What do you do when you've spent four years telling everybody and their brother that "Obamacare should be repealed root and branch" but then it turns out that Obamacare is delivering so many benefits to your state that even your home state Republicans don't want to get rid of its Medicaid expansion?
First, you start running an ad about how you're actually totally in favor of providing health care services to people who need them. And then you get your buddies at the Chamber of Commerce to help pivot you away from the teahadist message of repeal to a message about how you're leading the fight to "fix" Obamacare.
And as it's become clear that taking a hardline repeal Obamacare position isn't a political winner, that's pretty much what Senate Minority Leader Mitch McConnell has been doing over the past few weeks. Of course, he's also got the added complication of having a primary challenge from the Right, so he needs his pals to be especially clever with their "fix" wording.
Their solution, which you can see in the ad at the top of this post, is to say that McConnell is "leading the fight to fix this Obamacare mess" which to most people sounds like McConnell isn't focused on repeal, but instead just wants to make Obamacare work better. That's exactly where the country is, but it's not where GOP primary voters are. So the Chamber ad splits hairs by using language that is technically consistent with his repeal (because he can say that it's the "mess" that he's proposing to fix, and that he can only fix the mess by repealing Obamacare), but is designed to suggest that his focus is simply on making Obamacare better.
The fact that McConnell is walking on eggshells when it comes to Obamacare is all the evidence you need to understand how much the politics of health care reform have changed now that it's delivering real benefits on a massive scale. When repeal was an abstract concept, McConnell could bellow about it as loud and obnoxiously as he wanted. But now he can't, because if he did, the only thing he'd accomplish is to remind people that he wants to take away health care from tens if not hundreds of thousands of Kentuckians.
Don't forget, we're still less than two full months into Obamacare being a reality. If things have changed this much already, it's a pretty good bet that President Obama was right when he said that ten years from now, Republicans won't be calling it Obamacare anymore. Instead, they'll be trying to take credit for it.