In middle America, Republican in swing district feels impact of his health care vote | McClatchy Washington Bureau

The political pressure facing moderate Republicans around the country could be seen Thursday outside the suburban Kansas City district office of Kansas Rep. Kevin Yoder, where 60 protesters waved signs and vowed to hold him accountable for his “yes” vote on the GOP plan to overturn Obamacare.

Yoder was one of 23 Republicans in districts won by Democratic presidential candidate Hillary Clinton in November who had to choose between breaking with their party over a bill that was controversial at home, or throwing their support behind it to ensure a much-needed victory for their party.

Their decisions will come back to haunt them on the campaign trail, with many facing immediate blowback.

“There are a lot of members that can’t win on this,” said Rep. Emanuel Cleaver, a Missouri Democrat. “Either way, they’re in trouble.”

In the end, lawmakers like Yoder from Clinton-won districts helped carry the GOP plan to repeal the Affordable Care Act — widely known as Obamacare — to narrow passage Thursday by a 217-213 vote in the U.S. House. Fourteen of them voted yes. Nine voted no.

The Republicans’ Affordable Health Care for America Act would eliminate Obamacare’s individual mandate, loosen regulations on insurance companies and make major changes to Medicaid. The bill will now head to the U.S. Senate, where it is expected to face an uphill battle.

Until Yoder cast his ballot, it wasn’t clear which way he would go. He wouldn’t reveal his position on the bill beforehand, telling McClatchy’s Kansas City Star earlier this week that he still had “some concerns about the cost and the coverage.”

Just a few hours before the vote, Yoder’s office said he still remained undecided.

“He’s usually a late decider and there’s nothing wrong with that, it just means he’s thinking it all through and wants to make sure he does the right thing,” said Rep. Tom Cole, an Oklahoma Republican. “But you know, Kevin’s not someone whose usually one that’s an automatic yes or an automatic no, and honestly that pretty much reflects his district, which is much more of a swingy district.”

It wasn’t until after Yoder cast his ballot that Yoder issued a statement. He declined a request for an interview with the Star.

“We are seeing the dangerous collapse of Obamacare play out across the country,” he said. “Rather than forcing Americans to buy plans they don’t want or can’t afford, regulating insurance providers out of the market altogether, or leaving people with no options to choose from, the (GOP healthcare bill) makes the necessary changes to repair our health care system that’s collapsing before our eyes. For these reasons, today I voted yes.”

In the Kansas City area and on social media, the backlash against Yoder’s vote already has begun, with the protest at his district office organized by the progressive group Indivisible Kansas City, and a flood of angry messages on Twitter and Facebook.

“Today, you voted to put political party loyalty over the voice and best interests of your constituents,” one man tweeted at Yoder.

“As a resident of your district, I look forward to doing whatever I can to make sure you never hold public office ever again,” another tweeted.

“Every single spare dollar I have, every spare minute of my time for the next 550 days is going to be spent getting you out of office,” a woman wrote.

Ginny Krystel, a 62-year-old Leawood, Kansas, resident, said earlier Thursday in an interview that she made dozens of calls to Yoder’s office urging him to vote against the bill. Each time she was told by Yoder’s staff that the congressman had not made up his mind. 　

“I have written Yoder. I have called Yoder. I have gone to his office here in Overland Park,” Krystel said. “Let me put it this way: If Kevin Yoder is surprised that Ginny Krystel or many other people don’t want Trumpcare to pass, then I’m afraid he’s been asleep.” 　

Krystel, a breast cancer survivor, had difficulty obtaining insurance after leaving her job at Sprint in 2001. She was able to get coverage through a high-risk pool for $1,200 a month. The passage of the Affordable Care Act in 2010 reduced that monthly premium to $250 a month, she said.

“So for me, Obamacare was and is the greatest thing,” Krystel said. She said that she’s worried premiums for people with pre-existing conditions will skyrocket under the GOP plan and she’ll no longer be able to afford her monthly payments.

Other constituents were happy to see the bill pass.

Tammy Schrader, a 56-year-old single parent in Overland Park, Kansas, said that she canceled insurance for herself and her two children this year because her premiums had become too expensive under Obamacare.

“It was anything but affordable to me,” said Schrader, who owns a small engineering consulting business. She said that her premium for an insurance plan with a $5,000 deductible increased from $161 a month in 2014 to $720 a month for the same plan this year. “I don’t know what’s in this new bill. I just want the old one to go away,” she said.

Yoder said in his statement that “no one with preexisting conditions can or will be denied affordable coverage under the AHCA now or ever” and said that the bill “frees states to develop innovative ways to provide them with better coverage than they receive now and invests nearly $140 billion to help them succeed in doing it.”

A poll conducted by Public Policy Polling, a Democratic-leaning firm, found that as of last week, 59 percent of voters in Yoder’s district opposed the bill and only 21 percent supported it.

Clay Barker, the executive director of the Kansas Republican Party, said that Yoder had faced pressure on the bill from both opponents and supporters.

He said that the bill’s passage was important to Republicans because it will be seen as a sign that the GOP-controlled Congress can move the party’s agenda forward with a Republican president in the White House.

“It’s more of a psychological issue, not so much the particular policies in the bill, but they want to see Congress pass something,” Barker said. “It’s important to a lot of Republicans just to show momentum.”

Yoder won re-election in November by double digits, but his district is one that national Democrats plan to target in 2018 after Democrat Hillary Clinton won it in the presidential race. Yoder has also been rumored as a possible candidate for Kansas governor that year.

The Democratic Congressional Campaign Committee released a statement attacking Yoder shortly after the vote, saying that the congressman “just voted to increase your health insurance premiums and deductibles, toss 24 million Americans off of their insurance, and to slap you with an age tax if you’re age 50 to 64.”

The National Republican Congressional Committee, on the other hand, released a statement thanking Yoder “for keeping his promise to protect families in his district from Obamacare’s crushing effects.”

American Action Network, a nonprofit GOP advocacy group, announced it would include Yoder in a $2 million TV ad blitz in support of 21 vulnerable Republicans.

Patrick Miller, a political scientist at the University of Kansas, said that the bill was passed through a “very sped-up process” that’s unusual for Washington, where gridlock dominates.

“You have Republican members openly saying they don’t know what’s on the bill,” Miller said.

Miller said that if protections for pre-existing conditions are weakened, as the bill’s critics contend, then it could become a political liability for its supporters in 2018.

At the same time, if Yoder wants to move up in congressional leadership he was wise to vote for the bill, Miller said. “In Congress, much more so than state legislatures, there is punishment for dissenting from the party.”

David Jordan, the executive director of the Alliance for a Healthy Kansas, a group that has pushed to expand Medicaid in Kansas, said that lawmakers could face significant political fallout for supporting the legislation.

“This really is a terrible bill all around that impacts patients, every Kansan and impacts providers. And it really could have a disastrous impact on the state budget,” he said.

The legislation would block Kansas from expanding Medicaid – something which the majority of Kansas state lawmakers support – and would lead to reduced federal dollars for the state by shifting Medicaid funding to a per-capita system, Jordan said.

He cited a study from the Urban Institute, a Washington, D.C.-based think tank, which found that the policy change will cost Kansas $1 billion in federal aid over a 10-year period. Missouri will miss out on $3 billion in federal aid, according to the same study.

The Missouri Hospital Association said in a statement that the bill will reduce health insurance for more than 200,000 Missourians by 2020 and that states, such as Kansas and Missouri, which did not expand Medicaid “will be harmed disproportionately as the Act takes effect.”

“The legislation is grossly inequitable. The AHCA includes funding enhancements and losses targeted directly to states that expanded Medicaid and those that did not,” the statement said. “On a per-capita basis, those AHCA changes give the residents of expansion states 61 percent more than the residents of nonexpansion states, including Missouri.”