In May 21 Democratic primary for governor, Beshear talks most about health care, but Edelen questions his past contributors

L-R: Former state auditor Adam Edelen, state House Minority Leader Rocky Adkins and Attorney General Andy Beshear answered questions from Matt Jones at a debate in Lexington April 24. (Associated Press photo by Timothy D. Easley)

By Al Cross
Kentucky Health News

If health issues matter when it comes to your vote for governor in the May 21 primary election, the candidates have given you a few things to think about.

In the Democratic primary, Attorney General Andy Beshear has cast himself as the main defender of the 2010 Patient Protection and Affordable Care Act, which his father, then-Gov. Steve Beshear, used to expand Medicaid to many more of the state's working poor.

State House Minority Leader Rocky Adkins and former state auditor Adam Edelen also support the Medicaid expansion, and oppose Gov. Matt Bevin's plan, twice blocked by a federal judge, to require "able bodied" Medicaid beneficiaries to work, volunteer or perform other "community engagement."

Bevin's leading Republican primary foe, state Rep. Robert Goforth of Laurel County, favors the expansion and Bevin's plan to change it, said his campaign manager, T. J. Litafik.

All three Democrats have endorsed the legalization of medical marijuana, but Edelen also calls for decriminalization of possession of a half-ounce or less, to reduce jail costs and fund drug treatment, and he has criticized Beshear's plan to tax medical marijuana as part of a plan to shore up state revenues and pensions.

Edelen is attacking Beshear for the campaign help he got in 2015 from Altria Group, the nation's largest tobacco-products manufacturer, and Purdue Pharma, the maker of Oxycontin, the painkiller that primarily fueled the nation's opioid epidemic. At the time, Beshear was in a law firm that represented Purdue Pharma, but has said he took no part in its cases.

On Oct. 19, 2015, Purdue Pharma gave $100,000 to the Democratic Attorneys General Association, which was supporting Beshear in the nation's only fully competitive race for attorney general. On the same day, the DAGA got its second $25,000 contribution of the year from Altria, the tobacco firm that makes Marlboro cigarettes and now owns 35 percent of Juul Labs, maker of the most popular form of electronic cigarette.

Also on Oct. 19, DAGA sent $250,000 to groups in Kentucky running ads attacking Beshear's opponent, Republican state Sen. Whitney Westerfield of Hopkinsville. All told, it spent $1 million to help Beshear, who beat Westerfield by only 2,201 votes, 0.2 percent of the total. The Republican Attorneys General Association spent more than twice as much to help Westerfield.

Just before Beshear took office, Attorney General Jack Conway settled for $24 million a lawsuit that his predecessor, Greg Stumbo, had filed against Purdue Pharma in Pike County for its role in the opioid epidemic. After Beshear became attorney general, Purdue got Circuit Judge Steven Combs to seal the case file, including the only known deposition from a member of the family that owns the company. Stat, the medical-and-science publication of The Boston Globe, asked the judge to unseal the file, and Beshear's office took no position on the issue.

The judge unsealed the file, and the Court of Appeals upheld him, but Purdue has appealed to the state Supreme Court. The deposition of Richard Sackler, then head of the company, includes emails in which he endorses a lieutenant's recommendation that Purdue not "correct the false impression among doctors that OxyContin was weaker than morphine, because the myth was boosting prescriptions — and sales," Stat reported in February, after the deposition was leaked to ProPublica.

Beshear has responded to Edelen's attack with an ad noting that he has filed nine lawsuits against drug makers over the epidemic, and “won’t take their money.”

Beshear has emphasized health care more than any other candidate, calling for "lowering the cost of prescription drugs and holding pharmaceutical companies accountable" and putting a cap on Medicaid drug spending. He has published a plan on the issue that largely supports the provisions of the federal Patient Protection and Affordable Care Act.

Beshear said in his first ad that he is "helping lead a national effort to protect coverage for pre-existing conditions," the most popular feature of the act. He is among 16 Democratic attorneys general fighting a ruling by a federal judge in Texas that declared the act unconstitutional. On Twitter immediately after the ruling, he said, “I will lead the fight to overturn” it, but at a news conference said he would be "as vocal if not more vocal" than the others.

Ads from Beshear and Edelen both criticize Bevin on health care. Edelen claims the governor "sold out to the insurance companies, let them jack up premiums and kick thousands off their health care."

Asked how Bevin sold out, Edelen spokesman Matt Erwin said in an email, "Matt Bevin supports the elimination of the ACA in its entirety. Nobody would benefit more . .. than the big insurance companies who could return to denying coverage for those with preexisting conditions and offering plans that don't even provide coverage for basic health care services." He said Bevin's Medicaid plan would "cause tens of thousands of Kentuckians, if not more, to lose coverage."

Bevin's plan estimates that after five years, Kentucky's Medicaid rolls would have 95,000 fewer beneficiaries than without the plan, in large measure for failing to comply with its community-engagement and reporting rules. Tens of thousands of Kentuckians go on and off Medicaid each month as their eligibility changes. About 1.4 million Kentuckians are on the program, more than 400,000 through the expansion.

Adkins has stayed out of the Beshear-Edelen fray, hoping to be the alternative, and emphasizes education and economic development. His website notes that he and his running mate for lieutenant governor, Stephanie Horne, "are both cancer survivors and know the pain and cost of unexpected illness, and that's why they want to make sure every Kentuckian has access to health care."