Obamacare Showdown Over a Ham Breakfast in Kentucky

The state fair became a showcase for national tensions as politicians squared off.

Kentucky Sen. Mitch McConnell address the audience at the 50th annual Kentucky Country Ham Breakfast, Thursday, Aug. 22, 2013, at the Kentucky State Fairgrounds in Louisville, Ky.
National Journal
Jill Lawrence
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Jill Lawrence
Aug. 22, 2013, 2:20 p.m.

LOUIS­VILLE, Ky. — The ex­cite­ment at the Ken­tucky Farm Bur­eau Coun­try Ham Break­fast is usu­ally over how high the bids will go when a ham is auc­tioned. But this year, it came when Demo­crat­ic Gov. Steve Be­s­hear made an emo­tion­al case for the Af­ford­able Care Act as a chance to change his state’s long his­tory of poor health.

It was not what any­one ex­pec­ted — least of all Re­pub­lic­an Sens. Mitch Mc­Con­nell and Rand Paul, who sat stone-faced on­stage with Be­s­hear as he un­loaded on them without us­ing names.

Thus did the 50th an­nu­al ham break­fast at the state fair be­come a show­case for na­tion­al di­vi­sions and pas­sions, with some 1,600 diners as wit­nesses.

The may­or of Louis­ville, Demo­crat Greg Fisc­her, set a light mood with a brag-fest about his city’s food and res­taur­ant scene and the nearby farm­ers who have helped make Louis­ville “the na­tion­al lead­er” in the loc­al food move­ment, “on all the right lists” from Za­gat to South­ern Liv­ing.

But with­in mo­ments the break­fast crowd found them­selves watch­ing a heated Obama­care de­bate — the kind that nor­mally goes on in Wash­ing­ton, not at Ken­tucky ag­ri­cul­tur­al events.

Be­s­hear was the homespun pop­u­list, ap­peal­ing to people’s in­stincts to want the best for their friends, re­l­at­ives, and neigh­bors. The sen­at­ors, sur­prised by the full-bore polit­ics, struck back at the ex­pense of the health law and its im­pact on busi­ness. Those were fa­mil­i­ar ar­gu­ments made by the many vo­cal op­pon­ents of the law, strengthened this week here by UPS’s an­nounce­ment that it was elim­in­at­ing cov­er­age for spouses who could be ex­pec­ted to get or buy cov­er­age Jan. 1 un­der ACA.

Be­s­hear’s ad­vocacy, by con­trast, was strik­ing in its in­tens­ity and in how per­son­ally he ap­proached the is­sue, pick­ing up on the idea that many people who don’t have health in­sur­ance are em­bar­rassed by that and don’t talk about it.

The gov­ernor com­pared health in­sur­ance to “the safety net of crop in­sur­ance” and said farm­ers need both. He said 640,000 Ken­tucki­ans — 15 per­cent of the state — don’t have health in­sur­ance and “trust me, you know many of those 640,000 people. You’re friends with them. You’re prob­ably re­lated to them. Some may be your sons and daugh­ters. You go to church with them. Shop with them. Help them har­vest their fields. Sit in the stands with them as you watch your kids play foot­ball or bas­ket­ball or ride a horse in com­pet­i­tion. Heck, you may even be one of them.”

Be­s­hear went on to say that “it’s no fun” hop­ing and pray­ing you don’t get sick, or choos­ing wheth­er to pay for food or medi­cine. He also said Ken­tucky is at or near the top of the charts on bad-health in­dic­at­ors, in­clud­ing heart dis­ease, dia­betes, can­cer deaths, and pre­vent­able hos­pit­al­iz­a­tions. He said all that af­fects everything from pro­ductiv­ity and school at­tend­ance to health costs and the state’s im­age.

“We’ve ranked that bad for a long, long time,” he said. “The Af­ford­able Care Act is our his­tor­ic op­por­tun­ity to ad­dress this weak­ness and to change the course of the fu­ture of the com­mon­wealth. We’re go­ing to make in­sur­ance avail­able for the very first time in our his­tory to every single cit­izen of the com­mon­wealth of Ken­tucky.”

About half the audi­ence burst in­to ap­plause at that point while the oth­er half sat on their hands. But he wasn’t done. He cited a study that showed the law would in­ject about $15.6 bil­lion in­to the Ken­tucky eco­nomy over eight years, cre­ate 17,000 new jobs, and gen­er­ate $802 mil­lion for the state budget.

“It’s amaz­ing to me how people who are pour­ing time and money and en­ergy in­to try­ing to re­peal the Af­ford­able Care Act sure haven’t put that kind of en­ergy in­to try­ing to im­prove the health of Ken­tucki­ans. And think of the dec­ades that they have had to make some kind of dif­fer­ence,” Be­s­hear fin­ished poin­tedly.

Mc­Con­nell — first elec­ted in 1984 — smiled. Then it was his turn. He ap­prov­ingly quoted Team­sters Uni­on pres­id­ent Jimmy Hoffa as say­ing Obama­care was des­troy­ing the 40-hour work week and ex­pens­ive uni­on-ne­go­ti­ated health in­sur­ance plans, and squarely blamed Obama­care for the move by UPS, the biggest em­ploy­er in Ken­tucky.

“So, gov­ernor, the solu­tion to Obama­care is to pull it out root and branch,” the Sen­ate minor­ity lead­er said to cheers.

Paul, who wants to try to de­fund the law as a way to buy lever­age to delay it and ul­ti­mately kill it, picked up on Be­s­hear’s point about the eco­nom­ic be­ne­fits. “It’s go­ing to bring $15 bil­lion to our state. From where?” he asked, his voice rising. “From the Fed­er­al Re­serve, which is already sit­ting at minus $17 tril­lion. It’s not free. There are con­sequences to this.”

Later, Paul told Na­tion­al Journ­al Daily that he was sur­prised by Be­s­hear’s speech. “The farm break­fast is usu­ally a little less par­tis­an, and I had not planned to say any­thing about Obama­care,” he said. “This is more about farm­ers and is­sues dir­ec­ted to­ward farm­ers. I typ­ic­ally don’t talk about more par­tis­an is­sues be­fore a less par­tis­an crowd. I usu­ally take the op­por­tun­ity to talk about things that people tend to agree more on — two or three is­sues where I work with Demo­crats.” On Thursday, those is­sues in­cluded civil liber­ties and pulling back aid to Egypt.

Ken­tucky is a com­plic­ated polit­ic­al state — con­ser­vat­ive, with two Re­pub­lic­an sen­at­ors and neg­at­ive views of Pres­id­ent Obama, but Demo­crats still have a voter-re­gis­tra­tion edge over Re­pub­lic­ans (1.7 mil­lion last month versus 1.2 mil­lion for the GOP) and they have elec­ted a Demo­crat­ic gov­ernor, lieu­ten­ant gov­ernor, at­tor­ney gen­er­al, and sec­ret­ary of state. In ad­di­tion, Ken­tucky is un­usu­al in that the gov­ernor had the au­thor­ity to cre­ate a health in­sur­ance mar­ket­place and ex­pand Medi­caid un­der the Af­ford­able Care Act without hav­ing to go through the Le­gis­lature.

The ham break­fast made sense as a ven­ue to dis­cuss those de­cisions. “We know farm­ers would be a group that would stand to be­ne­fit from the Af­ford­able Care Act,” said Be­s­hear’s spokes­wo­man, Kerri Richard­son. “That was the reas­on­ing for the top­ic he chose.”

Be­s­hear has made clear he is a man on a mis­sion, to make his­tory by mak­ing a suc­cess of the Af­ford­able Care Act in a red, Obama-res­ist­ant state. It’s un­likely Mc­Con­nell and Paul will be caught off-guard again.

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