In it, but not of it. TPM DC
Health care remains an awkward topic in the Kentucky Senate race; Senate Minority Leader Mitch McConnell's (R-KY) has been eager to tout his opposition to the law, while his state has received national attention for its online marketplace working nearly flawlessly since the rollout. As of Nov. 2, over 5,500 people signed up for health insurance in the state using the state's website, Kynect.
McConnell has received strong, persistent criticism from tea party groups -- and primary challenger Matt Bevin -- on the right for not going far enough to defund the health care law. McConnell addressed the success of his home state's marketplace system by arguing that "85 percent" of new signups come from the state's Medicaid expansion. "That's free health care. If you want to give out free health care you're going to have a lot of interest," McConnell said earlier this month.
On the Democratic side, Secretary of State Alison Lundergan Grimes has avoided talking about Obamacare or touting Kynect's marketplace success. When pressed, Grimes said that Obama's apology for aspects of the health care law was "deserved" and that the president should "follow that up with action" on fixing the legislation. Grimes supports Obama's delay of the Obamacare employer mandate.
Grimes's campaign told TPM in an email, "She has called for an extension of the grandfathering period to allow the people of Kentucky to keep their current plans, as well as an extension of the enrollment period and mandate delay for all Americans until the federal website is fixed." Both proposed options are ones that experts say would help to unwind the law.
Sen. Mark Pryor (D-AR) has one of the highest-profile re-election battles in the country. His race against Rep. Tom Cotton (R-AR) has centered on issues like Medicaid, Obamacare and Social Security. Pryor's campaign most recently highlighted the fact that a senior aide on the Cotton campaign played a pivotal role in expanding Medicaid in Arkansas. Pryor also joined a number of red state Senate Democrats in pushing to extend the open enrollment period of the ACA. He had previously said in August that Obamacare is actually working.
In late December 2012, Arkansas Gov. Mike Beebe (D) announced that the state would seek to establish a partnership health insurance exchange, meaning people in Arkansas will have to shop for health care using the federal marketplace website. In April 2013 Beebe signed legislation moving his state from a state-federal marketplace to a state health insurance marketplace by July 2015. As of Nov. 2, just 250 people had signed up for health insurance through Healthcare.gov.
In Georgia, Democrats are optimistic about the vacancy created by Sen. Saxby Chambliss's (R) retirement. Michelle Nunn (D), whose father once held that very seat, announced her candidacy in the Senate race in July. She has supported a delay of the individual mandate in the law, aligning herself with conservatives, including Sen. Johnny Isakson (R-GA).
The top tier of Republican candidates for the Senate seat are Reps. Jack Kingston, Phil Gingrey, and Paul Broun. All have been very outspoken in their opposition to Obamacare. Most recently Rep. Phil Gingrey (R-GA) has said that if elected he would help repeal Obamacare in his first year in office or go home. Broun once said he opposed the law because it covers sex change operations and he likes "being a boy." More recently Broun said that the law is a bigger threat to the country than a national default.
In November 2012, Georgia Gov. Nathan Deal (R) announced that his state no longer planned to establish a state health exchange system. The federal government will take full responsibility for starting and maintaining a health insurance exchange starting in 2014. As of Nov. 2, 1,390 people signed up for health insurance using the federal website.
After enjoying a wide lead for months, polls have shown the race for Sen. Kay Hagan's (D-NC) seat tightening. Hagan, like her red state Democratic colleague Sen. Mary Landrieu (LA), has called for an extension of the open enrollment period and said Obama's legislative fix is a step in the right direction.
Hagan is expected to face North Carolina House Speaker Thom Tillis (R) in the general election. A major part of Tillis's platform is defunding Obamacare. On his campaign website he wrote, "Obamacare is a mortal threat to our economy."
In a reversal from his predecessor's plans, North Carolina Gov. Pat McCrory (R) announced in February that his state would not establish a health care marketplace and instead allow the federal government to establish a marketplace in 2014. As of Nov. 2, 1,662 people signed up for health insurance through Healthcare.gov.
Landrieu has been the leading Democrat to call for legislative fixes that would forbid insurers from canceling policies that do not meet the minimum standards under the Affordable Care Act, making good on the "if you like your plan you can keep it" promise. When Obama gave administrative instructions allowing insurers to continue existing policies for another year, Landrieu said she was "encouraged" by the proposal. Landrieu is also one of a number of Senate Democrats that supports a one-year extension of the open enrollment period of the Affordable Care Act.
Rep. Bill Cassidy (R-LA) is the mainstream Republican candidate facing Landrieu but recently tea party challenger Rob Maness has appeared to pick up some steam by winning the endorsements of the Senate Conservatives Fund and the Madison Project. Cassidy supported a bill in the House to allow people to keep their current health insurance plans and issued the following statement, "Constituent after constituent is calling my office, asking why they were deceived and why they are losing their insurance. On their behalf, we must save their insurance and replace Obamacare with patient-centered solutions that work." Maness has gone further, calling Obamacare a "scam."
Louisiana announced it would not be creating its own health insurance marketplace in 2011. The federal government is set to start running a health insurance exchange in 2014. Louisiana has some of the worst enrollment numbers as well, with administrative numbers revealing just 387 people signed up for health insurance through the federal website.
In West Virginia, Secretary of State Natalie Tennant (D) is facing Rep. Shelley Moore Capito (R-WV) for retiring Sen. Jay Rockefeller's (D-WV) seat. Tennant, one of the more conservative Democrats running for Senate in 2014, has been vague on the Affordable Care Act, even recently. She's said that there "are elements in the Affordable Care Act that we need and elements that must be fixed." Tennant has also called for a delay in enforcement of the penalty for Americans not signing up for insurance and, according to her campaign "supports West Virginians being allowed to keep their existing plans because our state should never be penalized for Washington's mistakes."
The National Republican Senatorial Committee has worked to closely link Tennant with the Obama administration's health care law, saying that she is an "Obama-supporting liberal" more like Senate Majority Harry Reid (D-NV) than Sen. Joe Manchin (D-WV).
In March, West Virginia received approval from the Department of Health and Human Services to set up a partnership marketplace, which means that users still must use Healthcare.gov to access the marketplace. The state posted a website offering information to help guide consumers to enroll in insurance plans through Healthcare.gov; as of Nov. 2, just 174 people signed up.
In Montana, Democratic candidate Lt. Gov John Walsh, through a spokesman, has said that the Obamacare rollout was "disastrous" and has called for Congress to "insurance companies accountable." His campaign has also argued that the Obama administration hasn't taken enough steps to fix the problems with the health care law. Walsh has embraced a proposal by Sen. Mary Landrieu (D-LA), another Democrat in a 2014 Senate race, which would require insurers to maintain plans for current policy holders.
On the Republican side, Rep. Steve Daines, also running in the Senate race, has strongly criticized the law. After Obama announced his administrative fix, he said from the House floor last week, "Today's announcement does very little to resolve the President's broken promise or provide hard-working Montana families with much-needed relief and protection from the President's failed health care law."
In March, Montana agreed to set up a federal-state partnership health exchange, which means users will still shop for health care using the federal marketplace. As of Nov. 2, 212 people enrolled through Healthcare.gov.
South Dakota's race for outgoing Sen. Tim Johnson's (D-SD) seat is tight. A recent poll found former Gov. Mike Rounds, the Republican frontrunner, leading Democrat Rick Weiland by 6 points. Weiland has taken a unique approach to broaching Obamacare. He recently said that if elected, he would push a proposal allowing citizens, regardless of age, to buy into Medicare instead of private health care plans.
"Medicare ought to be given the opportunity to compete by giving people (of all ages) an option ... about whether or not they want to enroll in Medicare or private health insurance," Weiland said, according to South Dakota's Argus Leader.
Weiland's proposal was conceived in part through his background as a state director of South Dakota's American Association of Retired Persons, the South Dakota newspaper reported.
"People understand Medicare," Weiland said. "It works, it's efficient, and all this other stuff that they're having now to focus on is extremely complicated and they don't understand it."
Rounds, meanwhile, has called for dismantling the law, even though two of his highly placed campaign advisers shepherded through a new state law that requires Obamacare policies go through insurers based in the state and requires normal commissions be paid.
South Dakota has plans to to keep "regulatory authority" over its health insurance system even though Gov. Dennis Daugaard (R) announced in 2012 that the state would not set up a state-based marketplace. In the meantime, just 58 people have signed up for insurance using Healthcare.gov.
Rep. Bruce Braley (D-IA) is the favorite to inherit the seat being vacated by progressive firebrand Sen. Tom Harkin (D-IA), since the Republican field is crowded and no clear frontrunner has yet emerged. Braley caught attention for being one of the few House Democrats to embrace Rep. Fred Upton's (R-MI) proposal to alter Obamacare so that insurers can sell existing plans to anyone -- not just current policy holders -- until the end of 2014.
Braley has both praised Obamacare and called for changes. He has said that he's committed to improve the law, adding that "Iowans simply can't afford to go back to a health care system where insurance companies could deny coverage based on pre-existing conditions, or cancel coverage when someone got sick, or increase premiums year-after-year with no justification."
But during a hearing on the Affordable Care Act in October, Braley said that the law is "doing a lot of great things in Iowa."