Sen. Mitch McConnell has won his life-long dream to be majority leader in the Senate. He had no trouble beating Alison Lundergan Grimes in Tuesday’s election in Kentucky. He has low favorable ratings in his home state (only 38% of voters approved of his work in mid-October), but President Obama is even less popular (only 35% of Kentuckians approved of him in 2013). McConnell lashed Grimes to the president and he sank her ship (among other things).
McConnell is set to become majority leader in 2015 and people already want to know how he is going to start dismantling the Affordable Care Act. McConnell has to navigate a tricky path with this task for two reasons.
One is that Humana is one of his biggest campaign donors. The Louisville company certainly won’t want the individual mandate to go away. You can see how much the insurer has given McConnell over the years in the chart above from OpenSecrets.org. Kindred is a long-term care provider, another influencer in McConnell’s healthcare calculus. (The Blackstone Group is a multi-national investment firm, in case you’re curious.)
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The other factor in the equation is the smashing success of KYnect, the state’s health insurance exchange. Medicaid expansion has extended coverage to many people in Kentucky, so it’s hard to see McConnell pushing a repeal of the ACA that would take insurance away from people in his home state. During the first open enrollment period, 413,410 Kentuckians got health insurance through kynect. in the final three days of enrollment, kynect processed more than 7,000 applications each day.
That makes it more likely that he would push a repeal of the device tax, or maybe try to roll back the employer mandate. PCORI also could be a target, as McConnell could try to block funding to the organization. Insurers have to pay a $2 fee per covered life to support this reseach group. He also could chip away at some of the taxes included in the bill or support the lawsuit that says the subsidies are illegal. That would not affect his constituents, because they get coverage from a state-run exchange. The lawsuit is focused on people who get subsidies when purchasing a policy from the federal exchange.
