Earlier in the week, the Washington Post highlighted the story of a Kentucky voter who is on expanded Medicaid with a high cost condition and who voted for Matt Bevin who had been running on rolling back Medicaid expansion. Quite a few liberal blogs tsk-tsk poorer Kentucky voters for voting against their direct interest. I think there is a bit more sympathetic and cynical way to look at their decision process.
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….
On Election Day, Blackburn voted for Bevin because he is tired of career politicians and thought a businessman would be more apt to create the jobs that Pike County so needs. Yet when it comes to the state’s expansion of health insurance, “it doesn’t look to me as if he understands,” Blackburn said. “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.”
They know that it is very likely that they are being lied to on major Tea Party policy planks and accept that.
“You have a lot of people who were told that if we got a majority in the House and a majority in the Senate, then life was gonna be great,” she said in an interview Thursday. “What you’re seeing is that people are angry. Where’s the change? Why aren’t there bills on the president’s desk every day for him to veto? They’re saying, ‘Look, what you said would happen didn’t happen, so we’re going to go with anyone who hasn’t been elected.’ ”
The Republican base voters are used to getting lied to on major policy planks. And in the Kentucky case, that looks probable to be true as well. Kynect is highly likely to go away, but it will be replaced by a reasonably well functioning Healthcare.gov with minimal hassle besides people having to create new accounts. Bevin has already started backtracking from his promise to take away Medicaid expansion from Kentucky residents. Instead, he is promising to keep Medicaid expansion but make it slightly worse and slightly more convoluted with a 1115 waiver that has to be approved by the dreaded Obama administration.
If there is an implicit assumption by Republican leaning voters that Democrats are trying to pick off with tangible policy benefits that the Republican candidate is likely lying to the voters the policy wedge disappears. From here, Republican leaning voters can can rationally vote on other, social and cultural grounds. The economic policy ground will be indistinguishable when implementation comes around.
And assuming Bevins does get a 1115 waiver passed, the election was not Medicaid expansion versus no Medicaid expansion but Coal, God, Guns and Gays versus those damn hippies in Louisville looking down at Appalachia.