do not believe Washington will keep its promise to pick up the tab. Republicans in Congress are egging them on, denouncing Obamacare’s disastrous launch as proof of the arrogance and folly of big government.”

“The chances of the federal government picking up the tab for the newly eligible Medicaid people long term is zero, which means that the next governor, whoever that may be, is going to be stuck with a huge, huge problem,” McConnell said at a Nov. 12 press conference which he limited to the subject of Obamacare. “The Medicaid expansion that we have already experienced, the Medicaid increases that we’ve already experienced, is the principal reason your kids’ college tuition is going up. . . . So we’re paying for it already.”

National Journal’s coverage has a video, the middle frame of which shows Gov. Steve Beshear and House Minority Leader Nancy Pelosi.

Thus did McConnell conflate recent increases in Medicaid spending with Democratic Gov. Steve Beshear’s expansion of the program to households earning up to 138 percent of the poverty line, from the current 69 percent. That will cost the state nothing for three years, because the federal government will pay the entire cost of care for the newly eligible. In 2017, the state will begin to hep out, hitting the law’s 10 percent cap in 2020.

Reinhard notes that Republican “tirades” also target food-stamp recipients, and “Pitting makers against takers is simply smart, hardball
politics for some Republicans whose “primaries that will be largely decided by a mostly white conservative
base that hates the welfare state. . . . Class warfare can work in a primary. But, ultimately,
Republicans’ scorn for antipoverty programs hinders the party’s efforts
to expand beyond its conservative base.”

Reinhard writes, “This opposition carries an unmistakable undertone of class warfare, a theme easy to exploit in states such as Kentucky, packed with low-income white voters who have a strong distaste for the federal government. To hear the rhetoric coming from Capitol Hill and the campaign trail, Medicaid and food-stamp recipients are a bunch of shiftless freeloaders living high on king crab legs and free health care, all on the backs of hardworking Americans.”