The Return of the Welfare Queen

Republicans are launching a class war with racial undertones — and hurting the poor whites they’ll need to win in 2014.

National Journal
Beth Reinhard
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Beth Reinhard
Dec. 12, 2013, 4 p.m.

LOUIS­VILLE, Ky. — The wel­fare queen, she has ris­en.

Spawned by Ron­ald Re­agan to turn blue-col­lar whites against the Demo­crat­ic Party, then bur­ied by Bill Clin­ton with a law “end­ing wel­fare as we know it,” she’s been ex­cav­ated un­der the first Afric­an-Amer­ic­an pres­id­ent as Re­pub­lic­ans in­veigh against the costs of health in­sur­ance and food stamps for the poor.

Twenty-five Re­pub­lic­an-led states have — astound­ingly — re­buffed bil­lions of fed­er­al dol­lars un­der Barack Obama’s sig­na­ture health care law to of­fer Medi­caid in­sur­ance to more poor people. To jus­ti­fy this un­pre­ced­en­ted re­jec­tion of fed­er­al re­lief, these gov­ernors and state law­makers say they just do not be­lieve Wash­ing­ton will keep its prom­ise to pick up the tab. Re­pub­lic­ans in Con­gress are egging them on, de­noun­cing Obama­care’s dis­astrous launch as proof of the ar­rog­ance and folly of big gov­ern­ment.

But all of this op­pos­i­tion car­ries an un­mis­tak­able un­der­tone of class war­fare, a theme easy to ex­ploit in states such as Ken­tucky, packed with low-in­come white voters who have a strong dis­taste for the fed­er­al gov­ern­ment. To hear the rhet­or­ic com­ing from Cap­it­ol Hill and the cam­paign trail, Medi­caid and food-stamp re­cip­i­ents are a bunch of shift­less free­load­ers liv­ing high on king crab legs and free health care, all on the backs of hard­work­ing Amer­ic­ans. 

Medi­caid ex­pan­sion is “the prin­cip­al reas­on your kids’ col­lege tu­ition is go­ing up,” Sen. Mitch Mc­Con­nell of Ken­tucky charged at a press con­fer­ence here.

New Medi­caid re­cip­i­ents “have no per­son­al re­spons­ib­il­ity for their health,” said state Sen. Joni Ernst of Iowa, a Re­pub­lic­an run­ning for the U.S. Sen­ate, in a memo from the state cap­it­al.

The myth­ic­al wel­fare queen was ac­cused of driv­ing a Ca­dillac and pump­ing out ba­bies to keep the gov­ern­ment checks com­ing.

And in Louisi­ana, Sen­ate can­did­ate and Re­pub­lic­an Rep. Bill Cas­sidy hy­po­thes­ized about a single wo­man forced to pay high premi­ums un­der Obama­care who thinks her neigh­bor could make more money. “But he would rather work few­er hours or work for cash or, per­haps, live out of wed­lock so that he and his girl­friend both qual­i­fy for the tax­pay­er-provided free in­sur­ance,” Cas­sidy wrote in a news­pa­per column.

The tirades don’t stop at Medi­caid.

The rhet­or­ic about re­ward­ing in­dol­ence is also per­vad­ing the de­bate over the farm bill, passed with sub­sidies for big ag­ri­cul­ture — but no food-stamp fund­ing for the first time in four dec­ades. Rep. Louie Gohmert of Texas said he’s heard “so many times” from con­stitu­ents stand­ing in line at the gro­cery store be­hind a shop­per buy­ing king crab legs. “Then he sees the food-stamp card pulled out and provided. He looks at the king crab legs and looks at his ground meat and real­izes be­cause he does pay in­come tax, he doesn’t get more back than he pays in. He is ac­tu­ally help­ing to pay for the king crab legs when he can’t pay for them for him­self.”

The myth­ic­al wel­fare queen was ac­cused of driv­ing a Ca­dillac and pump­ing out ba­bies to keep the gov­ern­ment checks com­ing; un­der the “food-stamp pres­id­ent,” as Re­pub­lic­an Newt Gin­grich dubbed Obama, she (or he) nets free health care and ex­pens­ive shell­fish.

“News­casts tell stor­ies of young surfers who aren’t work­ing but cash their food stamps in for lob­ster,” wrote Ma­jor­ity Whip Kev­in Mc­Carthy in a memo be­fore the House vote, re­fer­ring to a Cali­for­nia beach bum who flaunted his food-stamp-fin­anced life­style on Fox News. “Cost­ing tax­pay­ers $80 bil­lion a year, middle-class fam­il­ies strug­gling to make ends meet them­selves foot the bill for a pro­gram that has gone well bey­ond a safety net for chil­dren, seni­ors, and the dis­abled.”

The facts defy the ste­reo­types. The largest group of food-stamp re­cip­i­ents is white; 45 per­cent of all be­ne­fi­ciar­ies are chil­dren; and most people eli­gible for Medi­caid are fam­il­ies with chil­dren in which at least one per­son in the house­hold has a job. But pit­ting makers against takers is simply smart, hard­ball polit­ics for some Re­pub­lic­ans. Mc­Con­nell and Ernst both face GOP primar­ies that will be largely de­cided by a mostly white con­ser­vat­ive base that hates the wel­fare state. 


Same with the po­ten­tial Re­pub­lic­an pres­id­en­tial con­tenders in 2016. Gov­ernors who turned down the Medi­caid money, such as Bobby Jin­dal of Louisi­ana, Rick Perry of Texas, and Scott Walk­er of Wis­con­sin, have a leg up in GOP primar­ies over pos­sible rivals who ac­cep­ted the fed­er­al aid, such as Chris Christie of New Jer­sey and John Kasich of Ohio.

Class war­fare can work in a primary. But, ul­ti­mately, Re­pub­lic­ans’ scorn for an­ti­poverty pro­grams hinders the party’s ef­forts to ex­pand bey­ond its con­ser­vat­ive base. Wo­men and minor­it­ies dis­pro­por­tion­ately make up the “47 per­cent” that Mitt Rom­ney no­tori­ously de­rided for de­pend­ing on gov­ern­ment as­sist­ance. Even more sig­ni­fic­ant, block­ing Medi­caid ex­pan­sion and food stamps hurts the blue-col­lar whites the GOP in­creas­ingly de­pends on at the polls, crack­ing the door open to Demo­crats to com­pete for their votes. (Fact: When you sign up for Obama­care, you can also re­gister to vote.)

“Most people be­lieve the banks, the mort­gage com­pan­ies, Wall Street, and the in­sur­ance com­pan­ies are screw­ing them over, and if a year from now they think the Demo­crat­ic Party has their back, that could change the con­ver­sa­tion,” said Tom Per­ri­ello, pres­id­ent of the lib­er­al Cen­ter for Amer­ic­an Pro­gress Ac­tion Fund. “If we can get past all of the mis­in­form­a­tion and the race polit­ics, we may have a chance.”

That’s the Re­pub­lic­an Party’s worst fear: The Obama ad­min­is­tra­tion’s lar­gesse will reach a broad­er audi­ence and take hold as a coveted en­ti­tle­ment. These are the “gifts” to young people and minor­it­ies that Rom­ney blamed for his de­feat, and that the next Re­pub­lic­an nom­in­ee could come to fear.

DENY­ING DE­PEND­ENCY

To un­der­stand Ken­tucky’s con­flic­ted re­la­tion­ship with the fed­er­al gov­ern­ment, 50 years after host­ing Pres­id­ent John­son’s launch of the “War on Poverty,” is to meet Terry Rupe. The 63-year-old wid­ower can’t re­mem­ber the last time he voted for a Demo­crat, and he’s got noth­ing nice to say about Pres­id­ent Obama. He’s also nev­er had health in­sur­ance, al­though he star­ted work­ing at age 9. Since his wife’s death four years ago, he’s been tak­ing care of their 40-year-old, severely dis­abled daugh­ter full time. She gets Medi­caid and Medi­care as­sist­ance.

{{ BIZOBJ (video: 4625) }}

“I don’t have any use for the fed­er­al gov­ern­ment,” Rupe said, even though his house­hold’s $13,000 yearly in­come comes ex­clus­ively from Wash­ing­ton. “It’s a bunch of li­ars, crooks, and thieves, and they’ve nev­er done any­thing for me. I’m not un­grate­ful, but I don’t have much faith in this health care law. Do I think it’s go­ing to work? No. Do I think it’s go­ing to bank­rupt the coun­try? Yes.”

Rupe sounds like he could be stand­ing on a soap­box at a tea-party rally, but he hap­pens to be sit­ting in a back room at the Fam­ily Health Cen­ters’ largest clin­ic in Louis­ville — sign­ing up for Medi­caid. Rupe, who is white, in­sists that il­leg­al im­mig­rants from Mex­ico and Africa get more gov­ern­ment as­sist­ance than he does. (Il­leg­al im­mig­rants do not, in fact, qual­i­fy for Medi­caid or cov­er­age un­der the Af­ford­able Care Act.)

He’s not alone in think­ing this way. A ma­jor­ity of whites be­lieve the health care law will make things worse for them and their fam­il­ies, ac­cord­ing to a United Tech­no­lo­gies/Na­tion­al Journ­al Con­gres­sion­al Con­nec­tion Poll.

“Pres­id­ent Obama’s idea is tak­ing from the work­ing people to give to the people who won’t take care of them­selves. It’s re­dis­tri­bu­tion of wealth,” Rupe said. “I’ve al­ways taken care of my­self. You got these young girls who go out and get preg­nant and then they get $1,500 a month for hav­ing a kid, so they have two.”

On the oth­er side of town, Ad­ele An­der­son was sign­ing up for Medi­caid at a pub­lic lib­rary. The white, middle-aged wo­man makes $10 an hour as a child-care pro­vider; she also gets $86 a month in food stamps. She was un­aware that Re­pub­lic­ans voted to cut $40 bil­lion over 10 years from what’s called the Sup­ple­ment­al Nu­tri­tion As­sist­ance Pro­gram. “Demo­crats are too lib­er­al,” An­der­son said. “They just want to give handouts.”

The dis­dain she and Rupe show to­ward liv­ing on the gov­ern­ment dole at the very mo­ment they are do­ing just that is typ­ic­al in a state that dis­trusts Wash­ing­ton as much as it needs fed­er­al help.

Ken­tucky’s anti­es­tab­lish­ment fer­vor dates back at least to the Civil War. While stick­ing with the Uni­on, the state sym­path­ized, cul­tur­ally and eco­nom­ic­ally, with its South­ern neigh­bors and was the second-to-last state to rat­i­fy the 13th Amend­ment ab­ol­ish­ing slavery. Since the civil-rights move­ment, Ken­tucky has backed only Demo­crat­ic pres­id­en­tial nom­in­ees who were fel­low South­ern­ers — Jimmy Carter in 1976 and Bill Clin­ton in 1992 and 1996.

In late May of 2008, even as Obama was on the verge of clinch­ing the nom­in­a­tion, Ken­tucky Demo­crats over­whelm­ingly re­nounced the Afric­an-Amer­ic­an by way of Hawaii, In­done­sia, and Chica­go in fa­vor of Hil­lary Rod­ham Clin­ton. He lost the state by double di­gits to John Mc­Cain in 2008 and Rom­ney in 2012.

But even deep­er than Ken­tucky’s aver­sion to Obama is its des­per­a­tion for health care. Nearly one of six Ken­tucki­ans is un­in­sured. The state rates first or near the top na­tion­ally in stat­ist­ics on smoking, can­cer deaths, obesity, heart dis­ease, and dia­betes. In con­trast to the slow and tu­mul­tu­ous rol­lout of the fed­er­al web­site un­der the new health care law, en­roll­ment in the state-run ex­change and Medi­caid is sur­ging in the Bluegrass State.

Just don’t call it Obama­care. In Ken­tucky, a mar­ket­ing cam­paign has clev­erly branded it “kynect.”

“It really is stra­tegic,” said Bar­bara Gor­don, dir­ect­or of the state’s di­vi­sion of so­cial ser­vices, which is help­ing to over­see en­roll­ment. “We’ve had events where people say, ‘This sounds a whole lot bet­ter than that Obama­care!’ We train our people not to use that word, and it’s ef­fect­ive in break­ing down that wall against Pres­id­ent Obama.”

RED-STATE POVERTY

They for­got to tell that, however, to the staffer at the Cali­for­nia Square Apart­ments who an­nounced one re­cent morn­ing over the in­ter­com: “At­ten­tion res­id­ents. The present­a­tion for Obama­care will be­gin at 11:25.”

Few­er than a dozen people straggled in­to the lounge of the pre­dom­in­antly black af­ford­able-hous­ing com­plex, des­pite the prom­ise of a raffle. The prizes: a roll of pa­per tow­els, a jug of laun­dry de­ter­gent, and a bag of potato chips.

De­tra Moore, 43, didn’t need to be coaxed. She hasn’t got­ten reg­u­lar treat­ment for her asthma since March 2012, when the clin­ic where she worked as a med­ic­al as­sist­ant closed. She’s gone to the emer­gency room five times since then. “Thank you, Je­sus!” she cried after a state em­ploy­ee run­ning the num­bers on a laptop com­puter said she qual­i­fied for Medi­caid.

She’s been turned down be­fore. Obama­care in­creased the pool of eli­gible re­cip­i­ents from those at 100 per­cent to those at 138 per­cent of the fed­er­al poverty level. The new guidelines mean a per­son mak­ing less than $15,857 or a fam­ily of four earn­ing less than $32,500 can get Medi­caid. By and large, these are house­holds scrap­ing by on a min­im­um-wage job or two. The Kais­er Com­mis­sion on Medi­caid and the Un­in­sured cal­cu­lated that about 62 per­cent of the house­holds eli­gible for Medi­caid in­clude at least one work­er. Many of those sign­ing up for what Mc­Con­nell has re­peatedly dis­missed as “free health care” have paid taxes and con­trib­uted to the fed­er­al gov­ern­ment’s cof­fers.

Des­pite ample and ob­ject­ive stat­ist­ics show­ing that most wel­fare re­cip­i­ents are white fam­il­ies with chil­dren, the ste­reo­type of the wel­fare queen per­sists. Per­son­i­fy­ing it, Moore is a black wo­man who got preg­nant as a teen­ager. But then she fin­ished high school and got her as­so­ci­ate’s de­gree. She can’t af­ford a car, let alone a Ca­dillac, and she had to let a chance at a job pass by be­cause she couldn’t get there by pub­lic bus. To stay busy, she vo­lun­teers five days a week at Dare to Care, a food pantry.

“You’re talk­ing about the work­ing poor, and it’s a pretty sym­path­et­ic group,” said Per­ri­ello of the Cen­ter for Amer­ic­an Pro­gress Ac­tion Fund. “They’re not wel­fare queens driv­ing Ca­dillacs. These are people try­ing to pay the bills and keep the lights on.”

Yet Ken­tucky’s seni­or sen­at­or has put the health care law and its down-on-their-luck be­ne­fi­ciar­ies at the cen­ter of his reelec­tion cam­paign, vow­ing to elim­in­ate it “root and branch.” He and oth­er Re­pub­lic­ans are keen on cap­it­al­iz­ing on the Obama ad­min­is­tra­tion’s em­bar­rass­ing rol­lout of the fed­er­al health ex­change, so mired in tech­nic­al prob­lems that only 20 per­cent of the people ex­pec­ted to sign up for private in­sur­ance in the first month ac­tu­ally did. But while Health Care.gov is flounder­ing, Ken­tucky’s pro­gram is be­ing hailed as a mod­el. In a state ranked the 44th health­i­est in the coun­try, more than 72,000 people, most of whom are Medi­caid eli­gible, have en­rolled so far.

Still, Obama­care is so polit­ic­ally tox­ic that Mc­Con­nell con­tin­ues to flog the law that ap­pears to be work­ing in his own state. What’s more, he’s dis­qual­i­fy­ing its fledgling suc­cess by in­cit­ing class war­fare.

“The most suc­cess­ful part of it has been, if you’re talk­ing about get­ting people signed up, is people who are sign­ing up for something that’s free. That doesn’t sur­prise me very much,” Mc­Con­nell said at a press con­fer­ence last month. “We should have star­ted with the as­sump­tion, No. 1, that we have the finest health care in the world. No. 2, we have 85 per­cent of Amer­ic­ans with health in­sur­ance. How do you work on the 15 per­cent without des­troy­ing it for the 85 per­cent?”

Asked to re­spond to Mc­Con­nell’s re­marks, the cam­paign for his Demo­crat­ic op­pon­ent, Al­is­on Lun­der­gan Grimes, sent a writ­ten state­ment. “It’s un­for­tu­nate that Sen­at­or Mc­Con­nell chooses to look down on Ken­tucki­ans who need health care, in­stead of work­ing to fix the prob­lems,” wrote spokes­wo­man Charly Norton. “He ought to help those Ken­tucki­ans, not at­tack them.”

BLUE-COL­LAR PICKUP?

Ken­tucky’s gov­ernor, Steve Be­s­hear, is the only one in the South to have em­braced Medi­caid ex­pan­sion and set up a state-based health in­sur­ance ex­change. And for that, he’s be­ing hailed as a Demo­crat­ic lead­er who is pav­ing pop­u­list in­roads for his party among blue-col­lar whites. If enough of those so-called Re­agan Demo­crats be­ne­fit from Obama­care, the think­ing goes, they may start to view the Demo­crat­ic Party as a friend to work­ing people in­stead of as an en­a­bler of wel­fare cheats.

“Ken­tucky is the 47 per­cent,” said the state’s former treas­urer, Jonath­an Miller, a Demo­crat who served in Be­s­hear’s ad­min­is­tra­tion after un­suc­cess­fully run­ning against him for gov­ernor in 2007. “It’s been a very hy­po­crit­ic­al elect­or­ate that wants those en­ti­tle­ment pro­grams to pro­tect their fam­il­ies but at the same time doesn’t want big gov­ern­ment or elites in Wash­ing­ton in­ter­fer­ing in their lives. But I think Be­s­hear’s pas­sion for this is­sue might start turn­ing the tide.”

It’s a tough sell, however, to those who feel gov­ern­ment has nev­er done any­thing but screw them over. Rupe was dis­gus­ted when a fol­low-up let­ter about his Medi­caid ap­plic­a­tion in­cluded a voter-re­gis­tra­tion form. “I guess that’s the really im­port­ant thing on their mind,” he grumbled.

“It’s been a very hy­po­crit­ic­al elect­or­ate that wants those en­ti­tle­ment pro­grams to pro­tect their fam­il­ies but at the same time doesn’t want big gov­ern­ment or elites in Wash­ing­ton in­ter­fer­ing in their lives.”

In fact, the polit­ics of Obama­care are so volat­ile that Lun­der­gan Grimes re­fuses to say ex­pli­citly wheth­er she sup­ports Medi­caid ex­pan­sion in Ken­tucky. As a Demo­crat try­ing to nav­ig­ate this Obama-wary red state, she has cau­tiously cast her­self as more crit­ic than cheer­lead­er for the health care law. “As Al­is­on has said for months, there are parts of the Af­ford­able Care Act that need to be fixed, and the law is far from per­fect,” Norton said. When ad­dress­ing the struggles of low-in­come Ken­tucki­ans, Lun­der­gan Grimes prefers to fo­cus on the more pop­u­lar cause of rais­ing the min­im­um wage.

In­deed, the com­ing de­bate in Con­gress over the min­im­um wage will give Demo­crats an­oth­er chance to try to win over the blue-col­lar whites who have long viewed them as sops for a wel­fare state be­hold­en to minor­it­ies. If Lun­der­gan Grimes, for ex­ample, can peel some of those voters away from Mc­Con­nell, she has a chance to oust one of the most power­ful Re­pub­lic­ans in the coun­try.

Re­pub­lic­ans don’t have to trash the safety net to win elec­tions. Con­gres­sion­al can­did­ate Vance Mc­Al­lister threw his sup­port be­hind Medi­caid ex­pan­sion and trounced an Obama­care-bash­ing fel­low Re­pub­lic­an in a spe­cial elec­tion last month in Louisi­ana. Even Demo­crat­ic Sen. Mary Landrieu hailed Mc­Al­lister’s vic­tory, say­ing it proves that op­pos­i­tion to ex­pand­ing Medi­caid is a “polit­ic­al loser.”

“It’s un­fair to say Re­pub­lic­ans don’t care about poverty, but they should be held ac­count­able for com­ing up with pro­pos­als,” said Douglas Holtz-Eakin, an eco­nom­ic ad­viser to 2008 Re­pub­lic­an pres­id­en­tial nom­in­ee John Mc­Cain and the pres­id­ent of the Amer­ic­an Ac­tion For­um, a cen­ter-right think tank. “I ex­pect they will have to if they want to be seen as solu­tion-ori­ented prob­lem solv­ers who win elec­tions in­stead of just op­pos­ing Obama’s agenda.”

If Louisi­ana hadn’t re­jec­ted the ad­di­tion­al Medi­caid money avail­able un­der Obama­care, about 400,000 poor people would be eli­gible for gov­ern­ment-fun­ded health in­sur­ance. Across the coun­try, an es­tim­ated 5.4 mil­lion people would have qual­i­fied for Medi­caid cov­er­age, but they live in Re­pub­lic­an-run states that closed the door to them.

Be­cause Ken­tucky did take the cash, 308,000 poor people are now eli­gible for health in­sur­ance in the Bluegrass State. Over the 11 months lead­ing up to the elec­tion, Mc­Con­nell and oth­er Re­pub­lic­ans op­pos­ing Medi­caid ex­pan­sion will be hard-pressed to ex­plain why they want to take health in­sur­ance away from needy con­stitu­ents who be­long to their own party.

COR­REC­TION: An earli­er ver­sion of this story in­cor­rectly said that Rep. Bill Cas­sidy of Louisi­ana, who is run­ning for the Sen­ate, faces a primary. In Louisi­ana, all of the Sen­ate can­did­ates, Demo­crats and Re­pub­lic­ans, will be on the same bal­lot in Novem­ber.

DENYING DEPENDENCY

To un­der­stand Ken­tucky’s con­flic­ted re­la­tion­ship with the fed­er­al gov­ern­ment, 50 years after host­ing Pres­id­ent John­son’s launch of the “War on Poverty,” is to meet Terry Rupe. The 63-year-old wid­ower can’t re­mem­ber the last time he voted for a Demo­crat, and he’s got noth­ing nice to say about Pres­id­ent Obama. He’s also nev­er had health in­sur­ance, al­though he star­ted work­ing at age 9. Since his wife’s death four years ago, he’s been tak­ing care of their 40-year-old, severely dis­abled daugh­ter full time. She gets Medi­caid and Medi­care as­sist­ance.

{{ BIZOBJ (video: 4625) }}

“I don’t have any use for the fed­er­al gov­ern­ment,” Rupe said, even though his house­hold’s $13,000 yearly in­come comes ex­clus­ively from Wash­ing­ton. “It’s a bunch of li­ars, crooks, and thieves, and they’ve nev­er done any­thing for me. I’m not un­grate­ful, but I don’t have much faith in this health care law. Do I think it’s go­ing to work? No. Do I think it’s go­ing to bank­rupt the coun­try? Yes.”

Rupe sounds like he could be stand­ing on a soap­box at a tea-party rally, but he hap­pens to be sit­ting in a back room at the Fam­ily Health Cen­ters’ largest clin­ic in Louis­ville — sign­ing up for Medi­caid. Rupe, who is white, in­sists that il­leg­al im­mig­rants from Mex­ico and Africa get more gov­ern­ment as­sist­ance than he does. (Il­leg­al im­mig­rants do not, in fact, qual­i­fy for Medi­caid or cov­er­age un­der the Af­ford­able Care Act.)

He’s not alone in think­ing this way. A ma­jor­ity of whites be­lieve the health care law will make things worse for them and their fam­il­ies, ac­cord­ing to a United Tech­no­lo­gies/Na­tion­al Journ­al Con­gres­sion­al Con­nec­tion Poll.

“Pres­id­ent Obama’s idea is tak­ing from the work­ing people to give to the people who won’t take care of them­selves. It’s re­dis­tri­bu­tion of wealth,” Rupe said. “I’ve al­ways taken care of my­self. You got these young girls who go out and get preg­nant and then they get $1,500 a month for hav­ing a kid, so they have two.”

On the oth­er side of town, Ad­ele An­der­son was sign­ing up for Medi­caid at a pub­lic lib­rary. The white, middle-aged wo­man makes $10 an hour as a child-care pro­vider; she also gets $86 a month in food stamps. She was un­aware that Re­pub­lic­ans voted to cut $40 bil­lion over 10 years from what’s called the Sup­ple­ment­al Nu­tri­tion As­sist­ance Pro­gram. “Demo­crats are too lib­er­al,” An­der­son said. “They just want to give handouts.”

The dis­dain she and Rupe show to­ward liv­ing on the gov­ern­ment dole at the very mo­ment they are do­ing just that is typ­ic­al in a state that dis­trusts Wash­ing­ton as much as it needs fed­er­al help.

Ken­tucky’s anti­es­tab­lish­ment fer­vor dates back at least to the Civil War. While stick­ing with the Uni­on, the state sym­path­ized, cul­tur­ally and eco­nom­ic­ally, with its South­ern neigh­bors and was the second-to-last state to rat­i­fy the 13th Amend­ment ab­ol­ish­ing slavery. Since the civil-rights move­ment, Ken­tucky has backed only Demo­crat­ic pres­id­en­tial nom­in­ees who were fel­low South­ern­ers — Jimmy Carter in 1976 and Bill Clin­ton in 1992 and 1996.

In late May of 2008, even as Obama was on the verge of clinch­ing the nom­in­a­tion, Ken­tucky Demo­crats over­whelm­ingly re­nounced the Afric­an-Amer­ic­an by way of Hawaii, In­done­sia, and Chica­go in fa­vor of Hil­lary Rod­ham Clin­ton. He lost the state by double di­gits to John Mc­Cain in 2008 and Rom­ney in 2012.

But even deep­er than Ken­tucky’s aver­sion to Obama is its des­per­a­tion for health care. Nearly one of six Ken­tucki­ans is un­in­sured. The state rates first or near the top na­tion­ally in stat­ist­ics on smoking, can­cer deaths, obesity, heart dis­ease, and dia­betes. In con­trast to the slow and tu­mul­tu­ous rol­lout of the fed­er­al web­site un­der the new health care law, en­roll­ment in the state-run ex­change and Medi­caid is sur­ging in the Bluegrass State.

Just don’t call it Obama­care. In Ken­tucky, a mar­ket­ing cam­paign has clev­erly branded it “kynect.”

“It really is stra­tegic,” said Bar­bara Gor­don, dir­ect­or of the state’s di­vi­sion of so­cial ser­vices, which is help­ing to over­see en­roll­ment. “We’ve had events where people say, ‘This sounds a whole lot bet­ter than that Obama­care!’ We train our people not to use that word, and it’s ef­fect­ive in break­ing down that wall against Pres­id­ent Obama.”

RED-STATE POVERTY

They for­got to tell that, however, to the staffer at the Cali­for­nia Square Apart­ments who an­nounced one re­cent morn­ing over the in­ter­com: “At­ten­tion res­id­ents. The present­a­tion for Obama­care will be­gin at 11:25.”

Few­er than a dozen people straggled in­to the lounge of the pre­dom­in­antly black af­ford­able-hous­ing com­plex, des­pite the prom­ise of a raffle. The prizes: a roll of pa­per tow­els, a jug of laun­dry de­ter­gent, and a bag of potato chips.

De­tra Moore, 43, didn’t need to be coaxed. She hasn’t got­ten reg­u­lar treat­ment for her asthma since March 2012, when the clin­ic where she worked as a med­ic­al as­sist­ant closed. She’s gone to the emer­gency room five times since then. “Thank you, Je­sus!” she cried after a state em­ploy­ee run­ning the num­bers on a laptop com­puter said she qual­i­fied for Medi­caid.

She’s been turned down be­fore. Obama­care in­creased the pool of eli­gible re­cip­i­ents from those at 100 per­cent to those at 138 per­cent of the fed­er­al poverty level. The new guidelines mean a per­son mak­ing less than $15,857 or a fam­ily of four earn­ing less than $32,500 can get Medi­caid. By and large, these are house­holds scrap­ing by on a min­im­um-wage job or two. The Kais­er Com­mis­sion on Medi­caid and the Un­in­sured cal­cu­lated that about 62 per­cent of the house­holds eli­gible for Medi­caid in­clude at least one work­er. Many of those sign­ing up for what Mc­Con­nell has re­peatedly dis­missed as “free health care” have paid taxes and con­trib­uted to the fed­er­al gov­ern­ment’s cof­fers.

Des­pite ample and ob­ject­ive stat­ist­ics show­ing that most wel­fare re­cip­i­ents are white fam­il­ies with chil­dren, the ste­reo­type of the wel­fare queen per­sists. Per­son­i­fy­ing it, Moore is a black wo­man who got preg­nant as a teen­ager. But then she fin­ished high school and got her as­so­ci­ate’s de­gree. She can’t af­ford a car, let alone a Ca­dillac, and she had to let a chance at a job pass by be­cause she couldn’t get there by pub­lic bus. To stay busy, she vo­lun­teers five days a week at Dare to Care, a food pantry.

“You’re talk­ing about the work­ing poor, and it’s a pretty sym­path­et­ic group,” said Per­ri­ello of the Cen­ter for Amer­ic­an Pro­gress Ac­tion Fund. “They’re not wel­fare queens driv­ing Ca­dillacs. These are people try­ing to pay the bills and keep the lights on.”

Yet Ken­tucky’s seni­or sen­at­or has put the health care law and its down-on-their-luck be­ne­fi­ciar­ies at the cen­ter of his reelec­tion cam­paign, vow­ing to elim­in­ate it “root and branch.” He and oth­er Re­pub­lic­ans are keen on cap­it­al­iz­ing on the Obama ad­min­is­tra­tion’s em­bar­rass­ing rol­lout of the fed­er­al health ex­change, so mired in tech­nic­al prob­lems that only 20 per­cent of the people ex­pec­ted to sign up for private in­sur­ance in the first month ac­tu­ally did. But while Health Care.gov is flounder­ing, Ken­tucky’s pro­gram is be­ing hailed as a mod­el. In a state ranked the 44th health­i­est in the coun­try, more than 72,000 people, most of whom are Medi­caid eli­gible, have en­rolled so far.

Still, Obama­care is so polit­ic­ally tox­ic that Mc­Con­nell con­tin­ues to flog the law that ap­pears to be work­ing in his own state. What’s more, he’s dis­qual­i­fy­ing its fledgling suc­cess by in­cit­ing class war­fare.

“The most suc­cess­ful part of it has been, if you’re talk­ing about get­ting people signed up, is people who are sign­ing up for something that’s free. That doesn’t sur­prise me very much,” Mc­Con­nell said at a press con­fer­ence last month. “We should have star­ted with the as­sump­tion, No. 1, that we have the finest health care in the world. No. 2, we have 85 per­cent of Amer­ic­ans with health in­sur­ance. How do you work on the 15 per­cent without des­troy­ing it for the 85 per­cent?”

Asked to re­spond to Mc­Con­nell’s re­marks, the cam­paign for his Demo­crat­ic op­pon­ent, Al­is­on Lun­der­gan Grimes, sent a writ­ten state­ment. “It’s un­for­tu­nate that Sen­at­or Mc­Con­nell chooses to look down on Ken­tucki­ans who need health care, in­stead of work­ing to fix the prob­lems,” wrote spokes­wo­man Charly Norton. “He ought to help those Ken­tucki­ans, not at­tack them.”

BLUE-COLLAR PICKUP?

Ken­tucky’s gov­ernor, Steve Be­s­hear, is the only one in the South to have em­braced Medi­caid ex­pan­sion and set up a state-based health in­sur­ance ex­change. And for that, he’s be­ing hailed as a Demo­crat­ic lead­er who is pav­ing pop­u­list in­roads for his party among blue-col­lar whites. If enough of those so-called Re­agan Demo­crats be­ne­fit from Obama­care, the think­ing goes, they may start to view the Demo­crat­ic Party as a friend to work­ing people in­stead of as an en­a­bler of wel­fare cheats.

“Ken­tucky is the 47 per­cent,” said the state’s former treas­urer, Jonath­an Miller, a Demo­crat who served in Be­s­hear’s ad­min­is­tra­tion after un­suc­cess­fully run­ning against him for gov­ernor in 2007. “It’s been a very hy­po­crit­ic­al elect­or­ate that wants those en­ti­tle­ment pro­grams to pro­tect their fam­il­ies but at the same time doesn’t want big gov­ern­ment or elites in Wash­ing­ton in­ter­fer­ing in their lives. But I think Be­s­hear’s pas­sion for this is­sue might start turn­ing the tide.”

It’s a tough sell, however, to those who feel gov­ern­ment has nev­er done any­thing but screw them over. Rupe was dis­gus­ted when a fol­low-up let­ter about his Medi­caid ap­plic­a­tion in­cluded a voter-re­gis­tra­tion form. “I guess that’s the really im­port­ant thing on their mind,” he grumbled.

“It’s been a very hy­po­crit­ic­al elect­or­ate that wants those en­ti­tle­ment pro­grams to pro­tect their fam­il­ies but at the same time doesn’t want big gov­ern­ment or elites in Wash­ing­ton in­ter­fer­ing in their lives.”

In fact, the polit­ics of Obama­care are so volat­ile that Lun­der­gan Grimes re­fuses to say ex­pli­citly wheth­er she sup­ports Medi­caid ex­pan­sion in Ken­tucky. As a Demo­crat try­ing to nav­ig­ate this Obama-wary red state, she has cau­tiously cast her­self as more crit­ic than cheer­lead­er for the health care law. “As Al­is­on has said for months, there are parts of the Af­ford­able Care Act that need to be fixed, and the law is far from per­fect,” Norton said. When ad­dress­ing the struggles of low-in­come Ken­tucki­ans, Lun­der­gan Grimes prefers to fo­cus on the more pop­u­lar cause of rais­ing the min­im­um wage.

In­deed, the com­ing de­bate in Con­gress over the min­im­um wage will give Demo­crats an­oth­er chance to try to win over the blue-col­lar whites who have long viewed them as sops for a wel­fare state be­hold­en to minor­it­ies. If Lun­der­gan Grimes, for ex­ample, can peel some of those voters away from Mc­Con­nell, she has a chance to oust one of the most power­ful Re­pub­lic­ans in the coun­try.

Re­pub­lic­ans don’t have to trash the safety net to win elec­tions. Con­gres­sion­al can­did­ate Vance Mc­Al­lister threw his sup­port be­hind Medi­caid ex­pan­sion and trounced an Obama­care-bash­ing fel­low Re­pub­lic­an in a spe­cial elec­tion last month in Louisi­ana. Even Demo­crat­ic Sen. Mary Landrieu hailed Mc­Al­lister’s vic­tory, say­ing it proves that op­pos­i­tion to ex­pand­ing Medi­caid is a “polit­ic­al loser.”

“It’s un­fair to say Re­pub­lic­ans don’t care about poverty, but they should be held ac­count­able for com­ing up with pro­pos­als,” said Douglas Holtz-Eakin, an eco­nom­ic ad­viser to 2008 Re­pub­lic­an pres­id­en­tial nom­in­ee John Mc­Cain and the pres­id­ent of the Amer­ic­an Ac­tion For­um, a cen­ter-right think tank. “I ex­pect they will have to if they want to be seen as solu­tion-ori­ented prob­lem solv­ers who win elec­tions in­stead of just op­pos­ing Obama’s agenda.”

If Louisi­ana hadn’t re­jec­ted the ad­di­tion­al Medi­caid money avail­able un­der Obama­care, about 400,000 poor people would be eli­gible for gov­ern­ment-fun­ded health in­sur­ance. Across the coun­try, an es­tim­ated 5.4 mil­lion people would have qual­i­fied for Medi­caid cov­er­age, but they live in Re­pub­lic­an-run states that closed the door to them.

Be­cause Ken­tucky did take the cash, 308,000 poor people are now eli­gible for health in­sur­ance in the Bluegrass State. Over the 11 months lead­ing up to the elec­tion, Mc­Con­nell and oth­er Re­pub­lic­ans op­pos­ing Medi­caid ex­pan­sion will be hard-pressed to ex­plain why they want to take health in­sur­ance away from needy con­stitu­ents who be­long to their own party.

COR­REC­TION: An earli­er ver­sion of this story in­cor­rectly said that Rep. Bill Cas­sidy of Louisi­ana, who is run­ning for the Sen­ate, faces a primary. In Louisi­ana, all of the Sen­ate can­did­ates, Demo­crats and Re­pub­lic­ans, will be on the same bal­lot in Novem­ber.

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