The 66 percent of Owsley County that gets health coverage through Medicaid now must reconcile itself with the 70 percent that voted for Republican Governor-elect Matt Bevin, who pledged to cut the state's Medicaid program and close the state-run Kynect health insurance exchange.
Lisa Botner, 36, belongs to both camps. A Kynector — a state agent representing Kynect in the field — recently helped Botner sign up for a Wellcare Medicaid card for herself and her 7-year-old son. Without that, Botner said, she couldn't afford the regular doctor's visits and blood tests needed to keep her hyperthyroidism in check.
"If anything changed with our insurance to make it more expensive for us, that would be a big problem," Botner, a community college student, said Friday at the Owsley County Public Library, where she works. "Just with the blood tests, you're talking maybe $1,000 a year without insurance."
Yet two weeks earlier, despite his much-discussed plans to repeal Kynect and toughen eligibility requirements for Medicaid, she voted for Bevin.
"I'm just a die-hard Republican," she said.
Maybe I've been overthinking this. Maybe rural Kentuckians are just goddamn stupid after all. Stupid or racist? We may never know.
Owsley County Judge-Executive Cale Turner, a Democrat, said the election results didn't surprise him. His constituents wanted to express their opposition to Democratic President Barack Obama and what they perceive as "the liberal agenda" on social issues, Turner said.
"To be honest with you, a lot of folks in Owsley County went to the polls and voted against gay marriage and abortion, and as a result, I'm afraid they voted away their health insurance," Turner said. "Which was their right to do, I guess. But it's sad. Many people here signed up with Kynect, and it's helped them, it's been an absolute blessing."
Oh well. They'll just blame Obama for that too, I guess.
The trend seemed to hold across the state. At Transylvania University, political scientist Andrea Malji said she has crunched state data and found a "99 percent confidence level" between the counties' Medicaid enrollment levels and their gubernatorial choices. The larger the Medicaid numbers, the more likely they were to back Bevin, she said. The lower the Medicaid numbers, the more likely they were to favor the Democratic nominee, Attorney General Jack Conway.
So Bevin — who said during the campaign that "the fact that we have one out of four people in this state on Medicaid is unsustainable" — racked up votes in rural, mostly poor counties where far more of the local population than that holds a Medicaid card. This was true even in traditional Democratic Party strongholds, such as Pike and Breathitt counties.
Malji, who is from Pulaski County, where Bevin captured 72 percent of the vote, said she heard people back home denounce "Obamacare" while thousands rushed to sign up with Kynect. They didn't seem to realize that Kynect, Kentucky's response to the federal Patient Protection and Affordable Care Act, is the same thing as Obamacare, she said.
"There's either voter disconnect here, where the people weren't thinking about or weren't aware of Bevin's stance on health care, or these counties just have higher levels of social conservatives who thought it was more important to vote on social issues," Malji said.
Hanlon's Razor again: "Never attribute to malice that which can be adequately explained by stupidity." Or perhaps we should call it Bevin's Razor.
It's going to cut deep here.