At his first town hall meeting since coming out against the Senate Republicans’ health-care bill, Sen. Jerry Moran (R-Kan.) wanted to make himself clear.

He didn’t want legislation jammed through on a party-line vote, but he would “not necessarily” vote against it. He’d met people who “tell me they are better off” because the Affordable Care Act was passed, but he knew plenty of people were hurting, too.

“It’s worthy of a national debate that includes legislative hearings,” Moran said after the 90-minute event that brought 150 people to a town of 277. “It needs to be less politics and more policy.”

Moran, the only Republican senator holding unscreened town halls on health care this week, revealed just how much his party is struggling to pass a bill — and even how to talk about it. The people who crowded in and around Palco’s community center aimed to prove that there was no demand for a repeal of the ACA, even in the reddest parts of a deep red state.

That had taken some planning. Moran announced the Palco event with a full week’s notice, and Kansas’s pro-ACA groups mobilized to fill it. Planned Parenthood transported at least 20 people from the Kansas City suburbs, 4½ hours to the east; the city’s chapters of Indivisible did the same. The American Association for Retired People and Alliance for a Healthy Kansas made more calls, driving loyal voters to Palco. The result was a polite but heated round of questions that Moran occasionally chose not to answer.

When a 59-year old veteran named Jeff Zamrzla asked if it was time for “Medicare for all,” Moran waited for applause to die down, then moved on to the topic of Medicaid funding. With a smile and a shrug, he told women in bright pink Planned Parenthood shirts that he wouldn’t have an answer they liked.

“That was a win for Planned Parenthood patients,” said Elise Higgins, 29, the regional director of organizing for Planned Parenthood Great Plains. “He didn’t just talk about defunding.”

Moran did the opposite, largely allowing skeptics of the Republican bill to frame the whole conversation. For all 90 minutes, a woman named Yaneth Poarch, 46, stood behind the senator holding a sign with caricatures of Republican leaders, and the warning, “When you lose your health care, remember who took it away.”

Neither security guards nor staff did anything to move her.

The setting made the dissent, and Moran’s careful positioning, verge on surreal. Palco is in Kansas’s rural Republican heartland, miles from Moran’s home town of Plainville. The visitors from eastern Kansas, and the local Democrats from nearby Hays, found themselves next to Moran’s old roommate, some high school friends and a physician. All of it took place in Rooks County, which gave Donald Trump a 73-point landslide over Hillary Clinton last year; Moran beat a token Democratic opponent by 79 points.

Until this year, the voters who cast those ballots had confidently favored repealing the ACA. Like Trump, Moran ran on “full repeal,” claiming to be the first Republican member of Congress to do so.

“Obamacare was rammed through Congress on a purely partisan basis in the face of significant public opposition,” Moran said in 2015 after the new Republican majority in the Senate passed a test vote on repeal. Moran had chaired the party’s 2014 Senate campaign effort, making that majority possible.

On Thursday, Moran took another tone. He did not describe the task facing Republicans as repeal; it was “repair, replace, whatever language people are using.”

Pressed by activists and voters, Moran said that he did not want to cut back Medicaid. “I have concern about people with disabilities, the frail and elderly,” Moran said. “I also know that if we want health care in rural places and across Kansas, Medicare and Medicaid need to compensate for the services they provide.”

After the town hall meeting, Moran told reporters the version of the GOP’s bill that he opposed put too much of Medicaid at risk.

“Medicaid, except for the extension part of Medicaid, is not really a part of fixing the Affordable Care Act,” he said. “So we’ve coupled two things, both of which are very difficult. Kansas is a place that’s treated Medicaid payments very conservative. If there are people receiving those payments who don’t deserve them, deal with that issue.”

In Washington, and at the height of the tea party’s activism in Kansas, it had been easy to find conservatives who could sell Medicaid cuts. None of that came out in Palco. Instead, Moran was stopped several times by disability rights advocates who worried that the GOP’s bill would destroy their lifestyles.

“I am very worried about waivered services,” said Mike Oxford, a 58-year old activist with the disability group ADAPT.

“Well, my concern with Medicaid is in significant part related to people with waivered services — and you’re right,” said Moran.

Oxford, who carried a sign reading, “I am Medicaid,” said he was comforted by the answer. “Here in Kansas, that would be the only place they could find money,” he said. “The senator’s right — we’ve been skinned down to zero.”

But despite the thanks from people who wanted him to kill the Senate bill, Moran never ruled out a yes vote. Despite the Kansas Hospital Association’s opposition to the bill, Moran said he had not found any hospitals that benefited from the ACA. Asked after the town hall whether he could vote for a repeal-and-delay plan — favored, in some interviews, by President Trump — Moran didn’t rule it out.

“There’d be skepticism by many Americans because of how long it’s taken,” he said. “Can we come up with something in another year? Maybe, if that happened, there would be a desire on the part of all members of the United States Senate to find a replacement.”

The desire wasn’t there quite yet, he said. “There are senators with genuine concerns about this legislation. More senators than are having town hall meetings,” said Moran, who has two more town halls in western Kansas in coming days.

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