A good question for Republicans about the Affordable Care Act

As I noted earlier today, the New York Times has a terrific piece on the “surge in sign-ups” that is happening in West Virginia, thanks to the Affordable Care Act. The Times reports that some 75,000 people have now enrolled in Medicaid (which the Dem governor expanded), a level of demand that has “surprised officials.”

“Waitresses, fast food workers, security guards and cleaners described feeling intense relief that they are now protected from the punishing medical bills that have punched holes in their family budgets,” the Times says. “They spoke in interviews of reclaiming the dignity they had lost over years of being turned away from doctors’ offices because they did not have insurance.”

Which raises a question: how would the GOP Senate candidate in West Virginia, Rep. Shelley Moore Capito, respond if asked directly if she would take insurance away from all these people?

Capito, of course, is a gung-ho supporter of Obamacare repeal. But she has hedged on the Medicaid expansion itself. In December, she reportedly “declined to second-guess the decision” to expand Medicaid, asserting: “We are where we are now, and we have to figure out how to go forward.” But repeal would presumably roll back the Medicaid expansion, too. Does Capito support that?

Obamacare is of course deeply unpopular in red states, and embracing repeal, generally at least, may prove a winner here. Capito is favored. But with enrollment mounting, is there a point at which the question of what repeal would actually mean to all the people who have gained coverage becomes a hard one for Republicans to answer?

The Dem candidate for Senate, Secretary of State Natalie Tennant, has criticized Obamacare, arguing that premiums are too high and choice too limited. She has not said whether she would have voted for it, claiming she’d have brought “more West Virginia values” to the debate over passage.

But Tennant does not support repeal, and she supports the Medicaid expansion. A Tennant campaign spokesperson emails me this:

“Natalie supports West Virginia’s decision to expand Medicaid so that West Virginia tax dollars don’t go to provide health coverage for people in other states.”

Tennant supports the expansion as fiscally responsible (which is easier than calling for the expansion of a government program for the poor). But Tennant has also stressed that as the mother of a child with a pre-existing condition, she “understands the anxiety associated with not having access to affordable health care.”

This  is in keeping with how other red state Dems are handling the law. They are not embracing Obamcare. But they oppose repeal, and they are standing behind the general goal of expanding coverage to those who can’t afford it. This is true of Michelle Nunn in Georgia (where 57 percent support the Medicaid expansion) and Alison Lundergan Grimes in Kentucky, who wants the law fixed and supports making coverage available to hundreds of thousands of Kentuckians, rather than throwing “the baby out with the bathwater.”

None of these Dems were in Congress to vote for Obamacare, so they are free not to embrace the law overall while supporting a part that’s providing more and more coverage and security to people who lacked it.

As 2014 proceeds, will Republicans be pressed directly to account for the actual implications of their repeal stance? Republicans are supposedly going to offer their own alternative replacement for the law, but what would happen to those now benefitting from Obamacare? As Brian Beutler puts it:

What will Republicans propose to do about the X million people who will be newly insured by the end of March? They dedicated the entire final quarter of calendar year 2013 to effusing sympathy for people whose insurance policies were canceled because of Obamacare. It would be incredibly conspicuous for them to introduce legislation that would then kick millions more people off of their plans, particularly given the unlikelihood that they intend to create a similarly generous parallel system. But the only way to avoid that would be to include a grandfathering provision…Even if conservatives would agree to preserve something as monstrous as Obamacare, they know better than to make that promise.

When Mitch McConnell was recently asked by reporters what he has to say about those benefiting from the law in Kentucky, he pulled a homina homina homina. You’d think this question will be posed to more Republicans as the 2014 campaigning intensifies, and as enrollment continues to pile up, that question becomes more relevant — and perhaps more difficult — with every passing day.

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