The absolute gibberish coming from Mitch McConnell and his campaign over the last week about how the fate of 413,000 Kynect enrollees is “unconnected” to the repeal of Obamacare just ramped up to a whole new level.
The Washington Post’s Glenn Kessler just posted an exchange he had with Mitch McConnell’s campaign manager Jessee Benton, where he suggests that the 330,000 Kentuckians who gained Medicaid coverage through Kynect can actually keep their coverage even if Obamacare is repealed:
The Fact Checker expressed puzzlement about what would happen to the 300,000 people who joined the Medicaid rolls in Kentucky if the Affordable Care Act was repealed. “The ACA greatly expanded Medicaid—and provided the money to do it,” we noted. Reading between the lines, it appeared that McConnell was saying he would support the funding for the expansion of Medicaid even if Obamacare is repealed, and we asked if that was correct.
Benton responded: “Medicaid existed before Obamacare and will exist if we are able to repeal it. Obamacare loosened eligibility requirements for Medicaid recipients, and in the process, helped find many who were already eligible but no enrolled. These people would remain eligible even after a repeal. The federal government does allow states flexibility in setting requirements and Kentucky could be able to keep many of the newly enrolled in the program if we decided to.”
First things first: If the Affordable Care Act is repealed, the vast majority of those new people who signed up for Medicaid through Kynect who are newly eligible under the expansion (up to 138 percent of the FPL) will lose their coverage. Gone. Along with the 100 percent funding by the federal government next year under the ACA, which would eventually become 90 percent, with Kentucky paying the rest. I’m still trying to pull the exact figure from the Beshear administration on how much federal money that is in total next year, but it appears to be in the ballpark of $1.5 billion, which is gone along with the coverage of somewhere in the ballpark of 300,000 Kentuckians.
Secondly, the only way that people eligible for the Medicaid expansion could remain eligible once the ACA is repealed is if Kentucky passes a law making them eligible again. If you know anything about Kentucky’s state Senate, that is not happening. Especially considering what the price tag would be if Kentucky tried to do this on its own without the preferential payment plan for states under the ACA. So, lets just assume that Kentucky received about $1.5 billion next year to cover around 300,000 newly eligible people under the ACA. But without the ACA, Kentucky would have to foot the bill for 30 percent of these newly eligible people, just like everyone else under Medicaid. That would mean Kentucky and its cash-strapped budget would have to pay $450 million next year to cover these people under Medicaid. Republicans in the General Assembly were gnashing their teeth at the prospect of having to pay 10 percent to cover these people after a few years, so how are they going to take the prospect of now paying three times that amount, immediately? It’s just not plausible. (* Charles Gaba at ACASignups.net puts his estimate for Kentucky’s annual payment at $584 million, subtracted by those not under the Medicaid expansion)
Thirdly, think about what McConnell — through Benton — is saying here. He’s supposedly against Obamacare, except for the most expensive part that is the most “European socialized medicine” aspect of the law. What? So encouraging people to buy private insurance with subsidies is bad, an individual mandate to buy private insurance (h/t Heritage Foundation for that idea) is bad, consumer protections that bar insurance companies from discriminating against women and people with pre-existing conditions is bad…. but a huge expansion of people being covered by government insurance is the part he likes? Right. Amazing that McConnell chose to break out this strategy immediately after his Republican primary ended, huh?
What you are seeing here is the double-edged sword of Obamacare in electoral politics of 2014. “Obamacare” may not be popular in Kentucky now, but what Obamacare actually does in Kentucky is quite popular. This frantic squirming and obfuscation on the part of McConnell over the past week is a sign that taking away the healthcare coverage of over 400,000 Kentuckians — and all of the consumer protections within it — is just as politically toxic as being perceived as a supporter of “Obamacare.” But trying to portray yourself as an advocate of repealing Obamacare “root and branch” while simultaneously saying you can keep the biggest part of it intact can make you look ridiculous, and is certainly impossible to pull off without putting forth a stream of absolute gibberish.