Steve Beshear, former governor of Kentucky, put a strong emphasis on healthcare during his time in office which spanned the introduction of the Affordable Care Act, known as Obamacare, in a state where President Obama and his healthcare plan had low approval ratings.

Beshear, a Democrat who served as governor from 2005 to 2015, said he campaigned on a simple message. “I said I don’t care if it’s a Democratic idea or a Republican idea, if it’s a good idea, we are grabbing a hold of it and implementing it,” said Beshear. “I went around our state saying that and I would get a standing ovation whether it was in a Republican stronghold or a Democratic stronghold because people, regardless of their party, are really looking for that kind of leadership. Leadership that would rise above partisan politics and put the people first.”

As governor, Beshear had to deal with the challenge of working with two legislative bodies dominated by the different parties: A Republican Senate and Democratic House. “I said the elections are over and now the people of Kentucky expect us to be Kentuckians first and Democrats or Republicans second,” he said. “It didn’t work every time, but as I continued to talk and communicate with both sides of the aisle, pretty soon people would start responding to that message.”

“It didn’t work every time,” he conceded, “but as I continued to communicate with both sides of the aisle, soon people will start to respond to this message. And I learn that you must listen as well as talk. As a matter of fact, people who would listen twice as much as they talk, we would all be better off,” Beshear said.

“Everyone looks at the issues differently, and that’s human nature. And so, you have to have a conversation–both parties and individuals–in order to work through differences and find the common ground on which we can agree and move forward.”

Beshear pointed to an example. He wanted to raise the age at which a student could drop out of school from 16 to 18. He said he had no trouble convincing his fellow Democrats, but for five years Republicans resisted. His wife, Jane, who supported the change lobbied for it in the statehouse. “My wife is persistent. She kept smiling and saying, ‘I will be back.’ And we kept having those conversations and finally found a way.” The Republicans would allow the change statewide if 70 percent of the individual school districts approved. Beshear said he negotiated that down to 55 percent. When the Senate agreed he then began a campaign to get the district to vote for the change and within a few weeks he had reached the threshold. The effort took five years.

“We felt it was worth an eight-year effort, if necessary,” said Beshear. “It’s frustrating and irritating at times,” he said. “But you have to keep coming back to the realization that people have different opinions, and you just have to keep the conversation going. Be persistent but be understanding and listen and see it that you can find a way to work through. And we found a way to work through.”

Beshear said he had to understand the importance of respect rather than anger when a difference came up. “There are times we are as mad as hell. But we don’t win over people by going over and throwing gasoline at them, and a match at them. You must show you respect the difference of opinion. That doesn’t mean you agree with it. But you can disagree without being disagreeable,” said Beshear. “When you do it in that way, it always leads you the opportunity to find another day. “If you go and burn the house down the first time that you lose,” he continued, “you are never going to have the opportunity to move into that house. So, you’ve got to respect other people’s opinions, and you’ve got to leave room for the difference and find the way forward.”

While in office, Beshear said his focus was always on the people, and what he could do to better their lives. The controversial new federal health care law provided a dramatic opportunity for the state government to help people receive health care. While many surrounding states rejected the Obama program, Beshear initiated both key components, a statewide healthcare exchange and expansion of the Medicaid program subsidizing premiums for low-income residents.

“The main reason that it worked in Kentucky was because we turned it from a political issue to a people issue,” said Beshear. He noted that Kentucky’s health statistics had been among the worst in the nation for years. “I knew coming into office that healthcare was one of those areas where I might be able to make a little difference, but it is so complicated and so expensive we wouldn’t be able to make a lot of inroads there,” he said. “Never in my wildest dreams did I think that when I went out of office I would be known as the healthcare governor.”

“The Affordable Care Act was a tool to use to change the course of history in Kentucky in terms of health care,” he said, even though he noted it was as unpopular as President Obama in a staunchly red state. “But I also knew that I would not be doing our people justice if I did not try to grab a hold of this opportunity to make a huge difference I the future of our peoples’ lives.”

Beshear used federal planning money to help develop a sustainable state insurance exchange. Beshear also had to decide whether to expand Medicaid in the state to extend access to care to more low-income residents. “That was a tougher decision to make because I knew it was the right things to do, but I had to decide whether Kentucky could afford to do it from an economic standpoint, or would this be a budget buster, that would basically bankrupt the state.”

“So, I asked my support group first to come in to do an actuarial study and give me, to their best knowledge and ability, predictions about what the expanded program would do for Kentucky or to Kentucky,” said Beshear. He said that six months later, “They came in, sat down and looked me in the eye, and said ‘Governor, you cannot afford not to do this.’ So, I knew that was the right thing to do, and now I knew as much as I could, that we could afford to do it.”

Politically, the expansion plan was a huge risk. But Beshear said, “We just needed to figure out how we sell it. So, we went out across the state to campaign. On the campaign, I said, ‘You don’t have to like the President. You don’t even have to like me. Because it’s not about him, or me. This is about you, your family and your kids. So just do me a favor and it won’t cost you a dime. Just go on the healthcare website, look and see what you might be able to get. And I guarantee you, you are going to like what you see,” said Beshear. “We also sent out various people in all around the communities to talk to our people. We call them connectors. They were connecting people with health care, and we went into every library, every community and every festival last summer. That was my goal. I figured that if they saw what they could get, they were going to like it by what whatever it’s called. And that’s what happened.”

Beshear said people who had never had health care were able to go to the doctor for a check-up and to the dentist. “All at once, these families couldn’t believe that they can not only go but take their kids to get health care. They were thrilled,” he said. Beshear explained that when people have increased access to health care, they are able to find out about problems and chronic conditions sooner. “Because they are learning how to manage it, they are going to have a much better life and a longer life.”

Beshear said he began to be recognized for his work in health care reform in the state. He recalled being at a bowling alley with his grandchildren when a worker attendant said, “‘You were the governor, weren’t you?’ And I said, ‘Yes, I was.’ He said ‘All of my family have health care because of you. Thank you.’ The very next day, I went in a coffee shop to get some coffee, and the young girl behind the counter handed me a cup and said ‘Governor, I want to thank you for my health care,’”

Beshear’s wife, Jane, has played an important role in his professional work. “Quite honestly, I couldn’t have been as successful as I was without her,” he said. “She’s my chief advisor, my best friend, and my confidant. To have support like that makes a huge difference.” Through his life, Jane has given Beshear unconditional support. “We’ve now made 48 years in our marriage. Sometimes, you must compromise and negotiate and consent to different opinions to have a successful marriage. And that applies to how you deal with other people. Jane obviously would be supportively understanding, but more importantly, she could train me to debate, add ideas about issues and how we can all get things done.”

His career in politics had early ups and one major down. Beshear was elected to the statehouse at 29 and then became state attorney general. In 1974, he entered the state senate at age 35. Next, he became lieutenant governor at 39 and ran for governor when he was 43. “I was really a rising star and I ran for governor and I lost. Quite honestly, I was devastated.”

Beshear took the loss hard. He said he ran across a quote from a 1910 speech by Republican President Teddy Roosevelt that had an impact on him. The speech is titled The Man in the Arena. “He wrote something like this,
‘It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.’ It consoled me a little bit. I lost, and I lost something I really wanted. But at least I have tried and I’ve been in the arena.”

Twenty years later, while working to get a credible Democratic candidate to run in the 2007 Kentucky governor’s election every candidate that Beshear and his group suggested turned down the opportunity. “One of the fellows in this small group of people with me, came to me and said, ‘Well, Steve, I guess you are going to have to run.’ I literally laughed at it and said ‘Right, I have been there done that. That’s not going to happen,’ He said ‘No, I am serious. I want you to seriously think about it,’” said Beshear. Later the man handed Beshear a card that had the Roosevelt quote on the back. “He had no idea what that quote meant to me,” said Beshear. “But that made the case.”

Beshear’s second, successful campaign for governor illustrates his most important piece of advice. “Never give up. You need to be persistent. You never know what opportunity is your last. You are not always going to win, but you will learn a lot no matter if you win or lose. You take a step further in the effort you made. You are going to learn something somewhere along the way,” he urged. “I am not saying to be reckless in decision-making. Obviously, you calculate your opportunities and chances for success. But the risk is there. There are no sure gains. You’ve got to be willing to take the chance of losing to win.”