LOUISVILLE -- Donald Trump's campaign-style rally in Kentucky appears to have had no effect on Sen. Rand Paul, who told Louisville business leaders hours ahead of the president's visit that he hopes the plan will fail so "true negotiations" can begin.
Kentucky's junior U.S. senator was set to fly back to Washington as Trump was flying into Louisville, the two Republicans likely passing each other in the air as a standoff continues over a health care proposal that has tied Congress in knots.
"I've got to work. I've got to get to Washington so I can work on the coalition that is trying to defeat the bill," Paul told reporters on why he would not be attending Trump's rally. "I don't think they have the votes to pass it right now. And if the conservatives stay solid, the bill will at least be temporarily defeated and then the real negotiations begin."
Trump's Louisville event was the third such rally of his presidency. It came at a time when Republicans are divided over what to do with the Affordable Care Act, one of Obama's enduring legacies that so many conservatives have pledged to repeal.
In Kentucky, the law was embraced by a Democratic governor who expanded the state's Medicaid program and set up a state-run health exchange that led to more than 500,000 people securing health coverage. Since the law was enacted, Kentucky's uninsured rate fell from more than 20 percent to 7.5 percent, among the largest coverage gains in the country.
Since then, Republicans have taken control of the governor's office and the state legislature and pledged to scale back the law's implementation, arguing it costs too much.
The Republican proposal before Congress would continue the expanded Medicaid program for three years. After that, the federal government would dramatically cut funding for the program, leaving states to either pick up the cost or cut benefits.
Paul opposes that proposal, saying the Medicaid program should be cut back immediately because it is not financially viable. Paul said Kentucky could keep the expansion, but they would likely have to double their income and sales taxes to pay for it.
"I think that all of us want more people to have insurance at a lower cost. Somebody has to pay for it," he said.
Paul said his plan would not subsidize private insurance plans on the individual market. Instead, it would make it legal for people who do not have health insurance through their employer to join an association so they can have more bargaining power with insurance companies, which he said would make insurance more affordable.