Senate Minority Leader Mitch McConnell (R-Ky.) has made a habit of saying during his hotly contested race for re-election that repealing the Patient Protection and Affordable Care Act would not necessarily mean shutting down the state's popular insurance exchange that was established under the law. The claim leaves many experts puzzled.
McConnell is poised to become Senate majority leader if Republicans gain control of the chamber in November. But only if he wins his own race.
“If you just took the Kentucky exchange out of the rest of Obamacare, it would have almost no business,” said Paul Ginsburg, professor of health policy and management at the University of Southern California. “It's not the website that makes the difference, it's the tax credits and regulations which transformed the individual market.”
Joel Ario, a managing director at consultancy Manatt Health Solutions and one of the architects behind the federal health exchange, likewise said the exchange, called Kynect, could not function without the regulatory framework and subsidies that define the marketplace. “It's very hard to square the circle,” he said. “He's saying, 'I like Kynect, and I like the storefront … but at the same time, I want to take away the law that is the source of all those products in the store.' ”