Alison Lundergan Grimes got the best news she’s had in a few weeks on Monday, when the latest Bluegrass Poll found her two points ahead of Senate Minority Leader Mitch McConnell in the Kentucky Senate race.
Grimes has been consistently behind by a few points in most polls, and if you use polling averages rather than individual polls as your touchstone (as you should) then the most optimistic interpretation of this one poll is that it could portend the race returning to her favor. If things shake out that way, it would obviously be huge news. But the truth is, there’s no reason to assume that’s what’s going on. And it would be a real missed opportunity if the Grimes campaign allowed this one data point to reinforce the cautious tendencies that have allowed McConnell to avoid real accountability for his position on the Affordable Care Act, which he’s been obscuring with babble for months now.
We’ve examined his statements at length. Like many Republicans, McConnell claims to support repealing Obamacare completely. But unlike most Republicans, McConnell represents a state where ACA implementation has been extremely successful. Obamacare reduced the uninsured population in Kentucky by a larger percentage than any state in the union save Arkansas. Hundreds of thousands of people gained coverage through Medicaid. Tens of thousands through the state’s popular insurance exchange, Kynect. And while the Obamacare moniker remains unpopular in the state, the particulars of full repeal are unsupportable.
Which is why McConnell pretends Kentucky could just keep its exchange and its Medicaid expansion if the rest of the law disappears, and nobody would be worse off for it. This is untrue. McConnell knows it’s untrue. An crucially, it’s untrue in a way that requires him to traffic in the kinds of absurdities and demonstrable falsehoods that can come to define a candidate. But for that to happen, his opponent would have to make an issue of it. And Grimes has given McConnell a near-total pass.
That’s why the timing of the Bluegrass Poll is so important. It comes just a few days after McConnell repeated many of the same canards in front of the editors of the Cincinnati Enquirer—who didn’t quite seem to know how to press the issue. Next week, Grimes will meet with the same editorial board, and face off with McConnell in their sanctioned debate. These will effectively be the last two opportunities she has to lay the preposterousness of McConnell’s claims bare—to run against him not just as an unpopular, out-of-touch old guy, but as someone who isn’t actually on the level. Except, she won’t be able to do that if she keeps cowering from the issue.
Like he did when his Obamacare inconsistencies tripped him up back in May, McConnell told the Enquirer editors, “you can have an exchange, if you want to, with or without Obamacare.” That’s true, in much the same way that I could secure “BriansHealthPlans.com” on GoDaddy and call it an insurance exchange. It would be utterly meaningless without the regulations and subsidies that make the plans available on Kynect appealing and affordable.
In the ed-board meeting, McConnell also trotted out this claim: “the [Congressional Budget Office] says, if it all kicks in like it's supposed to, we'll only reduce uninsured Americans from 40 million to 30 million. So the cost benefit ratio of this has gotta be one of the worst in the history of the country.”
This is designed to leave the impression that Obamacare will only ever insure 10 million people, which would indeed be disappointing. But he said this in the face of overwhelming evidence that Obamacare has already reduced the uninsured population by about 10 million people, with more to come.
Here’s the CBO report he’s referencing. Sure enough, it projects that under the ACA, the number of uninsured nonelderly people will fall from 42 million in 2014 to 31 million in 2024. That line of data isn’t corrected for population growth. It’s also footnoted as follows.
The uninsured population includes people who will be unauthorized immigrants and thus ineligible either for exchange subsidies or for most Medicaid benefits; people who will be ineligible for Medicaid because they live in a state that has chosen not to expand coverage; people who will be eligible for Medicaid but will choose not to enroll; and people who will not purchase insurance to which they have access through an employer, an exchange, or directly from an insurer.
I don’t think McConnell supports providing unauthorized immigrants with federal health benefits, or expanding Medicaid to millions of poor people across the South and elsewhere. But those populations account for a huge chunk of the 30 million people the ACA will leave behind. And more to the point, the same CBO report makes clear that Obamacare is projected to reduce the uninsured population not by 10 million but by 26 million relative to the pre-ACA status quo. The uninsured population in Kentucky alone dropped by hundreds of thousands in a single year, and it’s a pretty small state.
McConnell knows all of this. He talks around it all in such easily discredited ways that it’s remarkable he’s gotten away with it since May. Even if he ultimately wins, it’d be a real waste if he gets through the entire campaign without being asked to reconcile the contradictions even once.