Sam Youngman

Sam Youngman: Will collapse of Kentucky Health Cooperative cure some of Bevin's ills?

Is there a doctor in the house?

Republican Matt Bevin's campaign for governor has been falling apart, struggling with self-inflicted wounds and in danger of flatlining in the closing days of the race.

The past few weeks have seen Bevin increasingly isolated from his own party, struggling to raise money, lashing out in odd ways and seemingly going out of his way to lose a race in a political environment that was all but gift-wrapped.

One of Bevin's biggest struggles has been explaining how he would address health care as governor, especially when it comes to the state's Medicaid expansion.

In February, when he released his "Blueprint for Kentucky," Bevin could not have been more clear about his plans for the expansion of Medicaid eligibility that Gov. Steve Beshear implemented with executive orders.

"Absolutely. No question about it. I would reverse that immediately," Bevin said.

Since that day in a Shelbyville warehouse, Bevin's position(s) has been in critical condition.

In July, Bevin said it was "an absolute lie" that he ever said he would reverse the expansion on his first day in office. In an August fund raising letter, he was back to calling for complete reversal.

At last week's Centre College debate, it was far from clear whether Bevin knew the difference between Medicaid, the health insurance program for low-income and disabled residents, and Medicare, the health insurance program for people 65 and older.

What makes this all the more strange is that, in a complete reversal from where we were a year ago, the Democratic candidate has been very clear about his health care position, even making a defense of the programs a part of his stump speech.

Shortly after implementing the federal health care law in Kentucky in October 2013, Beshear, backed up by U.S. Rep. John Yarmuth, predicted there would come a day when Democrats would run on and not from "Obamacare" in Kentucky campaigns.

I thought they were wrong, but that's what has happened.

In a short amount of time, the state's Democrats have gone from Alison Lundergan Grimes rambling on about doughnut burgers at the state fair to Jack Conway going on offense and calling Republicans "callous" for wanting to "kick a half million Kentuckians" off their health insurance.

At the first debate between the lieutenant governor candidates, Democratic state Rep. Sannie Overly offered a strong and comprehensive defense of the health care expansion while Republican Jenean Hampton suggested Kentuckians should get more exercise.

Since its inception, the issue has been a difficult one to discuss in a state where Obamacare is despised but Kynect, the state's health benefits exchange, is embraced (yes, they are the same thing).

In a federal race, U.S. Senate Majority Leader Mitch McConnell was on safe ground calling for the "root and branch" repeal of President Barack Obama's signature domestic accomplishment.

But largely on the strength of Medicaid expansion, Kentucky has seen its rate of uninsured residents plummet, and it's clear from Bevin's struggles and flip-flops on the matter that there is great political risk in championing a complete reversal that would yank coverage from 430,000 Kentuckians.

Then on Friday, Bevin and the rest of the state got some news that might have given the Republican an opening to transition from defense to offense.

The first October surprise — news that Kentucky Health Cooperative is shutting down, sending 51,000 Kentuckians in search of a new insurance provider on Kynect — sent shivers down the spines of Democrats.

For the first time in a long time, Bevin was very clearly on the attack, following up the Friday news dump with a blistering news release that used words like debacle, disaster and catastrophic.

The reality of the situation isn't quite so black-and-white or as terrifying.

Seven insurance companies still will offer plans when open enrollment starts Nov. 1, which is two more than last year.

But nuance is a campaign killer, and, if played right, Bevin could use the news to return to offense.

The good news for Democrats is that Bevin's lack of message discipline raises questions about whether he can take advantage of the latest development.

On Monday, Bevin was out with a strong new ad that featured his wife, calling Conway a political insider and pushing back on the Democrat's relentless attacks.

As good as the ad is, it's also another reminder that with three weeks until the election, Bevin is still playing defense.

Whether the collapse of Kentucky Health Cooperative will cure some of Bevin's ills remains to be seen.

After all, the medicine won't work if the patient won't take it.