Kentucky has had, by any measurement, a wildly successful implementation of a state health insurance exchange and Medicaid expansion under the Affordable Care Act. A substantial number of those benefiting from this are poor people in more rural areas of the state, who are overwhelmingly Republican. These are the same people who elected a Tea Party Governor promising to take away their health insurance.
Obamacare literally rescued over half a million people in Kentucky from dying due to lack of healthcare, or from bankruptcy due to medical bills.
To show their appreciation, Kentuckians elected a governor who promised to destroy their health insurance exchange.
Tea Party elect, Governor Matt Bevin, ran on a platform promising to completely remove the Kentucky state exchange as well as removing the Medicaid expansion so many poor Republican Kentuckians relied on. So of course, Republicans voted for him in droves.
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