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Before the ink was even dry on the Affordable Care Act back in March 2010, Senate Minority Leader Mitch McConnell (R-KY) announced his Republican Party's response. "I think the slogan will be 'repeal and replace', 'repeal and replace,'" Mr. McConnell said. "No one that I know in the Republican conference in the Senate believes that no action is appropriate."

Four years and 17 million ACA enrollees later, Congressional Republicans admit they still don't have a plan to replace it with. But while Senator McConnell is still calling the Affordable Act "disastrous" and "catastrophic," 370,000 of his constituents who obtained coverage through his state's Kynect health care marketplace would disagree. Making matters worse back home for McConnell, the enrollment rates are highest precisely where Republicans poll best.

That's the word from the Lexington Herald-Leader, which in late February reported "Eastern Kentucky counties lead in enrollment for Affordable Care Act": is the tool Kentuckians have used to sign up for health insurance, but in Estern Kentucky an old fashioned, boots-on-the-ground outreach -- in restaurants, cash advance businesses, and churches -- appears to be key to getting people to use the website...

A Herald-Leader analysis of who has enrolled and where shows that the percentage of previously uninsured who now have health insurance ranges from a high of 67 percent in Perry County to a low of 17 percent in Owen County.

A cluster of nine contiguous counties in southeastern Kentucky -- Perry, Leslie, Letcher, Breathitt, Owsley, Harlan, Wolfe, Lee, Letcher -- and their near neighbor, Whitley, have the highest rates of enrollment.

Many of those counties provided Mitt Romney with 40, 50 and even 60-point margins over Barack Obama in the 2012 election.

Those same counties also have the highest rate of enrollment perhaps because they also have the highest rates of uninsured residents and the worst health care outcomes in Kentucky. And that's saying something in a state America's Health Rankings scored 45th overall, with rankings for smoking (50), diabetes (38) and obesity (42) among the worst in the country. The Commonwealth Fund's State Healthcare Scorecard gave the home of Mitch McConnell and Rand Paul the same grim 45th place. And as it turns out, the Kentucky counties with the very worst health care outcomes are all within hollerin' distance (pun intended) of Rep. Hal Rogers, whose district leads the Blue Grass state in food stamp recipients as a percentage of the population.

Already facing a tough re-election fight, Mitch McConnell is going have to explain to those 370,000 people—one in 12 of all Kentuckians and equal to about 27 percent of the entire 2010 midterm electorate—why he wants to take away their health insurance. And as their numbers continue to grow with late sign-ups for private insurance and ongoing Medicaid enrollment, McConnell's only plan for hundreds of thousands of his "diskynected" constituents is to tell them to go to the emergency room. As he described the plight of the nation's 47 million uninsured five years ago:

"They don't go without health care."

Originally posted to Jon Perr on Wed Apr 02, 2014 at 12:46 PM PDT.

Also republished by My Old Kentucky Kos, Obamacare Saves Lives, and Daily Kos.

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Comment Preferences

  •  Fox Nooz ain't gonna like maybe they'll (10+ / 0-)

    just ignore Karl?

  •  It will be interesting to see him do a Town Hall (15+ / 0-)

    round about June when all these people have received their insurance of Medicaid cards and been to the doctor.

    My guess is it's going to get harder and harder to defend the idea of repealing the ACA, and the fixes (and they are needed) will take us closer to universal single payer over the next decade, or toward the Bismarck model used in Germany.

    Don't forget: before Ronald Reagan was on it, he decried Medicare as a socialist plot. This too shall pass, but we'll have to wait and see if McTurtle gets run out of town on a rail by his own constituents or not. By his newly insured constituents.

    Pope Francis: the Thumb of Christ in the eyes of the Pharisees.

    by commonmass on Wed Apr 02, 2014 at 01:03:06 PM PDT

  •  Kentucky is an interesting data point (13+ / 0-)

    An outsider would think Kentucky would fall solidly into the Republican camp but it really doesn't. Just because big ole' Mitch Mconnell and loud Rand Paul are Republicans, as well as the state Senate, and 5 of the six US House members, one might think Kentucky is much like South Carolina or something similar. It's not.

    The Gov, Lt. Gov and majority of the state House of Representatives are Dems. That's why they have And that's why Kentucky will have better health outcomes in the future.

    Every time my iPhone battery gets down to 47%, I think of Mitt Romney.

    by bobinson on Wed Apr 02, 2014 at 01:11:07 PM PDT

    •  It sure is purple rather than red. (9+ / 0-)

      My state is not dissimilar: we have (for now) a Tea Party gov and one GOP Senator (Susan Collins) but the lege and all of the state constitutional officers are Democrat (we have no lt. governor in Maine).

      Gov. Beshear was smart to expand Medicaid and set up an exchange. Our Governor will not, though a bill is pending in the lege to try to force him to.

      My guess is that McTurtle is, like annieli said, going to get it from all sides, and he'll deserve it.

      Pope Francis: the Thumb of Christ in the eyes of the Pharisees.

      by commonmass on Wed Apr 02, 2014 at 01:19:05 PM PDT

      [ Parent ]

  •  Dis-kynect (3+ / 0-)
    Recommended by:
    Aunt Pat, cosette, Edmund Xu

    Great slogan - Grimes should use it!

    Money should be treated like any other controlled substance; if you can't use it responsibly then you don't get to use it.

    by La Gitane on Wed Apr 02, 2014 at 07:04:49 PM PDT

  •  is gridlock a conservative value when people die (1+ / 0-)
    Recommended by:
    Already facing a tough re-election fight, Mitch McConnell is going have to explain to those 370,000 people—one in 12 of all Kentuckians and equal to about 27 percent of the entire 2010 midterm electorate—why he wants to take away their health insurance. And as their numbers continue to grow with late sign-ups for private insurance and ongoing Medicaid enrollment, McConnell's only plan for hundreds of thousands of his "diskynected" constituents is to tell them to go to the emergency room

    Warning - some snark may be above‽ (-9.50; -7.03)‽ eState4Column5©2013 "I’m not the strapping young Muslim socialist that I used to be" - Barack Obama 04/27/2013 (@eState4Column5).

    by annieli on Wed Apr 02, 2014 at 07:07:32 PM PDT

  •  The Equation? (2+ / 0-)
    Recommended by:
    StillAmused, Tuffie

    If a white Southerner believes one black person will benefit from anything, that Southerner is against it. Even if it really benefits him.

    That's how these assholes get poor people to vote for them.


    by Johnny Wendell on Wed Apr 02, 2014 at 07:10:09 PM PDT

  •  Taking away people's health care (2+ / 0-)

    just seems like such a mean-spirited and greedy thing to do.  Yet they still win elections on it in some places because so many people think "Fuck you, I've got mine!"  It's depressing how so many voters show contempt for people who aren't just like them.

  •  This sad old tired song... (1+ / 0-)
    Recommended by:

    ...the GOP does have a plan to replace the ACA.

    Die quickly.

    We've all been over this before.

    it fitfully blows, half conceals, half discloses

    by Addison on Wed Apr 02, 2014 at 07:14:07 PM PDT

  •  Moochers against welfare (and Mcconnell winning) (2+ / 0-)
    Recommended by:
    Norm in Chicago, Tuffie

    Many of the people who will benefit from Obamacare have strong views against Obama himself, and that will not change overnight if they get health insurance. There are the regions of the Appalachia which are plagued by terrible poverty and awful health outcomes, but guess what, some of them voted 6-1 Romney (race isn't even the factor here as hardly any minorities live there).

    McConnell will probably win. Yes, the polls are showing a tight race with Grimes in the mid-40s. At the same time, a Democratic president is in office, and he is massively unpopular in the state. That should mean that the undecideds shift to McConnell, with or without health insurance.

    •  FFS it's 7 months out. (0+ / 0-)

      If Allison is in the mid 40's I think she's doing fine.
      Get a grip.

      •  That's fine. (1+ / 0-)
        Recommended by:

        But the point is that the undecideds will shift to McConnell as the campaign heats up. This is a deep red state, and it will be incredibly difficult for a Democrat to win when a Democratic president is massively unpopular.

        Jack Conway (D) won 44% in 2010.

        Lunsford (D) won 47% in 2008.

        Mongiardo (D) got 49% in 2004.

        •  This surely seems pessimistic (2+ / 0-)
          Recommended by:
          wu ming, post rational

          Let it also be noted
          Alison Grimes won election in 2011 STATEWIDE in her run for Secretary of State with just under 61% of the vote. She had a "D" after her name on the ballot. SOURCE
          This was also with a "massively unpopular Democratic president" who happens to be black and have a funny middle name and who had NOT delivered 1 single enrolled Kentuckian into health insurance.

          In that same 2011 election let it be noted Steve Beshear won election in 2011 STATEWIDE in his run for governor with over 55% of the vote. He had a "D" after his name on the ballot. Source
          This was also with a "massively unpopular Democratic president" who happens to be black and have a funny middle name and who had NOT delivered 1 single enrolled Kentuckian into health insurance.

          I'm not saying it will be easy for a Democrat to win state wide in the Bluegrass State, but recent history shows it can be done, even with "that kind of person/Democrat" in the White House.

          If Addison (calling him by his given name when he was born in AL, and raised in GA, before he carpetbagged into KY) the McConnell is counting on a surge from undecided voters breaking his way as the campaign heats up, I believe the diarist gives grounds for this surge to be weak at best, or even a wash.



          "God has given wine to gladden the hearts of people." Psalm 104:15

          by WineRev on Wed Apr 02, 2014 at 08:30:35 PM PDT

          [ Parent ]

          •  They were not running for federal office. (0+ / 0-)

            Mitt Romney was elected governor of MA in 2002 with 52% of the vote. In 2012, he won 40% in the state.

            William Weld was similarly elected with 71% of the vote in 1994. Two years later, he won 45% in a Senate standoff against John Kerry.

            Federal and state offices have different dynamics.

    •  Agreed. (1+ / 0-)
      Recommended by:

      And in sheer numbers, 370,000 isn't that large in voting terms.  Half of them won't vote; and 70 percent will still vote R.

      As great as the ACA success so far is, I don't see it as a big election winner for multiple reasons, most of them to due with the idiocracy.

  •  Thank you for this diary (0+ / 0-)

    I have tried recently to see if I can find out if Grimes will actually use the line that "McConnell wants to take away your healthcare" in her campaign.  My biggest fear is that Grimes will actually be one of the Democrats who runs away from the ACA in 2014.  She has only made vague statements that she doesn't like the ACA, but she won't say what about the ACA bothers her or what she would like to change about the law.  

    My fear factor went up when I saw Gov. Beshear on the Chris Hayes show last night.  When asked by Steve Kornaki if he had advised Grimes on how to handle the ACA in KY, he dodged the question; this was a red flag that Grimes is deathly afraid of embracing any element of the ACA.  

  •  I don't know, do they even understand the ACA? (0+ / 0-)

    I'm willing to bet that most of those living in those eastern counties think Kynect has nothing at all to do with Obamacare. And that voting for the repeal of the ACA means blacks in the city lose healthcare while whites in Appalachia keep theirs.

    That fits pretty well with the reality disconnect most GOP voters suffer from.  And "I've got mine, screw you" is standard GOP thinking.

    I'd love to believe GOP voters will wise up. But if they were capable of that, they would have done it by now.

    •  Am hoping we'll see some surveys on how many (1+ / 0-)
      Recommended by:
      Norm in Chicago

      people attribute their coverage to Obamacare. I am guessing that in KY and elsewhere large numbers of those under 26 on parents' coverage, Medicaid expansion recipients and those who enrolled through sites like Kynect have no idea.

  •  Do people in Kentucky know kynect is obamacare? (3+ / 0-)
    Recommended by:
    cosette, gosoxataboy, bobinson

    Early on they did not.  The seemed to like Kynect but hated Obamacare.  Is this still so?  If so, it may be tricky to get people to switch their opinion and their vote, even if it is in their interest.

  •  With apologies to the "blues" trying to (0+ / 0-)

    survive in McConnell/Rand Paul Kentucky... you voted for these assholes (McConnell, repeatedly).

    You're not just fucked... you've fucked yourselves.

    Remember — you're 45th, overall, in health quality.

    Enjoy, dimwits.

    (hack... hack... cough...)

  •  I know that I will probably be quickly called a (1+ / 0-)
    Recommended by:

    troll but I am a life long liberal and a many year reader of this website.I couldn't be happier that these Kentuckians now have health insurance. I would bet that about 70 or 75% if them are on Medicaid. Hospitals and clinics are worried about how to care for these people who have a card that pays for less than half of what it costs to care for them.The people who bought an insurance plan through the exchange will probably still look down on the Medicaid folks and they will be more likely to vote. ACA is a great step forward but it is so far from a solution that we cant even see it from here and the idea that it will help defeat a Senate candidate in Ky seems nothing short of ludicrous......I hope that I am wrong

  •  Those margins ... (1+ / 0-)
    Recommended by:
    Edmund Xu

    My God.  The poorest parts of the state, voting Romney 90-9 in one of them.

    Half of me says what a collection of ignorant willful goobers.

    A quarter says oh those poor people.

    The last quarter says what a collection of poor willfully ignorant racists goobers.

    I also think imagining that new enrollees in these areas will suddenly vote Democratic is a pipedream.  Maybe one or two in ten will.  Not enough.

    The Turtle will survive.

  •  Dems have to run on this hard, without faltering (0+ / 0-)

    I've read too many articles from "boots-on-the-ground" workers who avoid connecting Kynect to Obamacare because of the potential of scaring people away.

    Many people don't know that Kynect exists because of Obamacare. They think Kynect is the state's alternative.

    •  Then Grimes has to run on Kynect (0+ / 0-)

      No need to mention B-Rock the Islamic Shock, the Bringer of All Evil.

      No need to say ACA.  

      Just Kynect.  Make Yertel the health care grinch.  But I don't think she will; I smell another Alex Sink / Rick Scott disaster here.

      •  it's really quite simple (1+ / 0-)
        Recommended by:
        d to the f

        keep it local. dems ran the kynect rollout, and did a bang-up job. people in kentucky will have health care because local dems made it happen. mcconnell is openly trying to take that away from them.

        all grimes has to do is tell them that mitch wants to take their kynect away. obama doesn't have to factor into it at all. whether she will is, as you say, an open question, but it's a pretty simple line to deliver.

  •  It is interesting to note that the success (0+ / 0-)

    in eastern Kentucky is attributed to "old fashioned, boots-on-the-ground outreach".  Hmmm.  Who would do such outreach?  Perhaps, a community organizer.

    I’ve said before, I will always work with anyone who is willing to make this law work even better. But the debate over repealing this law is over. The Affordable Care Act is here to stay. -- President Barack Obama

    by Its the Supreme Court Stupid on Thu Apr 03, 2014 at 03:10:03 AM PDT

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