Senate Majority Leader McConnell on Obamacare replacement: Don’t ask

Mitch McConnell meets ordinary folks as he grocery shops in Louisville’s Highlands neighborhood. They talk to him about their disdain for Obamacare. So how does he tell them things will get better?

“That’s what the replacement will be about, and we’re not here to announce it today,” the Senate majority leader told McClatchy in an interview. Congress took the first major step last week to end Obamacare, but offered no specific replacement.

On the eve of President-elect Donald Trump’s inauguration, which will give Republicans control of both the White House and Congress for the first time in 10 years, McConnell discussed his hopes for health care coverage and his relationship with Trump. He made it clear he does not share Trump’s warm feelings toward Russia or his skepticism about NATO, but the Kentucky Republican refused to criticize Trump’s recent caustic comments about Rep. John Lewis, D-Ga.

McConnell is leading a Senate with 52 Republicans this year, meaning a loss of three GOP supporters could force changes to or even doom Trump initiatives.

McConnell has a particularly thorny road, because “Kentucky has had one of the most successful (Obamacare) implementation experiences among states,” according to an analysis by the nonpartisan Kaiser Family Foundation.

Thanks to the law, the state expanded the Medicaid program, which provides coverage for lower-income people, in 2014, and built its own health insurance marketplace where consumers could compare polices and prices.

The state’s uninsured rate fell from 16 percent in 2013 to 8 percent the next year, one of the nation’s biggest drops. But McConnell sees strong sentiment against Obamacare. Experts see an opening.

They’ll give Trump the benefit of the doubt, but shortly after he gets in, people want to see some action,” said Al Cross, director of the Institute for Rural Journalism and Community Issues at the University of Kentucky.

McConnell was asked why he would want to undo a successful program. “It depends on how you define success,” he said. He pointed to “higher premiums and co-payments and higher deductibles and chaos in the private health insurance market.”

After all, McConnell figured, “if the goal was to expand Medicaid, that could have been done alone. . . . This overreach tried to turn the private health insurance market into a regulated utility.”

Republican Gov. Matt Bevin of Kentucky wants to scale back the Medicaid expansion but has faced resistance from state lawmakers. He’s proposed charging an income-based monthly premium for policies and ending coverage for those who don’t comply.

In Washington, McConnell’s biggest legislative task over the next two years is keeping Republicans in line.

“At one level, the GOP has all the power levers, but at another level, keeping the coalition together will be a challenge,” said James Pfiffner, who has written several books on the presidency and presidential transitions.

During the 2016 campaign, McConnell endorsed Trump after he had all but clinched the nomination. McConnell told Bloomberg Politics in June that “it was pretty obvious he doesn’t know a lot about issues,” and the senator was critical of Trump’s insults of ethnic and minority groups and women.

“I think all of that needs to stop,” McConnell said. “Both the shots at people he defeated in the primary and these attacks on various ethnic groups in the country.”

The senator, though, would not discuss Trump’s feud with Lewis, who was arrested and beaten during the civil rights protests of the 1960s. Lewis told NBC News’ “Meet the Press’ this week that he did not see Trump as a “legitimate president” because he believed the Russians helped Trump get elected.

Trump fired back. “All talk, talk, talk, no action or results. Sad!” he said of Lewis.

McConnell would not weigh in. “What I intend to do is speak for myself, and not speak for the president-elect,” he said.

Pressed on what he thought of the Lewis comments, McConnell said, “That’s the same question you’ve asked me twice. . . . I don’t have anything to say about it.”

McConnell is walking a political tightrope. Trump takes office Friday with an unusually low approval rating. McConnell was undaunted. “If approval rating was the determinant factor, he wouldn’t have been the nominee or gotten elected,” he said, noting that such ratings were low throughout the campaign.

Asked whether he remained concerned that Trump needs schooling on issues, McConnell asked his own question.

“Why don’t you ask me what my position is on things and you can draw your own conclusions?” he asked.

Trump wants to get tough on immigrants who are in the U.S. illegally and to build a wall along the border with Mexico. Four years ago, a bipartisan Senate coalition passed legislation, which later died in the House of Representatives, that would have cracked down on border security but also provided a path to citizenship for many who had entered the country illegally.

McConnell would not discuss that plan’s prospects. “I’m not going to sit here and tell you what may or may not be considered,” he said.

He was more specific on Russia and NATO. “They’re a big problem,” he said of Russia. And NATO “is the most important military alliance in world history and is more important than it ever was.” Trump was critical of NATO earlier this week.

Does Trump understand that? McConnell praised Trump’s nominees for the Pentagon, Homeland Security and the Central Intelligence Agency.

As for Trump’s understanding of the issues, “You’ll have to ask him,” McConnell said.

David Lightman: 202-383-6101, @lightmandavid