San Francisco Chronicle

Fear and confusion in McConnell’s state

- By Sheryl Gay Stolberg Sheryl Gay Stolberg is a New York Times writer.

WHITESBURG, Ky. — Dewey Gorman, a 59year-old banker who has struggled with opioid addiction, had just gotten out of the hospital in this tiny central Appalachia­n city 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 now 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.

And 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, 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.

McConnell, who was re-elected handily in 2014, seems committed to his party’s pledge to repeal the Affordable Care Act 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.

Kathy Collins, 50, who suffers from an autoimmune disease, was uninsured until she got Medicaid coverage through the law’s expansion. Sitting in her hospital bed Tuesday morning, she said she was surprised to hear that McConnell, whom she had voted for previously, was leading the charge to roll it back.

“He is?” she asked. “Well, then, he’s no good for Kentucky.”

Health care is a growing part of the region’s economy, and people there are also deeply concerned that the repeal will bring job losses to a region already racked by unemployme­nt from the coal industry downturn.

 ?? Jessica Ebelhar / New York Times ?? Kathy Collins, 50, who suffers from an autoimmune disease, voted for Mitch McConnell. She was uninsured until she got Medicaid coverage.
Jessica Ebelhar / New York Times Kathy Collins, 50, who suffers from an autoimmune disease, voted for Mitch McConnell. She was uninsured until she got Medicaid coverage.

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