Former Democratic Gov. Steve Beshear launched a major effort to thwart his Republican successor's healthcare policies, a move he described as an act of conscience that would protect his legacy and health insurance for more than half a million people.
Beshear announced "Save Kentucky Healthcare," a tax-exempt organization that will pay for an online campaign Beshear says will "educate voters about what is happening to health care in Kentucky."
"My conscience won't let me sit idly by as this progress is reversed and health care is stripped from our families," Beshear said in a news release.
As governor, Beshear issued executive orders to expand the state's Medicaid program and establish kynect, a state-operated exchange where people can purchase private health insurance plans with the help of a federal subsidy. More than 500,000 people have gotten health insurance through the programs, with more than 400,000 added to the state's Medicaid rolls.
Beshear's actions were possible because of the federal Affordable Care Act, President Barack Obama's signature healthcare law. But given Obama's immense unpopularity in Kentucky, most state Democratic politicians do not actively defend Beshear's reforms.
Republican Gov. Matt Bevin, who took office in December, opposes both programs because he says they are too expensive. Bevin said he will dismantle kynect by the end of the year, transitioning the 85,000 people who use it to a similar federal program. And he is asking the federal government for permission to charge some of the more than 400,000 people who have insurance through Kentucky's expanded Medicaid program to pay a small premium in order to keep their coverage. If the federal government says no, Bevin has said he will repeal the expansion altogether.
Organizations such as the one Beshear started can raise unlimited amounts of money, but their primary focus has to be on social welfare issues. They can pay for partisan political ads, but only as a secondary activity. In 2014, the social welfare group Kentucky Opportunity Coalition spent $5.4 million on TV ads supporting Republican Sen. Mitch McConnell's re-election, according to an analysis of data by the Center for Public Integrity.
It is unclear how Beshear will pay for his group. He has more than $279,000 left over from the money he raised to pay for his second inauguration in 2011, money that could be donated to a charity. Beshear could use the group to pay for ads to support the Democratic majority in the state House of Representatives, which could then work to block Bevin's agenda in the legislature.
The Kentucky House is the last legislative body in the South still controlled by Democrats. But Republicans need just five seats to take control for the first time since 1920, setting up a contentious and expensive fall election season.
A Gallup-Healthways survey, released last week, showed Kentucky leads the nation in the decline of its uninsured population. The survey, which interviews 500 people a day nearly every day of the year, attributed the decline to Kentucky's expanded Medicaid program and its state-based exchange. A Deloitte study, which Beshear commissioned and paid for with public funds, concluded Kentucky would net a savings of $819 million by 2021 from its expanded Medicaid program. Bevin has rejected the study, saying it is based on unrealistic assumptions.