Gov. Matt Bevin’s apparent narrow loss in his bid for re-election in Kentucky on Tuesday can be attributed to a variety of factors. Every election is a single data point with a multitude of explanations, each susceptible to bias.

But one of the salient reasons Bevin struggled — despite late support from President Donald Trump that nearly put him over the top — is that he tried to enforce federal work requirements for those receiving Medicaid benefits.

Medicaid has been a thorny issue for Republicans ever since President Barack Obama and the Democrats expanded it under the Affordable Care Act, a.k.a. Obamacare. Under the new law, states could expand Medicaid eligibility to those living “at or below 138% of the federal poverty level.” The federal government would cover nearly the entire cost for the first years of the expansion. It was an offer many states found impossible to refuse: a “free” entitlement!

Many Republicans rejected the Medicaid expansion — at least initially — because they saw immediately that it put them at odds with broader efforts to cut federal deficit spending, which the Tea Party had temporarily put into focus. But several Republican governors — including New Jersey’s Chris Christie, Florida’s Rick Scott, and Virginia’s Bob McDonnell — flip-flopped on the issue, as Democrats attacked them for denying health insurance to the “poor.”

Bevin, a Tea Party conservative who lost a tough primary challenge to Senate Majority Leader Mitch McConnell in 2014, tried to crack down on freeloading. But as Bruce Japsen of Forbes documented, Bevin’s efforts were an easy target for Democrat Andy Besmear. They allowed the opposition to paint him as hard-hearted, alienating him from the working-class voters that have supported Trump and the Republicans in several key swing states in recent years.

Beshear repeated the formula that helped Democrat Doug Jones defeat Republican Roy Moore in a special election for U.S. Senate in Alabama in 2017. Moore had plenty of other problems, but Jones avoided the tabloid issues and focused on the issue of health insurance for children. Health care remains a winning issue for Democrats, who are more trusted by the public to provide public goods, and protect entitlements, than the bean-counting Republicans.

The 2020 Democratic presidential field is fumbling away that advantage with ridiculous plans like Medicare for All, which would ban the private health insurance that half of the country currently enjoys, and impose crippling taxes on the economy. But Trump and the Republicans cannot coast on the unpopularity of Democrats’ big socialist plans. The GOP needs its own health care alternative — one that preserves benefits that Americans now take for granted.

Joel B. Pollak is Senior Editor-at-Large at Breitbart News. He earned an A.B. in Social Studies and Environmental Science and Public Policy from Harvard College, and a J.D. from Harvard Law School. He is a winner of the 2018 Robert Novak Journalism Alumni Fellowship. He is also the co-author of How Trump Won: The Inside Story of a Revolution, which is available from Regnery. Follow him on Twitter at @joelpollak.