Kentuckians voted against their successful health reform. Go figure.

If you’ve ever wondered why people often vote against their own best interests — or, worse yet, why they don’t bother to vote at all, on behalf of their own best interests — then your curiousity should be tweaked anew by what just happened down in Kentucky.

For the past few years, Kentucky has hosted the most successful health reform program in the country. Known as KYnect, it’s a state exchange modeled on Obamacare. Previously uninsured Kentuckians have taken full advantage. And the poorest among them — at last count, more than 400,000, roughly 10 percent of the state’s population — have flocked to Obamacare’s Medicaid expansion program. Governors decide whether to participate in that federal program; term-limited Democratic Gov. Steve Beshear opted in. All told, according to the U.S. Census, Kentucky has slashed its percentage of uninsured citizens more effectively than any other state. Pre-Obamacare, 20 percent were uninsured. Now it’s 9 percent.

And yet, in Tuesday night’s gubernatorial tally, Kentuckians elected Matt Bevin — the tea-partying, no-experience Republican millionaire, who has promised to kill KYnect and bar any new poor people from enrolling in Medicaid-Obamacare. The voters spurned Democrat Jack Conway, who promised to sustain these historic reforms. Go figure.

Here we have a state where, at least on health coverage, the system works. Government is successfully delivering crucial services to citizens, bettering their well-being and bottom line … then they turned around and voted for the tea-partyer right winger who vows to screw with the services. In fact, 69 percent of registered voters didn’t both to show up at all.

What’s most striking is that the poorest Kentucky counties — where KYnect and Medicaid-Obamacare have done the most good — voted for the tea-partyer in a landslide. I matched the economic stats to the vote results … and wow:

Clay County, reputedly the poorest of the poorest, gave Bevin 71 percent of its votes.
McCready County, which is nearly as poor, gave Bevin 65 percent.
Leslie County, which is nearly as poor as McCready, gave Bevin 77 percent.
Owsley County, another impoverished enclave, gave Bevin 70.5 percent.
Floyd County was one of the few to vote Democratic — roughly 20 percent of its citizens live below the poverty line — but most of the folks with a direct stake in health reform didn’t show up at all. In Floyd, 73 percent of registered voters stayed home.

Actually, this phenomenon, of people voting against their own best interests (or staying home), isn’t new at all. Political analyst Thomas Frank famously wrote a book about it, entitled What’s The Matter With Kansas? He argued that Republicans have successfully wooed downscale voters by tapping into their conservative cultural concerns — abortion, liberal elitism — thereby masking the GOP’s true agenda: economic benefits for the upscale. Frank said that, for downscale voters, the deal goes something like this: “Vote to get government off our backs; receive conglomeration and monopoly …. Vote to strike a blow against elitism; receive a social order in which wealth is more concentrated than ever before in our lifetimes, in which workers have been stripped of power and CEOs are rewarded in a manner beyond imagining.”

So now comes Matt Bevin, the tea-partying Kentuckian who spent his gubernatorial campaign warring against the “bankrupt” political establishment, taking aim at the establishment’s health reforms. Yet even though KYnect has polled well (typically better than Bevin), and even though Bevin has been reviled by Kentucky Republicans as a “con man,” he still won. Handily. Wouldn’t you think, by now, that people with a direct interest in the programs that benefit their lives would wake up and vote accordingly?

Well, it’s not that simple.

It’s been evident for years that many of the people who need government help dislike needing it. So they vote against what they need. As one news report concluded back in 2012, “They say they want to reduce the role of government in their own lives. They are frustrated that they need help, feel guilty for taking it, and resent the government for providing it.” This dovetails with the findings of British political scientist David Runciman, who noticed in ’09 that many of the town-hall agitators opposed to Obamacare were people whom the program was designed to help. He told the BBC: “This is a war on the entire political culture …. When politicians say to the protesting people, ‘We’re doing this for you,’ that just makes it worse.”

Yes, there were other factors at play in Kentucky. Jack Conway, the defeated Democrat, has now lost three statewide races in five years, so clearly he had little appeal. And let’s not forget Kim Davis, the anti-gay marriage bigot who was jailed after refusing to do her job as county clerk; Bevin cozied up to her cause and reaped a bumper crop of religious-right votes. And Bevin smartly expolited Kentucky’s ongoing hatred of Barack Obama, running a series of TV ads that tied Conway to The Other up in Washington. The same Other who has demonstrably improved the lives of hundreds of thousands of Kentuckians. So we’ve come full circle.

By the way, Bevin tried to soften some of his anti-reform rhetoric. Early on, when asked whether he’d kill Medicaid-Obamacare, he replied, “Absolutely. No question about it. I would reverse that immediately.” Now he claims that he’ll just block the new enrollees. It’s hard to know whether to believe him, particularly since Republicans in Kentucky — yes, Republicans — have called him a “pathological liar.” But, hey, the voters picked him anyway.

Some pundits are quite furious about the folks who voted or acquiesced against their own best interests. Charles Pierce of Esquire.com addresses them directly: “If your outrage over the treatment of a crackpot goldbricking county clerk outweighs the possibility that your aging grandmother is going to die of a treatable illness, then, well, I don’t know what to say to you except good luck and enjoy your freedom.”

I’ll put it more gently: By dint of our ballot decisions, we get the government we deserve.

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