The Affordable Care Act (ACA) has had some notable success in Kentucky. In 2013, there was an estimated half of a million Kentuckians who did not have health insurance. Kentucky was one of the few states that embraced the ACA and health care exchanges. They created their own health care exchange known as Kynect. The Democratic Governor of Kentucky Steve Beshear embraced the ACA and took advantage of the expansion of Medicaid for the citizens of Kentucky. Over 70,000 of Kentuckians have been able to sign up for Medicaid under the expanded coverage. About 25,000 have signed up for private health insurance through the newly created state exchange system. All told, because of the ACA, nearly one-fifth of Kentuckians who did not, previously, have health insurance, now have health insurance. Perhaps because of the wide-ranging implications, 43% of Kentuckians believe the ACA has had a successful implementation in Kentucky, although the same amount of Kentuckians believe the implementation in Kentucky has been unsuccessful. Despite those seemingly good numbers, 56% of Kentuckians still disapprove of the ACA. This is most likely caused by just 22% of Kentuckians viewing the implementation of the ACA as a success on the national level.
This should not be surprising, I guess. Only 3% of Kentuckians who voted for Mitt Romney in 2012 approve of the ACA, the approval of the ACA comes, almost entirely, from Barack Obama voters. 71% of Obama voters approve of the ACA. But, how do voters view the implementation of the ACA in Kentucky? 22% of Romney voters believe that the implementation in Kentucky is a success. 75% of Obama voters think that the implementation was successful in Kentucky.
The implementation in Kentucky was not perfect. On October 1st, when the exchanges were opened, Kynect's website crashed for six hours. But more servers were added that doubled capacity. Kynect's online capacity increased 80% in December. The call center's availability changed and are now open seven days a week to help with the increased demand. 40% of the new enrollees are under the age of 35 which is seen as a positive sign for the long-term stability of the ACA. Most of these things should be as a fairly successful implementation of such a comprehensive new health care law, especially compared to the unsuccessful rollout at the national level.
But why aren't more people seeing it as a success or have a more positive view of the law? Well, Republican lawmakers have built a fairly successful campaign against the ACA. The attacks will likely continue. Senator Mitch McConnell has continued to be critical of the law and uncharitable to the success of the law. Deriding those who signed up for the law, McConnell claimed that the ACA only has had this level of signups in Kentucky because they are essentially offering a free program in Medicaid. The attacks on those who receive benefits of the government always play well in states, such as Kentucky. Kentucky has a sizable amount of low-income white voters who have a distaste for the federal government.
Kentucky's Junior Senator has announced his own horror story with the ACA and Medicaid, that certainly will play well to a number of Kentucky voters. Unfortunately, Paul's story does not pass the smell test. Paul claimed that his son was told he didn't exist, which is not a message that he would receive. But it's possible, that he had to prove who he was because he may have little or no credit history from the report from Experian. The younger Paul was somehow signed up for Medicaid, which the older Paul claims nobody wanted. As someone who has signed up for Medicaid through MediCal, I can tell you that there is a process where you have to verify that you want to sign up for it and prove that you are eligible for it. People are not signed up, just because they show up at the local welfare store. More likely, the younger Paul incorrectly filled out his form by not stating that he was claimed as a dependent by his father. There are a variety of forms that I had to fill out and many people I had to talk to, in order to be determined eligible for MediCal. I really wish it was as easy as the elder Paul seems to sign up for Medicaid, it would have been much easier for my girlfriend and I to receive health insurance that we both needed.
The most popular politician in the state, Governor Beshear, believes in the positives of the ACA. He has advocated for Democratic politicians to stop running away from the ACA and start running on it. Beshear has offered the idea of looking for a longer view, stating that by 2014, the ACA will be seen as a net positive. This is a view, I also subscribe to. He also opined that Kynect was more popular in Kentuckians' eyes than the ACA. This is certainly possible, almost certainly probable. There's confusion of how the ACA will impact voting in Kentucky, because of Kynect's success.
Beshear's favorability in Kentucky dwarfs that of any other statewide politician, net favorability at +18. Beshear was elected with 56% of the vote in 2011 while Democratic candidates won all but one statewide elections. Despite Beshear's popularity, 44% of Kentuckians want a Republican as the next Governor of Kentucky, while 37% want a Democratic Governor. This is not surprising at all, considering Kentuckians are generally more likely to vote Republican than Democratic. Beshear's favorability among Republicans is 34/46, which is not terrible. His net favorability among Democratic Kentuckians is +41 and among Independents, it is +8. He outperforms Kentuckians' views on the success of the ACA. If Beshear continues on his crusade to advocate for the ACA, his popularity might slide a bit, but the popularity of the ACA will likely increase.