Mitch McConnell really doesn't like Obamacare — and since the health law polls badly in Kentucky, many observers thought this put him in a good position for his reelection. But what is Obamacare, anyway? At its core, the law expands health insurance coverage in two main ways. It creates a regulated framework intended to make private insurance more affordable, and it expands Medicaid.

in kentucky, the kynect is obamacare

In Kentucky, both of these are being implemented by the state's exchange, which is called the Kynect. According to the state, over 400,000 people have signed up for insurance on Kynect so far — 80 percent of them signing up for Medicaid, and 20 percent purchasing private insurance. And according to a recent poll, Kentuckians rather like it, as Sarah Kliff described here.

Put simply, the Kynect is Obamacare in Kentucky. Which is why these recent comments by McConnell, reported by Joe Sonka of LEO Weekly, are so absurd:

McConnell: "[Obamacare] was a big mistake, we ought to pull it out root and branch and start over." ... Q: ..."Should Kynect be dismantled?" McConnell: "I think that's unconnected to my comments about the overall question here."

McConnell's position is ludicrous because the Kynect was only created, and can only continue to exist in anything close to its current form, because of the federal health law's spending and regulations. MIT economics professor Jonathan Gruber told the Post that McConnell's position "makes no sense," because "exchanges don't work without mandates and subsidies — without those, there isn't enough demand and too much adverse selection." Without the billions in federal subsidies the law provides, and the requirements that insurance companies offer affordable coverage to people with preexisting conditions, a great many low-income Kentuckians wouldn't be able to afford to purchase private insurance. The Lexington Herald-Leader editorialized, "Kynect could not survive without the ACA's insurance reforms."

McConnell is afraid to actually stick to his past positions

Follow-up statements from McConnell's campaign make it clear he's trying to have it both ways — arguing that a repeal of Obamacare wouldn't necessarily mean the end of Kynect. "If Obamacare is repealed, Kentucky should decide for itself whether to keep Kynect or set up a different marketplace," said McConnell campaign spokesperson Allison Moore. "When Obamacare is repealed, Kentucky can choose to continue Kynect or alter it in a way that makes the best sense for Kentuckians," his campaign manager Jesse Benton said. McConnell has also emphasized that he'd prefer to let people buy insurance across state lines — but as the Post's Glenn Kessler points out, "This is the exact opposite of preserving a Kentucky exchange that appears to be working for the state."

Regardless of these attempts to obfuscate, the challenge McConnell faces is quite clear. Now that hundreds of thousands of Kentuckians are actually seeing the benefits of Obamacare, and liking them, McConnell is afraid to actually stick to his past positions, and say he'd prefer to take those benefits away.

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