Republican Senate Minority Leader from Kentucky Mitch McConnell chats with Democratic Senate Majority Leader from Nevada Harry Reid in the US Capitol in Washington, D.C., February 12, 2014.
Jim Lo Scalzo/EPA

The Kentucky case study

Few states have been as successful in implementing the Affordable Care Act as Kentucky, where the state’s two-term Democratic governor, Steve Beshear, has been a national leader on the issue. The results have been striking: just this week we learned that the uninsured rate in the Bluegrass State has been cut by a whopping 42% in just six months.
Senate Majority Leader Harry Reid (D-Nev.) seems to be having a grand old time reminding Senate Minority Leader Mitch McConnell (R-Ky.) of the developments.
“My counterpart, the senior senator from Kentucky, will address the Senate probably after I finish,” the Democratic majority leader said Thursday on the Senate floor. “In his home state of Kentucky, 360,000 people have signed up for coverage under the Affordable Care Act. Three hundred and sixty thousand.” […]
“Over a quarter million Kentuckians who did not have insurance now have health care under the Affordable Care Act. Or, in other words, Obamacare has reduced the uninsured population in Kentucky by 40 percent. I wonder when my friend from Kentucky will explain to the 270,000 Kentuckians how he plans to repeal the law without stripping their new health benefits.”
Reid referenced Kentucky five times during his remarks – and they weren’t long remarks.
McConnell’s spokesperson responded by touting a report from last fall, noting Kentuckians transitioning from old, substandard coverage plans to new plans. This was apparently intended to be proof of … something.
Reid’s needling isn’t just for entertainment and his comments this morning were more than partisan taunts. In fact, there’s an important underlying point to this: McConnell’s constituents are benefiting from the law and it’s clearly helping the state he represents. Do the senator and his allies consider this good news or bad?
The Associated Press had a report this week suggesting the answer is no mystery.
In one of the poorest areas of Appalachia, about 2500 people have signed up to get health insurance over the last six months – a number that represents more than a tenth of Clay County’s residents.
One hundred and twenty miles way, the county’s state senator, Robert Stivers, is laying out his plans to gradually gut the Affordable Care Act in Kentucky, which provided his constituents with insurance…. If Republicans can gain more seats in the state legislature here over the next year, he said, they will look to peel back Kentucky’s participation in the health-care law by limiting  the expansion of Medicaid in the state.
“I do think it should be repealed,” Stivers told the AP emphatically at the end of the interview.
McConnell is no different, remaining unmoved by his state’s recent progress and vowing to repeal the law in nearly every campaign speech, even as hundreds of thousands of his own constituents gain access to affordable medical care, some for the first time.
Of course, as a practical matter, it’s still a no-risk proposition for McConnell and his allies – the president isn’t popular in Kentucky; “Obamacare” still polls poorly in the state (many residents seem to think their state exchange is distinct from the Affordable Care Act); and every time a GOP lawmaker endorses repeal, he or she knows it’s inconsequential posturing because the law isn’t actually going anywhere.
But the fact that so many GOP policymakers say they want to take their constituents access to affordable health care away from them is still kind of bizarre.