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Senate Minority Leader Mitch McConnell (R-KY) failed in his goal to make President Obama a one-term president, but he’s still one of the most crafty and ruthless campaigners in politics, as his latest ad proves.

McConnell’s new ad recycles a message the senator knows works because it helped him win in 2008. The new ad is far more affecting. It focuses entirely on Robert Pierce, a worker from the Paducah Gaseous Diffusion Plant, where exposure to radiation left several employees with cancer. Pierce says throat cancer has weakened his own whispery voice, but he praises the senator for using his voice to help him.

McConnell is boldly trumpeting his help to the plant with the testimony of a man few will want to question. The record is much more complex, according to The Huffington Post‘s Jason Cherkis and Zach Carter.

The senator didn’t “spring into action” on Paducah until 1999, 14 years after the first workers became sick, when a Washington Post article uncovered that radioactive exposure was still occurring at the plant. But once the story was in the limelight, McConnell pushed for a practical solution: “He worked to pass what amounted to a new entitlement that allowed plant workers over age 50 access to free body scans and free health care.” Recently McConnell’s absence from the debate about the plant’s potential closing has led a union leader to say the senator has “given up on Paducah.”

An ad touting the ability to get people government-run health care is an unlikely way to open the campaign of a man who has vowed to repeal Obamacare “root and branch.”

Thanks to the president’s health reforms, 188,130 residents of McConnell’s state now have health coverage; of those, 100,359 have completely subsidized health insurance through Medicaid or SCHIP.

McConnell needs to explain what will happen to the more than 100,000 people who would lose coverage if his goal of repealing Obamacare is accomplished, says The Washington Post‘s Greg Sargent.

“McConnell’s new ad tells us he should be re-elected because his efforts to bring health coverage to people who lack it shows his willingness to ‘knock down walls’ for Kentucky’s ‘working families,’ helping ‘save people’s lives,'” Sargent writes. “So what about all the working people who would lose coverage if McConnell got his way?”

Unfortunately for McConnell, 2014 isn’t 2008.

Six years ago the senator could brag about providing some deserving workers with government health care without having to go into his actual policies on health care. In 2014, Obamacare is no longer theoretical; millions of Americans have gained coverage through Obamacare exchanges or by remaining on their parents’ coverage until age 26, thanks to the law.

If McConnell is arguing he did the right thing by helping those in need, he must also explain what would happen to these people if he gets his way and they lose their coverage.

Photo: Gage Skidmore via Flickr

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