This is getting outrageous.

Rep. Tom Cotton is running for U.S. Senate, advocating root-and-branch repeal of Obamacare as the key tenet of his platform, and he refuses to be honest about the impacts that policy change would have on Arkansans. For all of his big talk of principled stands and doing “the hard right over the easy wrong,” he has shown himself afraid or unwilling to level with the people of Arkansas about the policy change he is advocating for. Cotton’s explicit plan would repeal the private option, ending health insurance coverage for 200,000 Arkansans. He just won’t admit it. 


Lots of folks are pointing out that in yesterday’s Senate debate in Kentucky, Sen. Mitch McConnell gave absolute nonsense answers on what would happen to the hundreds of thousands of Kentuckians who have gained coverage if McConnell was successful in his goal of repealing the Affordable Care Act. 

Here’s McConnell:  


Kentucky Kynect is a website. It was paid for by a grant from the federal government. The website can continue, but in my view the best interests of the country would be achieved by pulling out Obamacare root and branch. … It’s fine to have a website.

Even in the context of a political debate, this stands out as cynical, transparently dishonest, and stupid. Horse manure fit for Churchill Downs.

Kynect is not simply a website, it is the health insurance marketplace created and funded by Obamacare (as well as the portal through which people enroll in the Medicaid expansion funded by Obamacare). Around 500,000 Kentuckians have health insurance coverage via Kynect. That’s via Obamacare. If Obamacare goes away, Kynect would go away, and the health insurance for those 500,000 Kentuckians would go away. McConnell said it was a “state exchange,” Kentucky “can continue it if they’d like to” and Medicaid expansion was a “state decision.” This is utter sophistry. If Obamacare goes away, the funding for the coverage expansion would go away. Is McConnell suggesting that Kentucky pay for the coverage expansion on its own? If so, how? McConnell is peddling a fantasy convincing only to someone not paying much attention (that’s probably the point) — that Obamacare can vanish while Kentucky somehow gets to keep all the popular stuff about Obamacare (like Kynect) that Kentuckians like. See here and here and here for more.  


If McConnell’s answer was nonsense, Cotton simply refused to answer at all. There was a remarkable moment in last night’s debate when panelist Gwen Moritz asked the candidates this: 

If you are elected, what would you like to see happen to the ACA? And please include in your answer exactly what effect your proposal would have on the 200,000 Arkansans who are now insured by the Arkansas private option

Emphasis mine. The question was specific and clear. Cotton’s two-minute response did not say a single word about the private option, or what would happen to the 200,000 Arkansans who would lose their coverage. Nor did he say a single word about the 40,000 other Arkansans who are enrolled in plans they purchased on the Arkansas Health Insurance Marketplace, the exchange created by Obamacare (90 percent of whom receive Obamacare subsidies to lower the cost of their insurance). They too would lose their health insurance if Obamacare was repealed. 


Cotton said Obamacare was a “disaster” for Arkansas, but said nothing — even when explicitly asked — about almost a quarter of a million people who have gained coverage, which remarkably has already cut the uninsurance rate in Arkansas in half. “What effect,” as Moritz put it, would his proposal have on them? He gave a laundry list of conservative talking points on health care reform: selling insurance across state lines, small business insurance pools, and block granting Medicaid (which, in the versions that Cotton voted for in the Ryan budget and the Republican Study Committee budgets, involves not only eliminating Medicaid expansion, but also massive funding cuts to the existing Medicaid program on top of that, including programs for kids such as ARKids).

Whatever one thinks of the merits or costs or feasibility of these individual ideas, there in nothing in Cotton’s response that would come anywhere close to offering coverage to the 240,000 Arkansans who would stand to lose their coverage if Obamacare was repealed. There is nothing in the response, as Pryor noted, that would address insurance companies discriminating against people who have pre-existing conditions attempting to buy health insurance, a practice banned by Obamacare. Or what about community rating, which keeps insurance companies from price discriminating against women? Or what about subsidies for people low-to-moderate-income people to buy individual health insurance? Or what about people being able to stay on their parents’ plan until age 26? 


If Cotton has a plan to cover all the folks on the private option after he eliminates all the funding for it, he needs to say so. If he has a plan to keep all of the popular parts of Obamacare in place while simultaneously repealing Obamacare, he needs to say so. Nothing in his responses at this debate, or in numerous other public statements on this topic, suggests he has anything of the kind.

Cotton has steadfastly refused to take a position on the private option, calling it a “state-based issue.” He has dodged it over and over and over and over and over and over


This is simple: the private option is funded by Obamacare. If you repeal Obamacare, the private option goes away. Health insurance for 200,000 Arkansans covered by the private option goes away. There’s no mystery about this: Cotton has voted to repeal Medicaid expansion numerous times. 

There are lots of tradeoffs inherent in the health care law, and it’s perfectly coherent for a conservative to advocate for repeal even though repeal means eliminating benefits, including benefits that are politically popular. Perhaps Cotton’s position is simply that the safety net for health care should be less robust. That’s fine. But it’s time for him to stand behind the real-world consequences of his policy preferences. It’s time for him to own that. It’s time for him to be honest. It’s time for him to explain himself to directly to those Arkansas who would lose their coverage if Obamacare was repealed. 

Tom Cotton said “Obama” 74 times in yesterday’s debate. But oddly, when it comes to what would happen if the hated Obamacare went away, he clammed right up.