Medicaid covers nearly 1 in 3 in the state, and people don’t know what to oppose: Obamacare or Republicans’ fix for it.
WHITESBURG, Ky. — Dewey Gorman, a 59-year-old banker who has struggled with opioid addiction, had just gotten out of the hospital in the tiny central Appalachian city of Whitesburg when he heard the word from Washington: His fellow Kentuckian, Sen. Mitch McConnell, had delayed a vote to repeal the Affordable Care Act. He felt torn about that.
“It’s broken. It’s broken very badly,” Gorman said of former President Barack Obama’s signature health-care law. “But if they want to take away insurance from 22 million people — a lot of them would come from these mountains. That would be devastating to our area.”
Perhaps nowhere has the health-care law had as powerful an effect as in Kentucky, where nearly 1 in 3 people receive coverage through Medicaid, expanded under the legislation. Perhaps no region in Kentucky has benefited as much as Appalachia, the impoverished eastern part of the state, where in some counties more than 60 percent of people are covered by Medicaid.
In few places are the political complexities of health care more glaring than in this poor state with crushing medical needs, substantially alleviated by the Affordable Care Act (ACA), but where Republican opposition to the law remains almost an article of faith. While some Senate moderates say the Republican bill is too harsh, Sen. Rand Paul, Kentucky’s other Republican senator, is among Senate Republicans who say they are opposed to the current bill for a different reason: They believe it does not go far enough to reduce costs.
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McConnell, who was re-elected handily in 2014, seems committed to his party’s pledge to repeal the ACA even if it might hurt some constituents back home. A study last year by the Kaiser Family Foundation found that the percentage of uninsured in Kentucky dropped from 18.8 percent in 2013, the year the health law was put in place, to 6.8 percent — one of the sharpest reductions in the country.
In Whitesburg, a city of roughly 2,000 people at the base of Pine Mountain, Gorman’s sentiment seems to be the prevailing one. In nearly two dozen interviews with health-care workers and patients, at the hospital and at a nonprofit clinic run by Mountain Comprehensive Health, Kentuckians sounded both fearful and flummoxed by the health-care…