Kentuckians surprised the pundits and pollsters on Election Day by voting against a gubernatorial candidate who supported ObamaCare and promised to defend its implementation under his predecessor. Instead, Kentuckians voted in favor of Matt Bevin, an underdog challenger who promised to undo the president’s health care law, root and branch. Bevin’s victory shocked the political establishment, who expected the opposite result.

When I saw these results my response was simply, “I’m not surprised at all!” Why not? Let me give you my insight as a doctor who hears from patients everyday and from someone who has spent the past few years talking to patients and doctors around the country about this issue.

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What I’ve heard is a drip, drip, drip of disappointment, disillusionment, and distrust with ObamaCare and the politicians who supported it. This is especially true among the people who initially supported the law – in particular, those patients and doctors who had insurance and have now lost their doctor or their plan, all of whom are paying far more in premiums and deductibles.

That’s what drove the election in Kentucky too. They’re just as mad about ObamaCare as everyone else. And they have every reason to be. ObamaCare has been an utter disaster in the Bluegrass State.

Let me count the ways. Let’s start with premium increases. Kentuckians have had some of the worst since ObamaCare went into effect in 2014. At the start of that year, the average premiums in the state were up by between 10 and 69 percent. For next year, the average plan is rising by another 23 percent. This is one of the highest average increases in the country for next year.

The state’s voters found out these numbers at the end of October, only days before they went to the ballot box to cast their votes. Remember: This is the law that President Obama promised would save families up to $2,500 a year. I haven’t found a single patient, anywhere, who has seen these savings. Most are paying far more than they were. Kentucky is no exception.

Meanwhile, the state’s co-op also failed in October. Co-ops were supposed to be ObamaCare’s silver bullet – the proof that bureaucrats could design a health insurance plan that was cheaper and had better coverage than the plans offered by insurance companies. It didn’t work. As of today, 13 of the 22 co-ops have failed while others are teetering all while taxpayers have shelled out roughly $2.4 billion in the failed experiment

While everything sounded good on paper, the bureaucrats created a system that required huge federal subsidies even though the long-term viability was iffy at best. Kentucky’s was a case in point. Even though it got nearly $150 million in low-interest federal loans, the co-op was in miserable financial shape. It spent nearly 50 percent more in benefits than it made in premiums. Naturally, it collapsed.

And as with so much else in the law, this failure left Kentuckians in the lurch. Now 51,000 people have to buy new health insurance for 2016. That means they have to buy the plans that are getting much more expensive. Kentuckians can’t win for losing.

Yes, Americans care about jobs and the economy as pollsters consistently point out. And yes, the issue of ObamaCare doesn’t seem to have the pizzazz and centrality it had in 2010. But it is undoubtedly what caused Matt Bevin to win in Kentucky by an 8-point margin—more than 10 points higher than the polls predicted.

Kentuckians showed that voters want candidates who can credibly promise to make great changes, if not end this failing experiment with their health care. Those who voted for the law, or make empty promises to undo but then fail to do so once they’re in office, are feeling the wrath of voters nationwide.

If that’s true now, it will definitely be true in 2016. Lost doctors and plan choices, higher premiums and deductibles, and the rest of Obamacare’s bad effects aren’t going away any time soon. In fact, they’re only going to get worse, hurting hardworking Americans for years to come. Those hardworking Americans just took it out on the Democratic Party in Kentucky. We shouldn’t be surprised when they do it on the national stage next year.

Strom is a fellow at the Jess Unruh Institute of Politics at the University of California.