LOUISVILLE, Ky. (AP) -- Senate Republican leader Mitch McConnell wants to repeal the Affordable Care Act, but he would not say Friday what that would mean for the 413,000 Kentuckians who have health insurance through the state's health care exchange.
McConnell told reporters that the fate of Kynect -- Kentucky's state-run health insurance exchange -- is not linked to the federal health care law. But the exchange would not exist if not for the federal law that created it.
Asked if a repeal of the health care law would mean Kynect should be disbanded, McConnell said: "I think that's unconnected to my comments about the overall question."
"What I would have done instead is first of all tear down the walls, the 50 separate silos in which health insurance is controlled, and pit all the health insurance companies against each other in a national competitive market," he said. "Competition almost always works to keep prices down and quality up."
McConnell's Democratic opponent, Kentucky Secretary of State Alison Lundergan Grimes, has said she opposes "taking away insurance that 400,000 Kentuckians just recently got access to." But the Democratic nominee has declined to say whether she would have voted for the law had she been in office when it was approved in 2010, saying only she would work to fix the law if elected.
The comments underscore the political sensitivity the federal health care law, sometimes known as "Obamacare," presents to candidates from both parties.
Some parts of the law are popular in Kentucky, and McConnell doesn't want to alienate constituents who now have health insurance in one of the nation's poorest states. But the law and the president whose name it evokes remain unpopular in Kentucky -- thus Grimes' rhetorical dancing over whether she would have voted yes when it passed four years ago.
McConnell, who would become Senate majority leader if he is re-elected and Republicans gain six seats in the November elections, and Grimes, the Democrats' prized recruit, are battling it out in one of the most closely-watched contests in the nation.
Kentucky Democrats have worked hard to separate Kynect from the disastrous rollout of the federal health care exchange, in which website failures made it difficult to enroll in the program. Many of those problems have since been fixed.
In Kentucky -- one of only two Southern states where Democrats control the House -- some Democratic candidates have begun to refer to the law as "Beshearcare," a reference to Kentucky's popular Democratic Gov. Steve Beshear. Republicans control the Kentucky Senate.
"I don't know if it's something our candidates will run on, but what I think it shows to the people of Kentucky is that Kentucky Democrats are just that. We are Kentuckians. And we don't do things maybe the way Washington, D.C. does," said state Rep. Sannie Overly, who is overseeing state House Democratic candidates as chairwoman of the House Democratic Caucus.
It's unclear if the strategy will work for Grimes in a state where "Obamacare" remains unpopular but Kynect is embraced as successful. Friday, in a joint news conference with fellow Republican U.S. Sen. Rand Paul, McConnell pointed to a report from the Congressional Budget Office that said the Affordable Care Act reduced the number of uninsured people nationwide to 30 million from 40 million.
"What is the cost-benefit ratio of this kind of destruction, the impact on our 16 percent of the economy, to have such a marginal reduction at the end of the day?" he said. "I think people of this state are entitled to know the answer to the question, how do you feel about it?"
Grimes, meanwhile, has been targeting Republicans who supported Matt Bevin in Tuesday's Republican primary. McConnell easily defeated the tea-party backed Bevin to win the GOP nomination.
"I hope you will take the time to get to know who I am and my true positions," Grimes wrote in an open letter to Republican voters. The letter said Grimes supports closing "tax loopholes that encourage big corporations to ship our good-paying Kentucky jobs overseas."
After the news conference, a McConnell spokeswoman said that if the Affordable Care Act is repealed, "Kentucky should decide for itself whether to keep Kynect or set up a different marketplace."
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