May 31, 2017

ON MAY 10, Republican Congressman Tom MacArthur walked into a buzz saw.

For almost five hours at a town hall meeting in Willingboro, New Jersey, MacArthur was "booed, heckled and generally chastised" by a crowd of several hundred angry constituents who called their representative things like "weasel," "killer" and "idiot," according to the Guardian.

But this wasn't about name-calling. These people were angry for a very specific reason: The May 4 passage by the House of Representatives of the American Health Care Act (AHCA), the Trump administration's foul attempt to "repeal and replace" the law that has transformed the structure of health care: the Affordable Care Act (ACA), popularly known as "Obamacare."

The AHCA--both in its original form that was withdrawn in March without coming to a vote, and the even worse version that passed the House by two votes in early May--is a disaster that would steal almost a trillion dollars from Medicaid and get rid of the protections mandated by the ACA for people with pre-existing conditions.

Hundreds pack a town hall meeting in Iowa to protest a Tea Party member of Congress

Last week, the Congressional Budget Office estimated that the bill would leave 14 million more people uninsured by next year, along with another 9 million over the next eight years. Since 28 million people are currently uninsured under Obamacare, that means the AHCA would leave more than 50 million people without health insurance by 2026.

THE MAN responsible for the amendment credited with winning crucial support from the arch-conservative Freedom Caucus--whose members felt the March version of the bill did not go far enough--is none other than Tom MacArthur.

And the people of Willingboro let him know how they felt about that. As Jim Newell reported in Slate:

One constituent explained how his wife had died two months earlier from brain cancer, and how he was taking his kids on vacation for Mother's Day. He worked in insurance. "The Affordable Care Act has plenty of flaws," he said. "The problem is this bill has a lot more flaws." A recovering addict told [MacArthur] that Medicaid was what "kept me clean this long." Without it, she said, "it's jail, institution, or death." [MacArthur] told her, and anyone else asking about Medicaid, that no benefits would be cut, and that the bill's $839 billion in cuts would simply force states to bring about efficiencies and innovation. (Some of those efficiencies that the states could settle on, of course, would be slashed benefits.) One man, whose wife is a cancer survivor and whose two children each have pre-existing conditions, engaged in a long, furious rant that lasted about 15 minutes. "You are the greatest threat to my life," he shouted. "You are what keeps me awake at night."

At least MacArthur showed up to face his constituents. Few of his Republican colleagues have shown even this much backbone. Citing data provided by the Town Hall Project, the Guardian reported that only 14 of the 217 House Republicans who voted in favor of the AHCA scheduled town-hall events during the House recess during early May.

Even among those 14 were politicians who went to laughable extremes to minimize confrontation. Utah Rep. Chris Stewart, for example, endured a stormy meeting in Salt Lake City after the first health care vote in March, so he held his second town hall at a high school in Sevier County--a rural community roughly 165 miles from Salt Lake City.

IN ADDITION to filling town halls with angry protesters, groups have organized "die-ins" to call attention to the fatal consequences of the AHCA in cities across the country, including Scottsdale, Arizona, and Concord, New Hampshire.

The Payback Project--described by the Nation as a joining of forces by MoveOn, Indivisible and the Town Hall Project for the purpose of "support[ing] local groups who are targeting their representatives and holding them accountable for their vote on the AHCA"--has played a prominent role in encouraging and publicizing such actions.

The Payback Project website features a searchable event database to find local opportunities such as Republican town halls to protest, and an "accountability wall" on which communities and individuals can share stories of their efforts to hold their representatives' feet to the fire for their health care vote.

"Accountability" is a common rallying cry for Indivisible, the movement founded by former Democratic congressional staffers with the aim of using Tea Party-style tactics--like constituents organizing for confrontations at town hall meetings with their members of Congress).

Indivisible has published specific guidelines for combating the AHCA, and its newly formed branches have played a role recent health care demonstrations in York, Pennsylvania; Palm Beach, Florida; Columbus, Ohio; and elsewhere.

Ultraviolet, to take another example, has shined a spotlight on the devastating impact the AHCA would have on women, by putting sexual assault and domestic violence under the category of "pre-existing conditions" and by barring Planned Parenthood from receiving Medicaid funds.

Ultraviolet has an online campaign and has organized protests in cities such as Portland, Maine--a potentially key location since Maine's Republican Sen. Susan Collins is seen as a likely "defector" from Republican ranks on this issue, due to her stated concerns about how the AHCA would affect health care for women.

GRATIFYING THOUGH it may be to watch the well-earned discomfort of Republicans facing the anger of their constituents, activists need to be wary of a Democratic Party that is less focused on blocking the ACHA than on cynically using the passion of the legislation's critics and opponents to win the midterm elections in 2018.

This is not to say that the focus on electoral politics makes no sense. The next stop for the AHCA is the Senate, and it's very unlikely that this body will produce a bill identical to the one approved so narrowly by the House. This means--assuming the Senate can pass a health care law at all--that the differences between the two would have to be reconciled in a conference committee, after which the new version would then be put to a fresh vote in both houses of Congress.

Thus, there is every reason to put pressure on Republicans who voted in favor of the AHCA in May to change their position--and their prime concern will be losing office in the next election.

But these Republicans should also be facing the threat that if they pass the AHCA, they will endure months of protests that will impede business as usual--from millions of people who are determined not to less this murderous monstrosity of a bill become the law of the land.

That's not the signal that Congressional Democrats sent with their incredibly ill-judged cheering in response to the House's passage of the AHCA. Rather than recognize the stakes involved, they were seemingly happy to see a devastating bill passed in the hopes that it will deliver them more seats in the midterm elections.

Performances like this have led to the Democrats' actually losing popularity since Trump took office, so they may want to hold off on planning their victory galas next November. More importantly, future Democratic victories won't do anything to stop the irreversible physical and financial damage that millions of people will suffer if the AHCA passes now.

One of the people who showed up to Tom MacArthur's town hall was Claudia Storicks, a former nurse disabled from diabetes and nerve damage in her foot. If she loses her coverage under the ACA, she told MacArthur, "my diabetes would get out of control, my foot would probably get worse, and I'd probably end up in hospital and losing my house."

"Next year, the public will have a chance to speak," she told the Guardian afterward. "And I don't think I'm going to vote for him again."

But if the AHCA passes and Storick's worst fears come to fruition, merely being able to vote Tom MacArthur out of office will be cold comfort.

U.S. HISTORY has shown time and again that progress comes about, not as a result of electoral "accountability," but because of mass mobilizations and a demand for change.

One way to do that, as Sean Petty noted in Jacobin, is to connect the struggle for universal health care with other fronts in the "palpable, hyper-politicized, mass resistance to Trump's overall agenda":

The Women's March on January 21 was the largest march in American history and helped spawn a nationwide defense of Planned Parenthood. Organized actions took place in over 150 cities, with marches of 5,000 to 6,000 in San Jose and Minneapolis. Given that the AHCA will take away Planned Parenthood's public funding, the single-payer movement can directly connect with these activists. The Women's Strike on International Women's Day helped buttress the idea that women's liberation and economic power are intimately connected. Similarly, a significant movement in defense of immigrants has emerged. Starting with the airport protests against the first Muslim ban, continuing with the Yemeni-owned bodega strike, and flowing into A Day Without an Immigrant protests, these actions have given the consequences of Trump's ruthless policies a human face and highlighted immigrant communities' agency and economic power. This movement should include the fight for immigrant health care, which Obamacare threw under the bus and the AHCA further threatens.

As Petty indicates, we need to be able to fight the Republicans' attempt to repeal the ACA while also laying the groundwork for pushing forward against the severe problems with the current health care system.

"The people who are protesting the Republicans' AHCA nightmare are right to take a stand," Dennis Kosuth and Alan Maass wrote for SocialistWorker.org, "but we shouldn't forget that health care should be a right, and every person should have access to it. The only solution to the crisis is a single-payer, Medicare-for-all system that covers everyone."

Democratic leaders like Nancy Pelosi continue to rule out single-payer on the false grounds that "the American people [are] not there yet." But single-payer bills are currently working their way through the legislatures in both California and New York.

Both bills face significant obstacles, but they show that there's nothing unrealistic about demanding Medicare-for-all, even with Trump in the White House. It's a fight that needs to be connected to the ongoing protests to stop the AHCA--not to repeal it in 2018, but stop it dead in its tracks right now.