LOUISVILLE, Ky (WHAS11) -- Mitch McConnell left no room for doubt.
"If I'm the leader of the majority in January, repeal of Obamacare will be the first item up in the United States Senate," the Senate Minority Leader said to a Downtown Rotary Club luncheon crowd on Thursday.
If Republicans can sweep the House, Senate and Presidency this fall, "we can begin to undo the mess that's been created in the last three and a half years," McConnell said.
The comments served to reiterate McConnell's unabashed commitment to the repeal of the Affordable Care Act. In an appearance at Hardin Memorial Hospital on Monday, McConnell acknowledged that the odds are still on the side of those who favor the law "because it's a lot harder to undo something than it is to stop it in the first place."
Some national news outlets and conservative observers interpreted McConnell's remarks as a lack of confidence in the repeal effort.
But McConnell is vowing the repeal of what he calls the "single worst piece of legislation passed in modern times."
"In addition to all of its other flaws, its a job killer on top of it," McConnell said in a WHAS11 interview. "And of course this economic situation is fundamentally the biggest issue ahead of us in this election."
It is an election that McConnell described as one that will decide the direction of American society.
"Look, I think our country is in serious trouble," McConnell told the Rotarians.
McConnell said America is at a crossroads -- between a society that focuses on security and one that embraces opportunity.
Caught in the middle is the 17 percent of Americans without health insurance.
McConnell was caught in that middle on Fox News Sunday when host Chris Wallace pressed him to explain how Republicans plan to provide universal health coverage for the estimated 30 million uninsured Americans.
"That is not the issue," McConnell replied in a comment that sparked a firestorm on the left. "The question is, how can you go step by step to improve the American health care system?"
During a question and answer session with the Rotary Club, McConnell addressed the question.
"The poor are covered by Medicaid, the elderly are covered by Medicare," McConnell explained, "so we're talking about a universe of 30 to 40 million people who are uninsured."
"They fall into about two categories. Half of them are young people who think they're going to live forever and really just don't want to spend their money that way, and the others have genuine affordability problems," McConnell continued.
"This is a vexing issue."
Vexing, but - McConnell says - not worth compromising a health care system that is working for most of America.
"For those 83 percent who are already covered, nothing good is going to happen (if the law is enforced)," McConnell said. "Premiums are going up. It will make the healthcare for 83 percent of Americans worse, and many Americans will lose the coverage they have as a result of this."
Asked what elements of the law may survive a Republican repeal, McConnell explained that some health insurance companies are already responding to market demands and adding benefits without government mandates, such as allowing children to remain on their parents' insurance policies until the age of 26. McConnell repeated his suggestion that state governments and not a federal approach are the appropriate jurisdiction to construct high-risk insurance pools for people with pre-existing conditions.
"These are difficult problems," McConnell said. "They would not have all been totally solved even by Obamacare. But my view is you don't foul up the health care for 83% of America, raid Medicare for a half trillion, in order to deal with these problems."
"In short to use a medical metaphor, what I would not have done is take out a meat ax to the entire American medical system. I would have instead pulled out a scalpel."