U.S. Rep. Lynn Jenkins faced a boisterous and sometimes angry crowd in Lawrence Monday as she was peppered with questions and comments about a Republican plan to repeal and replace the Affordable Care Act, commonly known as Obamacare.
A crowd of about 400 people turned out for the event at the Dole Institute of Politics on the University of Kansas campus, where Jenkins faced the same kind of reaction that many other GOP members of the House and Senate have faced in recent weeks.
But Jenkins, who was herself part of the loud and angry opposition forces that showed up at town hall meetings in 2009 when Obamacare was first being debated, tried unsuccessfully to calm people's fears, insisting several times that nobody would lose their health coverage under the GOP plan, and that costs would actually go down while people will enjoy more options for coverage.
"The intent is to provide transition rules so that no one that has health care is thrown off of their health care, and folks that don't have coverage are able to get coverage," Jenkins said at the outset of the event.
Several times, however, Jenkins' voice was drowned out by chants from the crowd, saying "We don't believe you," and "Do your job." It was the kind of mood and reaction not often seen at the Dole Institute, which touts itself as a place that advocates calm and civil discourse over political issues.
Just as the town hall meeting was getting underway, the nonpartisan Congressional Budget Office released its estimates of the bill's potential impact, saying it would reduce the federal deficit by $337 billion over the next 10 years, but that 24 million Americans would lose their health coverage over that same period, including 14 million in 2018 alone.
Most of the savings would come from cuts in Medicaid, the joint federal and state health insurance program for the poor, and by repealing many of the taxes imposed under Obamacare on high-income taxpayers.
Jenkins, however, said she disagreed with the CBO's estimates, echoing what has become a popular talking point for Republicans, although she did not offer any other estimates of her own.
Several Republicans have noted that the CBO's original estimates of how many people would gain coverage under Obamacare were overstated. But others point out that's because the U.S. Supreme Court overturned part of the law, which initially required all states to expand their Medicaid programs, saying instead that Congress could only make that an option for states.
Kansas is one of 19 states that opted not to expand its Medicaid program, although efforts are underway in the state Legislature to do that this year.
Marci Nielsen, a health policy expert from Lawrence who has worked at both the state and federal levels, said that since the Supreme Court made that ruling, the CBO's ongoing estimates about the impact of Obamacare have proved to be accurate.
"It’s one thing to disagree on fundamentals of what insurance should be and whether it’s a right. That’s an appropriate debate," Nielsen said in a phone interview after the town hall meeting. "But to divert attention by questioning whether CBO estimates are accurate is incredible to me."
"I'm in favor of repealing Obamacare, and I'm in favor of replacing it with a single-payer system," said one man who said he was from Eudora, prompting loud cheers of support from the audience.
Another woman, Janella Williams, said she had started a small business, something she said would not have been possible without the Affordable Care Act.
"I have a medical condition that I've had since 1995, when I was 29 years old, and if I don't get treatments every seven weeks, I will lose the use of my left hand, my left side and my right foot," she said. "So currently, under the plan I have right now that I'm able to afford, I can be a contributing member of society."
Jenkins, however said that under the GOP plan, people with pre-existing conditions like hers would receive tax credits that would help them buy insurance. However, for younger Americans, those tax credits would be significantly less generous than the subsidies available through Obamacare.
According to the CBO report, the Republican plan would leave in place many of the more popular features of Obamacare, such as the requirement that insurers cannot deny coverage for pre-existing conditions and that children can stay on their parents' coverage through age 26.
But it would repeal the mandates that most individuals have coverage and that most large employers provide group health plans to their workers.
In addition, it would drastically overhaul Medicaid, converting it into a kind of block grant program that sends money to states based on the number of individuals enrolled in those programs, and reducing those payments so that states that did not expand their Medicaid programs under Obamacare would either have to pay for the expansion groups themselves or remove those people from the program.
One woman who spoke up at the meeting said that could have drastic consequences for her family.
“My medically fragile child is on a Medicaid waiver for services,” she said. “The Home and Community Based (Services) waiver is one of the many things that will likely be cut in a per-capita cap on Medicaid or a block grant.”
The woman said her son would likely lose that coverage if Medicaid funding is cut because the state of Kansas already faces a budget shortfall and probably could not afford to make up for reductions in federal funding.
“Again, I want to reassure everyone that no one is expected to be thrown off their insurance, whether they’re in Medicaid, Obamacare like I do, or an independent, employer-sponsored plan,” Jenkins said, prompting groans from the audience.
A spokeswoman for Gov. Sam Brownback issued a statement saying Kansas would be better off under the proposed changes to Medicaid.
“Federal changes to Medicaid should protect the states that did not previously expand ObamaCare," spokeswoman Melika Willoughby said. "The flexibility of block granting based on a per-capita formula best allows for state-based innovation and care and Kansas is well positioned to lead the country in innovation.”
The GOP health plan was not the only issue discussed during the town hall meeting, which was moderated by WIBW-TV news anchor Melissa Brunner. But it did dominate most of the hour-long discussion.
Others expressed more general anger and disappointment in President Donald Trump’s administration, and they urged Jenkins to speak out more forcefully to denounce some of the controversial remarks he has made or posted on Twitter.
Jenkins, however, said she did not support Trump in the 2016 elections and originally backed Carly Fiorina for the GOP nomination. But that wasn’t enough to satisfy some people in the audience.
One of those was Pam Ensley of Topeka, who said she was not only concerned about proposed changes in the health care law, but also frightened by talk of privatizing Social Security and Medicare, the federal health insurance program for the elderly.
“If you have any sway with (House Speaker Rep.) Paul Ryan or (Senate Majority Leader) Mitch McConnell, who think they know better than we do, tell them people in Kansas are damn mad,” Ensley said.