Senator Mary Landrieu is one of the most vulnerable of red state Democratic incumbents, and her reelection challenges — like those of other red state Dems — are said to be all about Obamacare.

But in an interview today, Landrieu vowed to campaign aggressively against GOP foe Bill Cassidy’s opposition to the Medicaid expansion in the state, offered a spirited defense of the law — while acknowledging it has some problems — and even insisted he’d be at a “disadvantage” over the issue.

This week a state legislative committee in Louisiana is expected to consider a measure that would put a constitutional amendment before the voters this fall that, if approved, would direct the state to accept $16 billion in Medicaid money to cover 242,000 people. Even if the ballot measure is not green-lighted by the legislature, Landrieu said she will continue to press the issue — and hit Rep. Cassidy over it.

“That would be a real setback for the people of Louisiana, many of whom are working 30, 40, 50 hours a week but find themselves caught in the Jindal gap because the state refuses to expand health care options to the working poor at little to no expense,” Landrieu told me, referring to Governor Bobby Jindal’s opposition to the expansion.

“This issue is not going away — it will become an issue in the 2015 governor’s race,” she added. “Cassidy has wrapped himself up with Jindal. The question is whether people who work full time or part time in the U.S. should have access to quality and affordable health care.”

Landrieu has been a vocal proponent of a “keep and fix” message on Obamacare. But Republicans have argued Dems aren’t actually offering any fixes. Landrieu noted she’s advocating for making the provision of coverage voluntary for businesses with fewer than 100 employees and adding a more affordable “copper” plan. She reiterated her support for the law’s goals — and said Cassidy’s embrace of repeal would be politically problematic for him.

“It’s a solid law that needs improvement,” Landrieu said. “My opponent offers nothing but repeal, repeal, and repeal. And even with all the law’s setbacks, we’re seeing benefits for thousands of people in Louisiana.”

“I think the benefits that people have received are worth fighting for,” Landrieu continued, citing an end to discrimination against preexisting conditions and extended coverage for young adults on parents’ plans. “I think Bill Cassidy is going to be at a distinct disadvantage. He has insurance, but he’s also denying it to the 242,000 people who fall into the Jindal gap. He also wants to take coverage away from tens of thousands who have gotten it for the first time.”

The law — and the president — are deeply unpopular in Louisiana, and red state Dems are running in an “increasingly polarized and Republican region” where votes for Senate increasingly correlate with votes for president. The Louisiana race is very close. Asked whether the ACA and Obama were serious liabilities for her, Landrieu said: “This race will be won not on the president’s record, but on my record…The Affordable Care Act won’t be the centerpiece of my campaign. The centerpiece will be my leadership and ability to deliver for the people of my state, no matter who the president is.”

Dems also face a “midterm dropoff” in core voters, which could get worse in a runoff under Louisiana’s system. Asked about this, Landrieu replied: “I’ve run and won three times, with and without presidents at the top of the ticket. In 2002 we had higher turnout in the December runoff than we did from my base in the first primary. I’m prepared to run a very aggressive field campaign. I’ve never relied just on TV.”

In the near term, the focus will be on the Medicaid expansion: “Will I defend the good parts of the Affordable Care Act? Yes. Will I urge improvements to parts that can be fixed? Absolutely. Do I have to tie Cassidy to Jindal? He’s already done that himself.”


UPDATE: I should add that in the interview, Landrieu didn’t just talk about Cassidy. She also discussed other potential GOP opponents who are running (in addition to Cassidy, there are conservative challengers Rob Maness and State Rep. Paul Hollis), noting that the crowded field is one reason the race could be headed for a runoff.