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Kentucky confronts the consequences of its decision

Kentucky's governor-elect ran on a platform of gutting the state's health network. Now, even some of the people who voted for him are worried about the effects.
Matt Bevin talks with voters on May 17, 2014 in Fountain Run, Ky. (Photo by Win McNamee/Getty)
Matt Bevin talks with voters on May 17, 2014 in Fountain Run, Ky.
Arguably more than any other state, Kentucky has created an amazing health network. Under Gov. Steve Beshear's (D) leadership, the state's success story has served as a national model for overhauling an ineffective system, replacing it with an effective system that costs less and covers more.
And now it's likely to be torn down on purpose. Gov.-elect Matt Bevin (R) ran on a platform of dismantling Kynect and scrapping Medicaid expansion on the state, despite the fact that it's been a literal life-saver for many families in his adopted home state. Last week, the Republican won his race easily, offering him the opportunity to do exactly what he promised to do: gutting health security for much of Kentucky.
The obvious question, of course, is why voters who stood to lose so much would vote for a gubernatorial candidate intent on deliberately making their lives harder. Republican officials, however, assumed that many of these Kentuckians wouldn't bother to show up on Election Day, and those assumptions largely proved true.
But the Washington Post's Amy Goldstein reported this week from Pike County, Kentucky, where many in the community have come to rely on the state's health network, but where many nevertheless voted for the far-right candidate who's voted to destroy that network.

Dennis Blackburn has this splintered self-interest. The 56-year-old mechanic hasn’t worked in 18 months, since he lost his job at a tire company that supplies a diminishing number of local coal mines.... He has a hereditary liver disorder, numbness in his hands and legs, back pain from folding his 6-foot-1-inch frame into 29-inch mine shafts as a young man, plus an abnormal heart rhythm -- the likely vestige of having been struck by lightning 15 years ago in his tin-roofed farmhouse. Blackburn was making small payments on an MRI he’d gotten at Pikeville Medical Center, the only hospital in a 150-mile radius, when he heard about Big Sandy’s Shelby Valley Clinic. There he met [Mindy] Fleming, who helped him sign up for one of the managed-care Medicaid plans available in Kentucky.

It would appear Blackburn is exactly the kind of Kentuckian who would go out of his way to protect the health benefits he needs -- and yet, Blackburn voted for Bevin last week because the far-right candidate isn't a "career politician."
Now that Election Day has come and gone, Blackburn is facing deeply unfortunate circumstances: the governor he helped elect, who vowed to take away his health security, is probably going to do exactly what he promised to do.
Blackburn told the Washington Post, “[I]t doesn’t look to me as if [Bevin] understands. Without this little bit of help these people are giving me, I could probably die.... It’s not right to not understand something but want to stamp it out.”
My point is not to be unsympathetic. It seems this man is facing serious health issues and I can only hope he, and others like him, receive the assistance they need.
But Matt Bevin did not hide his intentions, and Kentucky will now try to live with the consequences of the voters' decision. The state was a model for the nation; Kentuckians had an opportunity to keep that model in place; and now they've chosen to go in a very different direction.
I should note that the future isn't entirely clear. Bevin ran on an anti-healthcare platform, but he's begun to hedge on some of the details, vowing to come up with a new, as-yet-unstated plan, which will likely cost more and cover less, but which may prevent hundreds of thousands of Kentuckians from losing their health security altogether.
In the meantime, however, a lot of families are worried about just how much damage a Bevin administration will do, and by all appearances, those fears are well grounded.
Postscript: During the campaign, Bevin publicly vowed to publicly release his tax returns after the election. Reporters asked the governor-elect last week if he still intends to do what he said he'd do. "I don't," Bevin said, declining to take additional questions on the subject.
Perhaps this offers hope to those who face losing their health benefits? If Bevin is already breaking his word on some promises, maybe he'll go back on his promise to dismantle the state's health system?