Steven Brill writes: "In the deep-red, Bluegrass state, the Affordable Care Act is an unlikely hit. Just don’t call it by that name." - Obamacare is a massive new government income-redistribution program providing health insurance, through subsidies and the expansion of Medicaid, to millions of people who could not otherwise afford it. Across the country, 87% of all those who bought insurance on the exchanges got subsidies, while everyone who got added to the Medicaid rolls got coverage for free.

Steven Brill, who a year ago wrote Time’s special report “Bitter Pill: Why Medical Bills Are Killing Us,” is writing a book about the business and politics of health care, to be published this year by Random House

Steven Brill writes in Time:

Obama’s Legacy or Albatross?

Across the country, however, polls continue to show that more people disapprove of Obamacare than approve of it. The difference in Kentucky is not just about a website that functioned well from the start.

[Kentucky Governor Steven] Beshear and his team did a smarter job setting expectations and anticipating hurdles. For example, they were unafraid to acknowledge how complicated buying health insurance would be for consumers, let alone consumers buying it for the first time. Rather than tout, as the President did, that logging on to Kynect would be as simple as buying an airplane ticket online, the Kentucky team prepared from the start to guide people through the complicated process of buying insurance, especially for the first time.

They took full advantage of federal funds available to deploy specially trained assistants–those Kynectors, like the ones who helped the Browns–at all enrollment centers to guide consumers through the process. And unlike the federal exchange, they included on their website a tool for people to search for insurance agents who could help them enroll (and be paid by the insurance companies for doing so). In fact, 44% of the Kentucky enrollees on the exchange used an agent.

More important, Beshear’s basic sales pitch was better because, unlike Obama, the Kentucky governor was unafraid to highlight what Obamacare really is: a massive new government income-redistribution program providing health insurance, through subsidies and the expansion of Medicaid, to millions of people . . . who could not otherwise afford it.

Across the country, 87% of all those who bought insurance on the exchanges got subsidies, while everyone who got added to the Medicaid rolls got coverage for free.

Enroll America, a nonprofit organized by Obamacare advocates to encourage people to enroll nationally, reported that many people did not even know that generous subsidies were available to help pay for premiums. Enrollment would have been even higher, the report concluded, if officials had done more to highlight the subsidies and emphasize the low cost of getting coverage.

Of course, in a political climate where anything that smacks of income redistribution is a liability, that was something the Obama team was not likely to do. Beshear–whose state is so disproportionately poor that 80% of the people coming to Kynect got Medicaid–had no such compunctions.

That also may explain why, while Obamacare may not help McConnell or hurt Grimes, it is not likely to generate the same kind of partisan loyalty for Obama and Democrats generally that Medicare and Social Security did. Unlike those two entitlement programs, which are for everyone, Obamacare is a program for the uninsured and the underinsured. That’s a minority of Americans, maybe 25%. Everyone else gets health insurance from their employers, is protected by Medicare or was poor enough to qualify for Medicaid before the law expanded it.