A back-and-forth over the federal health care law Wednesday between U.S. Senate Minority Leader Mitch McConnell and Democrat nominee Alison Lundergan Grimes made clear the pitfalls both sides fear when discussing the controversial topic.
Grimes belatedly seized on remarks McConnell made Friday, when he said his repeated calls to repeal "Obamacare" were unrelated to the future of Kynect, the health care exchange Gov. Steve Beshear set up under the federal Affordable Care Act.
When asked specifically whether the state exchange, which more than 400,000 Kentuckians have used to sign up for Medicaid or private insurance, should be dismantled, McConnell suggested that Kynect could stand on its own if the federal law pushed by President Barack Obama was repealed.
"I think that's unconnected to my comments about the overall question," McConnell said last week.
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Five days later, the Grimes campaign accused McConnell of trying to "destroy" Kynect.
"Mitch McConnell has been in the fantasyland that is Washington for so long that he cannot tell the difference between fact and fiction," Grimes' senior adviser Jonathan Hurst said in a statement Wednesday. "McConnell has voted to destroy Kynect — and he has said he will do it again. In the U.S. Senate, Alison Lundergan Grimes will fix the law to ensure it is working for all Kentuckians."
McConnell did not retreat from his stance Wednesday, noting through aides that states were free to set up exchanges before the health care law, as Massachusetts and Utah did, and would be free to do so after repeal of the law
"Despite the cancellation letters that were sent to tens of thousands of Kentuckians happy with their insurance, Kentucky did not need a mandate from Washington to start an insurance market exchange, and it doesn't need one to continue operating it," said Robert Steurer, a spokesman for McConnell's Senate office.
Democrats and state officials belittled that reasoning, noting that federal subsidies for expanded Medicaid eligibility and for private insurance plans bought through Kynect would vanish if the law was repealed.
"His claim about Kynect is disconnected from reality," said U.S. Rep. John Yarmuth, D-Louisville.
Jill Midkiff, spokeswoman for the Cabinet for Health and Family Services, said Wednesday that the federal health care law provided Kentucky with about $252 million to create Kynect.
"Subsidies through the exchange to help cover the cost of private health insurance and the Medicaid expansion are both part of the ACA, and critical to the long-term health of our population and its access to affordable health care options," Midkiff said.
The health care law, however, is not an easy line of attack for Grimes, demonstrated by the length of time it took her campaign to comment.
Grimes has remained vague when asked about how she would fix the law, and last week, she twice refused to tell the Associated Press whether she would have voted for the law.
On Wednesday, the Herald-Leader asked the Grimes campaign specifically how she would fix the law. In response, Grimes spokeswoman Charly Norton referred the paper to the answer the campaign gave to The Courier-Journal for its primary election voters' guide.
"Kentuckians deserve fair flexibility to insure their families are not bankrupted by the lack of access to affordable health care," Grimes told the newspaper. "However, the Affordable Care Act is not perfect; there are parts that need to be fixed. We must investigate and address the botched national roll-out, offer relief to small businesses, make sure individuals can keep their current plans, and address affordability issues."
Although Grimes has been careful to avoid fully embracing the law, the McConnell campaign on Wednesday viewed Hurst's response as an endorsement of "Obamacare."
"We applaud the decision by Alison Lundergan Grimes to finally provide a full-throated defense of Obamacare after months of ducking, dodging and deceiving voters about her position," said Allison Moore, McConnell's campaign spokeswoman. "She joins every other Obama-Reid recruited candidate who assured voters of their efforts to 'fix' Obamacare only to play party politics while plans are cancelled, premiums rise and jobs are lost."
While McConnell has sought to make the health care law a central part of his strategy to tie Grimes to Obama, who remains deeply unpopular in Kentucky, his campaign must also contend with polling that shows far more Kentuckians favor Kynect than "Obamacare."
An NBC News/Marist poll conducted earlier this month showed that 57 percent of registered Kentucky voters have an unfavorable view of "Obamacare" but only 22 percent held an unfavorable view of Kynect. Another 29 percent had a favorable opinion of Kynect, 29 percent had never heard of Kynect, and 21 percent were "unsure" how to rate the state program.