Constituents jeer and boo Nebraska lawmaker over healthcare concerns
This post has been republished from Professor Patricia McCoy’s Substack. Her new book, “Sharing Risk: The Path to Economic Well-Being for All,” is available from The University of California Press.
Over the past two weeks, Nebraska constituents grilled a Republican congressman on recent health insurance cutbacks during a pair of town halls. Their angry response — and the congressman’s difficulty in allaying their concerns — signal potential voter backlash as those cutbacks are rolled out.
Last month, Congress enacted H.R. 1, also known as the “One Big Beautiful Bill Act,” making sweeping cuts to Medicaid and other social safety nets. Now that the House of Representatives is in August recess, some members of Congress have been holding town halls to explain the law to constituents.
One of them is Rep. Mike Flood, who represents Nebraska’s 1st Congressional District. Congressman Flood, a Republican, voted for H.R. 1, and held a live telephone town hall on July 28 to discuss the new law and health care with constituents. A Nebraska voter who participated in the call shared details with me, and I wanted to report on that event, along with Flood’s subsequent raucous town hall meeting on August 4.
But First, a Recap of Congress’ Cutbacks to Medicaid and Obamacare
Rep. Flood spent most of the July 28 telephone town hall fielding questions on how H.R. 1 will affect Medicaid and Obamacare coverage under the Affordable Care Act (ACA). Here’s a brief recap of the key developments:
Tougher Medicaid Requirements
First, H.R. 1 made it harder for people to qualify for and remain on Medicaid, which is free or almost free health coverage for low-income residents. In the most notable change, Medicaid applicants and recipients will have to document that they meet work requirements or qualify for an exemption, starting at the end of 2026. Under the new requirements, people will have to prove they work at least 20 hours per week (or perform community service or attend school) to qualify for coverage — unless they qualify for an exemption such as a disability. Once on Medicaid, beneficiaries will have to update their documentation every 6 months, or risk losing coverage.
House Republicans defend these requirements, arguing that millions of Medicaid recipients don’t, but should work. That’s flat wrong, however, because almost all Medicaid recipients who are able to work do work. According to Brookings, in 2022 only about 300,000 Medicaid recipients who were able to work 80 hours a month “did not work because they did not want to” — less than 1% of all recipients. Yet, the non-partisan Congressional Budget Office (CBO) estimates that 10 million people will lose health insurance coverage by 2034 due to H.R. 1. That’s more than 30 times the 300,000 Medicaid recipient who could work but do not want to.
Paperwork Barriers Could Push People Off Medicaid
Something else is going on. The real purpose of those paperwork requirements appears to be knocking low-wage people who are working off Medicaid in order to free up money to pay for tax cuts for the affluent. The reason that could happen is that some workers will not be able to prove their work status to the degree of detail that bureaucrats require. There are many ways hard-working adults who otherwise would qualify for Medicaid could stumble over the new government paperwork requirements, as I discussed earlier this summer. That happened when Arkansas adopted a similar work documentation requirement for Medicaid in 2018. Ultimately, 18,000 Arkansas recipients were kicked off of Medicaid, even though most of them were actually working or qualified for an exemption. The problem was, they couldn’t produce the paperwork to prove it and they lost their Medicaid benefits as a result.
Obamacare Premiums Set to Skyrocket
Rep. Flood’s town hall also touched on ACA (Obamacare) health coverage and its cost. That’s a real concern, because Obamacare premiums are set to spike by 75% on average overnight when the expanded federal subsidies for those premiums expire on December 31. This rate hike will affect 92% of Obamacare policyholders. H.R. 1 could have extended those subsidies but did not, and no other extension is on the horizon. CBO estimated that not renewing the expanded premium subsidies would cause 4.2 million Obamacare participants to lose their health insurance by 2034. That’s on top of the 10 million forecast to lose Medicaid by then.
A Domino Effect of Coverage Loss
The Medicaid and Obamacare cutbacks in health coverage feed on each other in a highly destructive way. By definition, Medicaid recipients are poor or nearly poor. For instance, in Nebraska and the other 39 states with higher Medicaid income limits, in 2025, a family of four will only qualify for Medicaid if its annual income is below $44,367.
People thrown off of Medicaid for failing to dot the i’s and cross the t’s of the work documentation requirements will be left with two options — both flawed:
1. Employer Coverage: Some may qualify for employer-based health coverage at work. But many low-wage workers — especially those at small businesses — won’t be offered insurance on the job. And others with health insurance at work won’t be able to afford the premiums, which presumably is why they were on Medicaid to begin with.
2. Obamacare Plans: The ACA Marketplace technically accepts all applicants regardless of income. But without subsidies, coverage will be unaffordable for low-income applicants. In 2025, a 40-year-old nonsmoker paid an average of $500 a month for an unsubsidized benchmark ACA plan. Meanwhile, insurers are requesting more rate increases from state insurance commissioners for 2026.
What Rep. Flood Told Constituents on July 28
Rep. Flood deserves credit for holding a telephone town hall on July 28 — and an in-person town hall with more than 800 people on August 4 in Lincoln. Last March, Rep. Richard Hudson (N.C.), chair of the House GOP’s campaign arm, told Republican lawmakers to stop holding in-person town halls. That’s why it’s rare for Republicans like Rep. Flood to actually choose to face tough questions in public. In this day and age, it is refreshing to see that.
Even so, the response at Rep. Flood’s telephone town hall may have revealed how few solutions GOP lawmakers have for constituents losing health coverage. On July 28, Rep. Flood offered this advice to people struggling to afford Obamacare:
“One idea is to shop in the market to find out what you can get. Number two is to call the Nebraska Department of Insurance and file a grievance and have the Department of Insurance look into it as a consumer complaint. And third, what I would urge you to do is call my office in Lincoln.”
Let’s break that down:
- Shopping around can help some consumers save, but only to a point. Many people — especially those with serious health conditions or low incomes — won’t find anything affordable once the expanded premium subsidies disappear.
- Filing a consumer complaint won’t reduce premiums or deductibles. Insurance commissioners can’t negotiate special discounts for individual people and often are the ones who approved the high rates in the first place.
- Calling a congressional office is unlikely to yield better results. While Rep. Flood’s staff may be helpful, they lack authority to force insurers to lower premiums or deductibles.
In short, none of these options provides real relief to people priced out of their healthcare coverage.
Bottom line, members of Congress who voted for H.R. 1 and its health coverage cuts now are backed into a corner. Some, like Congressman Flood, have faced medical emergencies involving themselves or family members and are empathetic to constituents’ health challenges. But the healthcare affordability crisis that Congress manufactured in H.R. 1 leaves members of Congress with no good answers when constituents confront them about how people will afford health insurance now that H.R. 1 is law.
Town Hall Tension in Lincoln on August 4
Telephone town halls such as Rep. Flood’s on July 28 are becoming the town hall format of choice because constituents have to call in by phone and their questions are moderated. In the telephone format, constituents can only speak one at a time. There is no way to gauge the audience’s reaction or for participants to heckle the speaker.
But to his credit on August 4, Rep. Flood also hosted an in-person, televised town hall at Kimball Recital Hall on the University of Nebraska-Lincoln campus. It lasted nearly 90 minutes and quickly turned tense. Rep. Flood was met with boos and jeers throughout, especially when he tried to defend H.R. 1’s impact on health care.
By my count, he answered 38 questions spanning a variety of topics, including the national debt, Gaza, January 6, farm aid, and Jeffrey Epstein. But health care dominated — 11 questions (one-third) touched on health or health insurance, with 7 focused directly on health coverage.
Audience members asked:
· “So how can you justify taking health care away from 78,000 Nebraskans?”
· “Keeping Nebraska in mind, what actions are you going to support or initiate that will provide health care and food assistance for low-income families . . . ?”
· “[W]ould you sign on or write up a bill for Medicare for All?”
· “[W]hat plans does the Congress have for providing reasonable-cost health insurance to Nebraskans?”
Rep. Flood’s answers to each of these questions was met by heckling and boos. His responses— which included claims that reducing Medicaid would lower private insurance rates and that Nebraska hospitals would receive more federal money—did not satisfy the crowd.
A Warning Sign for H.R. 1 Supporters
Recent developments help explain the audience’s intense interest in health insurance and its cost on August 4. Today, 17% of Nebraskans are on Medicaid. That percentage is even higher in rural Nebraska. In 2018, Nebraska voters approved a ballot initiative to expand Medicaid, with 54% support statewide. In Nebraska, Lancaster County’s Election Commission finds roughly 35% of Lincoln voters are registered Democrats, with 38% registered Republicans and 25% registered as non-partisan voters. Consequently, the Medicaid vote shows that concerns about health coverage crosses party lines.
Rep. Flood’s August 4 town hall underscored just how deeply voters care about health insurance access — and how disconnected supporters of H.R. 1 may be from public sentiment. It’s uncertain if Republican lawmakers like Rep. Flood will continue holding in-person events with their constituents. But the distrust voiced in Lincoln will not disappear. As H.R.1’s health coverage rollbacks unfold, so too may the political consequences.
This post has been republished from Professor Patricia McCoy’s Substack. Her new book, “Sharing Risk: The Path to Economic Well-Being for All,” is available from The University of California Press.
BC Law: Impact 