In it, but not of it. TPM DC

GOP Senate Candidate Joni Ernst Takes Puzzling Obamacare Stance

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AP Photo / Charlie Neibergall

"What we have to do is protect those that are on Medicaid now; those that are on Social Security now. That, we need to protect. We have made promises to these people," Ernst, a state senator, said in an interview with the New York Times, while also calling for trimming federal spending on education and the I.R.S.

She added, "We have to understand there's a problem, and address it. But those that are already engaged in Social Security, Medicare, Medicaid, we need to protect that for them."

Ernst's positions -- repeal Obamacare but protect those on Medicaid -- are difficult to reconcile. About 78,860 Iowans have gained coverage under Medicaid expansion due to federal funds authorized by Obamacare, according to administration figures provided on May 1. If Obamacare is repealed, the federal funds for the new Medicaid beneficiaries would disappear.

The candidate's campaign website says she's "staunchly opposed to the Obamacare law" and "supports immediate action to repeal Obamacare."

Without Obamacare there would have be another source of funding in order to protect coverage for those Iowans. The state of Iowa could theoretically step in and fund the program through state dollars. But that would cost millions and there's no indication the state is prepared to do that. Ernst didn't point to an alternate funding stream she would support in the Times interview.

Ernst's campaign spokeswoman didn't return multiple requests for clarification of her position.

The Medicaid expansion provides federal funding for states to cover residents up to 133 percent of the federal poverty line. It's a lucrative deal: the federal government pays the full cost through 2016 and no less than 90 percent thereafter. It was made optional by the Supreme Court; Iowa adopted it.

Ernst's remarks reflect the changing national politics of Obamacare as millions of Americans gain insurance coverage under the law. Republicans universally support fully repealing Obamacare but some have had trouble reconciling that with their constituents who are benefiting from it.

Earlier this year, Senate Minority Leader Mitch McConnell (R-KY) stumbled on to the same problem after Obamacare cut his state's uninsured rate by some 40 percent. He told reporters that his push to repeal Obamacare was "unconnected" to the future of Kentucky's state-based Obamacare exchange, called Kynect.