Politics

On a hot September day, a small crowd gathered around 6th district Congressman Andy Barr at the Fall Festival in Midway. He ticked off his record — the tax cuts bill passed last December, scaling back parts of the Dodd-Frank consumer protections and the Republican attempt to repeal and replace the Affordable Care Act.

“The country is back,” Barr said. “Americans are better off now as a result of the policies we put in place. The country’s more prosperous, we’re stronger.”

James P., who didn’t want to be identified by his last name, strikes up an argument with Barr.

“Hey, I’ve got some questions, buddy,” the man said before launching into a criticism of Republicans’ attempts to undo the Affordable Care Act.

He said the monthly premium has gone up on the health insurance he gets through his employer and thinks Barr should find ways to stabilize the insurance markets instead of attack Obamacare.

“My health care was fine before last year,” James P. said.

“Obamacare is deteriorating the private health insurance market,” Barr responded. “That’s the whole point, sir, that’s why we’re trying to fix it.”

“It doesn’t sound to me like you’re trying to fix it, it sounds to me like you’re trying to tear it apart,” James P. said.

A Dead Heat

Kentucky’s 6th congressional district extends from central Kentucky to the foothills of Appalachia. It’s a true swing district that includes a mix of rural and urban areas and, over the last few decades, voters have flipped several times between sending Republicans or Democrats to Washington.

And with recent polls showing the race in a dead heat, it could be a contest that helps determine whether Republicans keep control of the U.S. House of Representatives. The race has drawn so much attention nationally that both President Donald Trump and former Vice President Joe Biden are set to make appearances inside the district over the next few days.

One of the many issues voters in the district will have to consider as they head to the polls is how candidates would deal with the Affordable Care Act, which provides health coverage to more than half a million people in the state.

The issue has proven to be contentious in the district — Barr had to face crowds of protesters who attended town hall meetings after he threw his support behind the Obamacare repeal effort last year.

The measure, which passed out of the House but ended up failing in the Senate, would have changed how states fund their Medicaid programs by shifting to block grants or per capita caps on spending.

It also would have let states apply for waivers to disregard some mandates of the Affordable Care Act, like the law’s ban on insurance companies charging higher premiums for people with pre-existing medical conditions.

Democratic challenger Amy McGrath, a retired Marine fighter pilot, said she wants to keep the Affordable Care Act in place and look for ways to expand government-sponsored health coverage to more people.

She’s accused Republicans of only trying to undermine the signature policy of former President Barack Obama, instead of trying to improve health care.

Amy McGrath

“In their ideological push to repeal it and get rid of it, they don’t have a replacement, they don’t have anything to make it better,” McGrath said.

McGrath said she wants to impose other health care changes — like allowing people to buy in to Medicare at age 55 instead of 65. She also said she supports creating a government-run health insurance agency that would compete with private insurers.

This is one of the main planks of McGrath’s platform; yet in recent elections, Kentuckians have overwhelmingly supported statewide candidates who campaigned on getting rid of Obamacare.

She thinks this year, voters in the 6th district will feel differently.

“They elected people who basically said ‘vote for me, I’ve got something better.’ They didn’t tell people what that better was and now we’re finding out they didn’t have anything better and they’re actually trying to make things worse,” McGrath said.

Despite the failure of the Obamacare repeal bill, Congress was able to chip away at one of the biggest parts of the policy — getting rid of the individual mandate requirement that all citizens have health insurance, which will take effect in 2019.

“That’s not taking anything away from people, that’s giving people the freedom to make choices on their own,” Barr said.

President Trump’s administration has worked to undermine other parts of the law — including ending so-called cost-sharing payments that help low-income people pay deductibles and co-pays, and shrinking the annual open enrollment period from three months to six weeks.

Barr said going forward, he supports allowing people to buy insurance across state lines and purchase cheaper insurance plans that circumvent certain Obamacare regulations.

“Unfortunately, while well-intentioned, the Affordable Care Act actually decreased choices for people. It caused people to lose their health plans,” said Barr. “And premiums and deductibles have skyrocketed and people are really hurting as a result. We have an obligation to my constituents to keep working to fix that.”

McGrath said Obamacare isn’t a perfect piece of legislation, but it’s a starting point and needs to be given an opportunity to succeed.

“We need to get people into office that want to make it better — that want to bring premiums down, bring health care to people, make it more affordable, not trying to undermine the system and make it worse,” McGrath said.

About 90,000 Kentuckians have health insurance that was purchased on the Obamacare marketplace this year. And more than 460,000 are covered as a result of the state’s expansion of Medicaid under the Affordable Care Act.

Ryland Barton is the Capitol bureau chief for Kentucky Public Radio.