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ACA trips up both of Kentucky's U.S. senators

The senior and junior senators from the Bluegrass State know they want to destroy the federal health care system. What comes next? They have no idea.
Kentucky Senators Mitch McConnell, left, and Rand Paul address the media during a press conference, May 23, 2014, in Louisville, Ky.
Kentucky Senators Mitch McConnell, left, and Rand Paul address the media during a press conference, May 23, 2014, in Louisville, Ky.
Senate Minority Leader Mitch McConnell (R-Ky.) found himself in an awkward position last week when talking about the Affordable Care Act. On the one hand, the law is working very well for McConnell's constituents, and in this election year, Kentuckians are not eager to give up their new benefits. On the other hand, McConnell is committed to destroying the federal health care system at all costs.
The result was complete incoherence. Over the course of a few days, McConnell made a series of bizarre remarks about the ACA, which he tried to clarify with even more nonsensical rhetoric. With each passing comment, the longtime senator seemed more confused by the basics. By late Friday, McConnell's position seemed to be that he intended to repeal the entirety of "Obamacare," only to have Kentucky replace it soon after with an identical system that the state should somehow try to pay for.
As Sam Youngman reported, McConnell's confusion is proving to be contagious.

Sen. Rand Paul ... talking to reporters after speaking at an event in Frankfort, said he wasn't sure whether Kynect, Kentucky's implementation of President Barack Obama's health care law, should be dismantled, saying there were far bigger questions that make a simple answer impossible. "There's a lot of questions that are big questions that are beyond just the exchange and the Kynect and things like that," Paul said. "It's ... how we're going to fund these things."

Paul specifically told reporters, "I would repeal all of Obamacare." Asked about possibly dismantling the Kentucky exchange marketplace created and subsidized by the federal law, the junior senator added, "You know, I'm not sure."
How reassuring.
Maybe I can help explain this to Paul.
As we discussed last week, the federal law the senator wants to destroy created exchange marketplaces, including the Kynect system that's working great in Kentucky, where insurers compete for consumers' business.
In theory, if Paul and McConnell successfully demolished the federal system, Kentucky could keep its exchange marketplace, but the problem is, the senators seem to be operating with an incomplete understanding of how the system works.
Again, as we've talked about, for most Kentuckians who visit the state-based exchange marketplace, there's a federal subsidy that makes insurance more affordable. For that matter, the coverage plans included in these exchanges are regulated heavily to guarantee consumer protections.
In other words, destroy the ACA and Kentucky would be left with something resembling its Kynect marketplace, only it'd offer worse and more expensive insurance plans. Making matters even worse, many Kentuckians learn they're eligible for Medicaid coverage through the Kynect exchange. Destroy the law and Medicaid expansion disappears, leaving these families with nothing.
Paul has given the issue enough thought to know he's eager to destroy the federal system, but even after all of these years, he hasn't given the issue enough thought to know what to do in the aftermath.
That, of course, would take a little effort -- for which neither the senior senator nor the junior senator from Kentucky are prepared.