(Nathan Schwarz/YouTube)

During a week most Republican senators spent in the political equivalent of the witness protection program, Sen. Ted Cruz willingly stood trial before his constituents all across this sprawling state over his push to repeal much of the Affordable Care Act.

He debated a self-described “dirty liberal progressive.” He met a psychologist who told him that he and his colleagues were “scaring the living daylights” out of her. He encountered protesters in a border town, a conservative Dallas suburb and this liberal stronghold.

Some who attended his events took the opposite view — that not shredding the law known as Obamacare would be the real misdeed. But Cruz’s main offense, in the view of the most vocal and most frustrated attendees, has been to participate in the GOP effort to undo and replace key parts of the ACA — which will resume when lawmakers return to Washington on Monday.



Bill Kelberlau, 68, of Georgetown, Tex., speaks with a reporter after the Ted Cruz town hall in Austin. (Ilana Panich-Linsman/for The Washington Post)

Cruz, who did two Sunday news show interviews, is suddenly at the center of a last-gasp attempt to work out differences among GOP senators and pass a bill by the end of July — a goal that Sen John McCain (R-Ariz.) said on CBS’s “Face The Nation” is “probably going to be dead.”

The Texas Republican is pushing a controversial amendment that would prompt a deeper rollback of the ACA. The measure could bring reluctant conservatives on board, but it also threatens to alienate key GOP moderates.

“I think really the consumer freedom option is the key to bringing Republicans together and getting this repeal passed,” Cruz said on ABC’s “This Week with George Stephanopoulos.” His proposal would let insurers sell narrower plans that don’t comply with ACA coverage requirements — to cover maternity or dental or preventive care, for instance — so long as they also offer even one plan that does.

“I think that reopens an issue that I can’t support, that it would make it too difficult for people with preexisting conditions to get coverage,” Sen. Shelley Moore Capito (R-W.Va.) told the Charleston Gazette-Mail.

Cruz is grappling with a state that, much like the rest of the country, has been deeply divided and firmly gripped by the months-long GOP effort to fulfill its signature campaign promise. Virtually everywhere he traveled over the July Fourth recess, no matter where the conversation started, it inevitably veered to health care. That may help explain why so many of his colleagues kept much lower profiles.

But Cruz, who built a national reputation on strident conservatism and has fiercely criticized the ACA for years, seemed to relish debating health care with vocal liberal critics. In a red state where he holds little crossover appeal, Cruz sees his best path to a second term, which he will seek next year, in rallying his conservative base to turn out for him. Even as he antagonizes a growing number of voters concerned about the fate of the ACA, doing his part to push for a full or even partial repeal is one key way his allies think he can make that happen.

Whether such legislation can pass is increasingly uncertain — to both Cruz and Senate GOP leadership. “I believe we can get to yes,” said Cruz last week. “I don’t know if we will.”

Engaging with foes

Cruz spent Thursday evening in a hotel ballroom here at a town hall hosted by Concerned Veterans for America, a group backed by the billionaire conservative Koch brothers. The organization held two events for Cruz over the past week, with one more coming Saturday, with the aim of offering a more controlled environment than typical town hall meetings.



Cruz takes questions from audience members in Austin. (Ilana Panich-Linsman/for The Washington Post)

To attend, people were required to register in advance. The group’s policy director, Dan Caldwell, moderated the discussions, keeping them mostly focused on veterans’ issues and selecting a handful of audience questions submitted in advance.

The first half of Thursday’s event here so closely resembled Wednesday night’s version in suburban Dallas that Cruz even cracked the same joke about banishing bureaucrats to Iceland — and received similarly limited laughter.

But the predictability ended when Gary Marsh and others jumped in without being called on by Caldwell and engaged Cruz in a tense back-and-forth over health care.

“Can I please request that you refer to it as the Affordable Care Act,” Marsh told Cruz at one point. Cruz declined, drawing some applause. The senator said he did not believe in “deceptive speech” — prompting outraged laughter from his critics.

Cruz, dressed in a dark blazer, khaki pants and brown cowboy boots, then launched into a detailed defense of his opposition to Obamacare and the imperative to roll it back.

Caldwell tried to redirect the conversation to the questioner he had originally called on. But Cruz overruled him, allowing Marsh a chance to respond. Marsh, a 67-year-old retiree, said he knew he could not change Cruz’s mind, but he hoped to sway others in the room.

“Repealing Obamacare was the single biggest factor producing a Republican House, a Republican Senate and I think ultimately a Republican president,” Cruz said. He said the “central focus” of Republicans now should be to lower premiums.



A police officer keeps people from demonstrating on hotel property at the Renaissance Austin Hotel, where Cruz held his town hall. (Ilana Panich-Linsman/for The Washington Post)

Marsh proudly called himself a “dirty liberal progressive” in a conversation with reporters after the event. John Walker, 69, walked over to confront him. The self-described conservative wasn’t pleased.

“You monopolized the meeting. That’s the problem I have with you and everybody else that does that,” Walker told him. In an interview, Walker, who is retired and on Medicare, said he favors replacing Obamacare with “something better” that would make coverage affordable for his adult children, who can’t manage premiums. He said he is not yet convinced that the Senate GOP bill would accomplish that.

A similar flash of discord appeared Wednesday in McKinney, the Dallas suburb. After Cruz finished speaking, Buddy Luce was not happy with what he heard from the senator about overhauling Obamacare.

“I’m not impressed with a plan that takes away —” the 65-year-old attorney started explaining to a reporter. Before he could finish his thought, Ivette Lozano had rushed over to argue with him.

“I’m a family practitioner,” she told him. “Obamacare is putting me out of business.”

“Don’t you think health care is a human right?” he asked her.

“No, I think it’s personal responsibility to take care of you,” she responded.

“If you don’t think health care is a human right, then we’re just on a different wavelength,” Luce retorted.

‘Manifest disaster’

For 47 minutes, the McKinney town hall was free of controversy. As Cruz spoke to Caldwell about veterans’ matters, the audience listened quietly. But then came a query from a far corner of the hotel ballroom. And the mood quickly shifted.

“You all on the Hill are scaring the living daylights out of us with the health-care nonsense that you’re doing,” said Misty Hook, who described herself as an “overflow” psychologist who works with veterans unable to obtain services through the Department of Veterans Affairs. She worried about the GOP push to allow insurers in some states to opt out of certain coverage requirements.

“What are you going to do to help make sure that mental-health-care services are reimbursed at a proper rate so that we can continue to provide services for veterans?” asked Hook, the urgency apparent in her voice.

Cruz, leaning forward in his armchair, offered an extended defense of the effort to undo key parts of Obamacare. He called it a “manifest disaster,” prompting some to shake their heads in disagreement.

“You didn’t answer her question about how mental health is going to be covered,” one woman interjected.

“Well, I am answering it right now,” Cruz replied. But before he could continue, Luce abruptly jumped into the conversation from the other side of the room. He continued breaking in, eventually drawing a warning from the senator: “Sir, I’m happy to answer your questions, but I’m not going to engage in a yelling back-and-forth.”

Outside the event, a few dozen protesters lined up about an hour before it started and displayed signs with such messages as “GOP Care Treats the Rich Kills the Weak” and “Yea! ACA fix it don’t nix it.” Pam Slavin, who helped organize the protest, estimated that about 150 people showed up for it by the time it ended. Cruz had encountered similar protests when he visited McAllen on the U.S.-Mexico border.

After the event, Cruz called the health-care back-and-forth a “good and productive exchange.”

“This is an issue that inspires passion, and quite understandably. People care about their health care,” Cruz said.

As Republican senators prepare to return to the Capitol, there is ample doubt among them that they will be able to strike a deal.

A ‘50-50’ prospect?

“I would probably put that as 50-50,” Sen. Bill Cassidy (R-La.) said on “Fox News Sunday.” Cassidy is among the GOP senators who have voiced concerns about Cruz’s amendment.

But to many on the right, Cruz’s idea could be key to winning over hesitant conservatives who want to see a more forceful strike against Obamacare. Senate Majority Leader Mitch McConnell (R-Ky.) is expected by some to place greater responsibility on Cruz to pitch his amendment to skeptics, which could put more of a burden on the Texan to help save the broader effort. Cruz’s team said he looks forward to continuing his push.

Many close observers say they think Cruz is likely to support the final version of the bill, even though he does not support the initial version McConnell released.

[At parades and protests, GOP lawmakers get earful about health care]

[A town hall in Kansas shows Republican struggles with health-care bill]



Bob Kafka, 71, a disabled Vietnam veteran, talks with an Austin police officer as he and others try to enter the Renaissance Austin Hotel property, where Cruz held a town hall meeting Thursday. “Ted Cruz is hosting veterans today, but he doesn’t represent all veterans,” Kafka said. (Ilana Panich-Linsman/for The Washington Post)

Cruz, like President Trump, thinks that if Republicans fall short, the Senate ought to vote on a narrower bill to repeal the law — what he calls a “clean repeal” — and focus on replacing it afterward. But McConnell has embraced a very different kind of backup plan: Working with Democrats on a more modest bill to stabilize insurance markets.

Broad disagreements over how to structure the nation’s health-care system are sharpening the contrasting way lawmakers such as Cruz are viewed at home.

As she stood in line with her husband to talk to Cruz after the Wednesday town hall, Jennifer Beauford, 42, said she wants a “full repeal and I don’t want a replacement.”

“Health care is not a constitutional right. It’s a privilege,” said Beauford, who identified as a conservative Cruz supporter.

Outside among the protesters stood Kerry Green, 46, a history teacher who wore a shirt printed with the Declaration of Independence. A self-identified Democrat, Green held up a sign urging health care “for the 21st Century” rather than the 20th. She sharply criticized the GOP bill.

As for Cruz? “He needs to go,” she said.

David Weigel in Washington contributed to this report.

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