With the news this week that more than 600,000 Washington residents have acquired new health care plans through the state exchange, U.S. Rep. Cathy McMorris Rodgers said it’s unlikely the Affordable Care Act will be repealed.

“We need to look at reforming the exchanges,” the Eastern Washington Republican said Thursday.

The five-term congresswoman and chair of the House Republican Conference kicked off her re-election campaign this week with visits to Walla Walla, Colville and Spokane. She faces Democratic challenger Joe Pakootas.

McMorris Rodgers has been part of the Republican leadership in the House that has voted multiple times to repeal parts or all of President Barack Obama’s signature health care law. GOP members have said the law is unworkable, will increase costs for some and force others into inadequate coverage or plans they don’t want.

McMorris Rodgers continued those criticisms Thursday, but said the framework established by the law likely will persist and reforms should take place within its structure.

“It is a top-down, one-size-fits-all approach to health care,” she said. Consumers should have more choice for their coverage, and Democrats should abandon the idea that everyone will enroll because of the mandate, McMorris Rodgers added.

The congresswoman also said that the 85 percent of enrollees who received Medicaid coverage is a sign the program is not sustainable and many will receive subpar care.

“You’re seeing where they’ve had to reduce programs for the very people it’s meant to help,” McMorris Rodgers said. “Somebody’s going to have to pay the bill.”

She also discussed the assignment of a new fleet of Washington-made jet tankers to an Air Force base in Kansas instead of Fairchild Air Force Base in Spokane, the feasibility of immigration reform this year and efforts to address the need for more medical education opportunities in Eastern Washington.

KC-46s go to Kansas, Oklahoma; not Airway Heights

McMorris Rodgers said the Air Force’s final decision not to send its first batch of next-generation jet fuel tankers to Fairchild should not be read as an indication base officials and the community made a poor pitch.

“I believe Fairchild is doing everything right,” she said.

The KC-46 Pegasus, replacing the 1950s-era Stratotankers that soar above Spokane’s skies as part of the Fairchild mission, is manufactured by Boeing in Everett. The yearslong vetting process of bases to house the new tankers ended with Wednesday’s announcement that McConnell Air Force Base in Wichita, Kan., and Altus Air Force base in Oklahoma will be the first to receive the aircraft in 2018.

McMorris Rodgers said top defense officials at the Pentagon have assured her Fairchild remains in a strong position to receive tankers sooner rather than later.

Cited as a priority issue by many members of Congress and Obama, 2013 came and went without an immigration package, to the chagrin of many advocacy groups.

McMorris Rodgers said she still thinks a deal could be struck before the election. “I believe there is a path that we get a bill on the floor by August,” she said.

A bipartisan plan was passed in the Senate last spring but made no headway in the Republican-controlled House. McMorris Rodgers echoed the concern brought up by many in the chamber, saying she wants to see stronger border security. But she said she’d support a bill that grants legal status to those undocumented immigrants working toward citizenship, allowing them to remain in the country to work and go to school while they wait their turn in the current system.

“We’re going to have to push that this is a legal status, not amnesty,” she said.

Changing graduate medical education funding

McMorris Rodgers is pushing for a pilot program that will break the link between graduate medical education funding and Medicare compensation rates that put Washington at a disadvantage. The goal is to increase residency opportunities for medical students at health care providers in areas like Eastern Washington that have historically had few such positions.

Greater Spokane Incorporated has embraced such legislation, saying it will increase residency opportunities for graduates trained at the new Biomedical and Health Sciences building on the Washington State University Riverpoint campus.

The proposal has been mired in committee since its introduction in February 2013. McMorris Rodgers said there’s been resistance from those who benefit under the current Medicare-based model.

“There’s winners and losers in this,” she said. “The winners aren’t interested in changing it.”