January 22

The ongoing implementation of health care reform in Kentucky is a riveting story, with implications both for the 2014 elections and for health reform’s broader future. In this deep red state, the Dem governor may be the most outspoken defender of Obamacare in the south, and while the law is deeply unpopular, its implementation appears to be helping more and more poor and rural Kentuckians each day.

Meanwhile, the number one opponent of Obama’s agenda — Mitch McConnell — is on the ballot, and he continues to call for the total repeal of the law, while declining to answer directly when asked what he has to say about the large numbers of people who are benefitting from it.

But now check out this new ad that the McConnell campaign just rolled out: It touts his efforts to make health care available to sick people who desperately needed it. It features the tale of an energy plant worker who was exposed to radiation and got throat cancer. He notes that “many others” suffered the same fate, and that McConnell “stepped in and helped create cancer screening programs”:

This ad would seem to give Democrats an opening to press hard on a question: What would McConnell do for the large numbers of his own constituents who would lose access to health coverage, and the sense of security it is bringing, if he gets his way and Obamacare is repealed?

This is, at bottom, a moral argument. Here’s what Kentucky governor Steve Beshear recently had to say about the Medicaid expansion:

“This is a moral issue. Every person in the country deserves access to affordable health coverage. The Medicaid expansion is part of the way we can do that. These folks out here without insurance aren’t a group of aliens from another planet. They are our friends and neighbors. They are people we shop and go to church with. They are the farmers out on the tractors. They are our grocery clerks. They are our former classmates. They are people who go to work every morning praying they don’t get sick. No one deserves to live that way.”

McConnell’s new ad tells us should be reelected because his efforts to bring health coverage to people who lack it shows his willingness to “knock down walls” for Kentucky’s “working families,” helping “save people’s lives.”  So what about all the working people who would lose coverage if McConnell got his way?

The McConnell response would be that Obamacare is the wrong way to expand coverage, and he regularly argues that it constitutes giving “free health care” to people, so time to “repeal it root and branch.” But that isn’t an answer to the question at all.

Beltway observers will scoff at the notion that this is a hard question. Republicans, this line of thinking tells us, will have no trouble whatsoever making the Obamacare debate only about rising premiums, lost coverage, and Obummer Job Killing Big Gummint Kenyan Muslim Socialism.

After all, McConnell’s Dem opponent, Alison Lundergan Grimes, is taking an extremely cautious approach to the law.

But she would not repeal Obamacare, and she does voice support for the law’s general goal of expanding coverage to hundreds of thousands of Kentuckians. McConnell’s own ad shifts the debate into one about the moral virtues of helping expand coverage to those who desperately need it. As enrollment numbers continue to mount, you’d think local reporters would, in this context, press McConnell harder to account for the true implications of his repeal stance. That may happen in other races as well.

Will that affect the outcome in the Kentucky Senate race? I have no idea. But it’s an argument worth having.

* NORTH CAROLINA’S EXPERIMENT IN SLASHING SAFETY NET: Annie Lowrey has a deep dive into North Carolina’s experiment in rolling back unemployment benefits, and the early returns are not pretty: Economists note that while it has prodded some to seek work, more have dropped out of the labor force altogether.

Statistics don’t tell the full story. North Carolina still has nearly 350,000 listed as officially unemployed, and many more, including those living in depressed rural areas, have given up even looking for a job. For them, the safety net is gone, and largely out of sight, countless families have slipped deeper into poverty…Many jobless workers are accepting jobs for far less pay than they made before, and in many communities, there are simply not enough jobs.

* A BOOST FOR MEDICAID EXPANSION IN VIRGINIA? Democrats prevailed last night in a three-way special election that put them in striking distance of controlling the Virginia Senate. Republicans, who control of the House of Delegates, want to hold the Senate in part to make it harder for new Dem Governor Terry McAuliffe to implement the Medicaid expansion. With 200,000 Virginians reportedly in peril of falling into the state’s “Medicaid gap,” an expansion in this major presidential swing state would be a victory for Obamacare.

* OBAMA AGENDA ON BALLOT IN FLORIDA: The Fix crew has an interesting look at Charlie Crist’s bid to unseat Florida governor Rick Scott. Counter-intuitively, Crist, who is now a Democrat, is working to associate himself with the president, since he won the state (whose demographics are shifting) twice and perhaps Obama’s approach works here. Footnote: Crist has been slamming Scott for dragging his feet on the Medicaid expansion (which is being used as a weapon against other GOP governors, characterizing him as “callous” and “heartless.”

* CRIST HOLDS SMALL LEAD OVER SCOTT: Related to the above: The robofirm Public Policy Polling finds Crist leading Scott among Florida voters by a statistically insignificant two points, 43-41. This, even though 62 percent think implementation of Obamacare has been unsuccessful. Meanwhile, large majorities support raising the minimum wage and extending unemployment insurance, two key Obama agenda items.

* OBAMA PREPARING FOR BIG “YEAR OF ACTION”? The Hill has a very interesting look at the ways in which John Podesta may be sharpening Obama’s economic message and preparing the White House for a serious spate of executive action on the economy and climate change:

Podesta has long argued that executive actions provide a dual benefit, both rallying the base through policy victories and creating a perception of momentum and snowballing accomplishments. “Progress, not positioning, is what the public wants and deserves,” Podesta wrote shortly after the 2010 midterm elections — a disaster for Obama.

Also, progress and accomplishments might not make a bad contrast with a party that remains obsessed with repealing Obamacare, which would in effect take us back to the old system.

* AND DEMS FACING BLOODBATH IN SENATE? Real Clear Politics’ Sean Trend has a deep look at the Senate map and Obama’s approval ratings, concluding that the Beltway conventional wisdom hasn’t caught up to just how much of a threat his slide is to Dem control of the Senate. However, there’s a flip side:

If the president’s job approval is still around 43 percent in November — lower than it was on Election Day in 2010 — the question would probably not be whether the Democrats will hold the Senate, but whether Republicans can win 54 or 55 seats. Given the numbers right now, that should not be unthinkable. But there’s a flip side to this. If Obama’s job approval doess a reasonable chance that Republicans could walk away from this cycle with just a handful of pickups. 

As Trende notes, Senate races — which are heavily candidate-dependent — also have a tendency to be full of surprises. Bottom line: It’s way too early to have any idea what’s going to happen.