It was a rough start to a recess week for Blum, a second-term lawmaker representing a swing district that voted narrowly for President Trump last year after supporting Barack Obama in 2012. Blum is a member of the conservative House Freedom Caucus who initially declined to support the Republican plan to replace the Affordable Care Act but ultimately voted last week for the American Health Care Act.

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The way Blum struggled Monday night to explain his vote — through the loud boos of rowdy, impolite and infuriated constituents — is just a narrow sampling of the the growing concern and confusion caused by Republican plans to revamp the nation’s health-care system. But it indicates the difficult balancing act many Republican lawmakers from swing districts will need to strike as the complex debate continues in Washington.

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Blum said that the bill had been improved to his liking, but he agreed with constituents upset about the rush to pass it. He called the legislation “Trumpcare” several times during the town hall meeting, but in an interview with The Washington Post called it “Obamacare 2.0″ and admitted that the bill doesn’t repeal the current health-care law.

“This isn’t a repeal and replace. This is Obamacare 2.0. We’ve probably changed 10, 20 percent of the bill is all,” he said in the interview.

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Footage of Blum’s combative television interview aired just before the town hall meeting started. The reporter, Josh Scheinblum, asked Blum about his decision to hold four town hall meetings this week across Iowa’s 1st Congressional District and why his staff was prescreening attendees to ensure they actually lived within the district’s boundaries.

“Some would make the case that you represent all Iowans … shouldn’t all Iowans have a voice at the table or at least have the option to?” Scheinblum asked.

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“I don’t represent all Iowans — I represent the First District of Iowa,” Blum said. “That would be like saying, ‘Shouldn’t I be able to, even though I live in Dubuque, be able to go vote in Iowa City during the election because I’d like to vote in that district instead?’”

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“Would you still take donations from a Republican in Iowa City?” Scheinblum asked.

Blum smiled, stood up and removed his microphone.

“This is ridiculous. This is ridiculous. He’s just going to sit here and badger me,” Blum said as he walked away.

Scheinblum stayed seated, asking Blum to come and finish the interview. Blum headed for the door and waved him off.

“Would I take donations?” Blum said. “Wow.”

Blum raised more than $1.8 million during his 2016 reelection campaign. His top two donors were out-of-state entities: A PAC controlled by Rep. Mark Meadows (R-N.C.), chairman of the House Freedom Caucus and the conservative Club for Growth. His next three most generous donors were Iowa-based companies, according to Federal Election Commission data reviewed by the nonpartisan Center for Responsive Politics.

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When a constituent later asked Blum whether he would decline to take out-of-district campaign donations if he’s barring out-of-district Iowans from attending his town halls, he demurred.

“This is an official event as a congressman, this isn’t a political event — so when we’re talking about contributions coming from outside the district, that’s a political thing,” he told the crowd.

That sparked a wave of boos.

Blum continued: “The Democrat opponents I’ve ran against the last two cycles have far outraised me both those cycles, and more of their money has come from outside the district than mine.”

About 1,000 people showed up Monday night at Dubuque Senior High School to hear from Blum, 62, a former software executive who once coached high school basketball in the gymnasium where he spoke. His son, Taylor Blum, is honored on the walls of the gym for scoring 1,202 points as a member of the basketball team.

With his wife and daughter in the audience, people in the prescreened crowd shouted at Blum throughout the evening, complaining that he started late, that he didn’t immediately start answering questions about health care and that he said that his district offices are open and eager to deal with constituent concerns.

“You’re never there!” one woman shouted.

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Eight volunteers checked in constituents as they arrived, while staffers ushered them upstairs to the gym. At least four police officers — including the police chief — stood watch. Blum’s staff banned constituents from waving handwritten posters or campaign signs, so local Democrats distributed red and green sheets of paper. They instructed the audience to hold up the green sheet if they agreed with Blum; the red sheet if they disagreed.

Asked about the TV interview, Blum said that he had agreed to be interviewed by KCRG-TV during a visit to the Dubuque Dream Center that assists lower-income, mostly African American children in the city. He added that the station also wanted to interview his wife, Karen, about being a congressional spouse.

“Well, we get there and we were ambushed; they didn’t want to do anything on the Dream Center … that became apparent very quickly,” Blum said. “It was very apparent that he had an agenda. It’s my right to say that this interview is over.”

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Blum defended his decision to hold four town hall meetings this week, noting that other GOP colleagues opt to hold “pop-up town halls” with little notice or small “coffee town halls” with just a handful of supporters.

Anticipating detailed questions about the health-care bill, Blum had a copy of the legislation with him on stage plus charts and graphs explaining the changes.

“This bill, Trumpcare — whatever you want to call it — is about the individual market only,” he said. “That’s 12,000 people in my district. Twelve thousand people in my district. So if you’re in the group health insurance program through your employers, if you’re getting your insurance through the group health insurance, nothing changes.”

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“That’s not true! That’s not true!” people screamed from the bleachers, waving the red sheets.

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“If you’re getting your insurance through Medicare, nothing’s going to change. Nothing’s going to change,” Blum said. “If you’re currently getting your health insurance through Medicaid nothing’s going to –”

The crowd drowned him out as he finished his sentence.

One woman complained that “You voted on this bill in a rush — there were no committee hearings. This pertains to my life. This is not democracy works and you know that. … What was the rush?”

“We did hold hearings,” Blum told her. “I always said the process was bad. It was rushed. It was rushed and there should have been hearings. And we should have had an open amendment process, which we should have. And I was highly verbal about that. I told the president the very same thing — that we should not rush this, we should try to make it bipartisan and try to get Democrats on board.”

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More red sheets. More boos.

Dallas Knapp, 22, a local college senior, had asked Blum about his television interview. He was still shaking off the adrenaline after the event.

Local Democrats “are getting more interested and engaged or there’s just people who otherwise weren’t paying attention that are now realizing how important a point in time this is for our politics,” he said.

Ruth O’Rourke, a Democrat from nearby Maquoketa, agreed: “His Republican friends stayed home, and I think that was a bad sign for him.”

But another woman named Ruth, who declined to give her last name, said she had come to support Blum and was disgusted at the overwhelmingly Democratic crowd.