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.
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.
The Welfare State?
"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."
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."
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.
This article appears in the December 14, 2013 edition of National Journal Magazine as Return of the Welfare Queen.