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McConnell flubs health care basics in key debate

Either the Republicans' Senate leader is confused by the basics of health care policy or he's choosing to mislead the public on purpose.
Minority Leader U.S. Sen. Mitch McConnell (R) and Kentucky Secretary of State Alison Lundergan Grimes (D) rehearse before their debate on October 13, 2014 in Lexington, Ky. (Photo by Pablo Alcala/Pool/Getty)
Minority Leader U.S. Sen. Mitch McConnell (R) and Kentucky Secretary of State Alison Lundergan Grimes (D) rehearse before their debate on October 13, 2014 in Lexington, Ky.
The political world's rules are coming into sharper focus. When a candidate flubs a process question -- issues related to electoral considerations that have little to do with actual substance -- the media is supposed to take that very seriously, possibly even characterizing it as disqualifying. When a candidate flubs a policy question -- dealing with issues that will make a material difference in people's lives -- the media is supposed to back off, occasionally even applauding his or her savviness.
With the rules in mind, the big story out of last night's Senate debate in Kentucky is probably supposed to be Secretary of State Alison Lundergran Grimes' (D) reluctance to say which presidential candidate she voted for in 2012 -- an issue the media has deemed extremely important, but which actually affects no one.
There was, however, arguably a far more important development last night: Senate Minority Leader Mitch McConnell's (R) total incoherence on health care policy. Benjy Sarlin reported overnight:

Turning to health care, McConnell struggled to explain how he squared his promise to repeal Obamacare with his claim that Kentucky could also keep its popular state health care exchange, which runs on subsidies provided by the law, and the state's Medicaid expansion, which was financed by federal dollars under the health care law as well. [...] Pressed as to whether he personally supported maintaining the exchange if Obamacare were repealed, he responded that "it's fine to have a website, yeah."

No, actually, it's not. As we've discussed before, 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, if McConnell succeeds in destroying the federal health care system, he'd leave his constituents with a "fine" website that would offer worse and more expensive insurance plans. Complicating matters, many Kentuckians learn they're eligible for Medicaid coverage through Kentucky's Kynect exchange. Destroy the law and Medicaid expansion disappears, leaving these families with nothing.
It's why McConnell's rhetoric last night can charitably be described as gibberish. With the health security of hundreds of thousands of Kentuckians on the line, this seems a tad more significant than whether Grimes voted for the president two years ago.
Making matters slightly worse, the Republican senator also told viewers that the Congressional Budget Office found that "Obamacare" would cost the nation 2.5 million jobs.
That's ridiculously untrue. What the CBO actually said is that the law will empower 2.5 million Americans to leave the workforce if they want to, no longer feeling forced to stay at a job in order to have benefits for them and their family.
That is a selling point, not a flaw. Among the advantages the ACA offers the public, this is a feature, not a bug.
The question then becomes whether McConnell doesn't understand how to read a Congressional Budget Office report, which would raise alarming questions about his basic competence as a longtime federal lawmaker, or whether McConnell does understand the policy and he chooses to mislead the public on purpose.
There doesn't appear to be a third option.