The millions of people who marched last Saturday got the national headlines. But the two dozen protesters holding signs in an icy morning rain outside the Best Western in Kingston, New York, last Wednesday may matter just as much. They were there because freshman Republican Congressman John Faso was addressing a local chamber of commerce—they wanted him to know he'll be seeing more of them if his party moves forward in dismantling the Affordable Care Act.
Faso has just entered Congress, but holds a key spot—he's been named to the House Budget Committee, which will play a key role in ACA repeal efforts. Those who want to keep Obamacare intact know how important he is. Four days earlier, 150 sign-waving activists had appeared at his district office in Kingston, complete with a brass band. A Faso staffer told a local town supervisor that their phone lines are being "inundated" with calls about the ACA.
Last October, Faso had signed a repeal pledge put forward by a conservative group. But at the chamber breakfast, he had a different message: "They talk about repeal and replace. I prefer reform." He told the group that any changes should "hold harmless" those who currently get coverage through the ACA, that he wants a long lead-in period for any revisions, and that any new plan must have the support of Democratic leaders. (Faso's office didn't respond to requests for comment for this story.)
Faso, like many Republicans, is in somewhat of an awkward place politically. A January CBS poll found that only about one in five Americans want to see the law repealed entirely—and among those who do want full repeal, half want a replacement ready to go. Under the GOP's "repeal and delay" plan, however, they would pass a bill scrapping the ACA, then put off the effects of the repeal until they figured out their own health insurance reform plan.
Local protests are turning the pressure up on members of Congress weighing this plan. In Grand Rapids, Michigan, the year's first town hall with Republican House member Justin Amash on January 17 was so jammed that many constituents were turned away at the door. The 250 who did get in made for a restive crowd. Interrupted frequently, Amash wasn't ten minutes into his remarks before audience members demanded that he refer to the "Affordable Care Act" instead of "Obamacare." About a fourth of the questions that followed were about the ACA.
Amash told them that he supports a plan that wouldn't repeal the ACA until individual states replace it with their own plans. (He was one of nine Republicans to vote against a January 13 reconciliation bill that was one of the first steps toward ACA repeal.)
House Republican Tom MacArthur of New Jersey also voted against the reconciliation bill. "I'm getting a lot of calls [about health care]," he told the Washington Post. "What I'm hearing from people is, they're much more concerned about the substance of the fix than the timing of the fix."
The effects of these calls were obvious inside a private meeting of Republican lawmakers, where many of them were having doubts about repealing too quickly without a replacement, according to audio leaked to the Washington Post.
In some cases, the protests won't likely change Republican positions but are creating YouTube moments reminiscent of the anti-ACA Tea Party protests of 2009. On Martin Luther King Day, Washington State House Republican Cathy McMorris Rodgers had part of her speech drowned by chants of "save our health care." On January 18, 58 people showed up with signs at a district office of Virginia House Republican Barbara Comstock. They included a ten-year-old with a life-threatening genetic condition whose insurance might stop paying for her treatment if the ACA's lifetime coverage caps were repealed.
In Aurora, Colorado, House Republican Mike Coffman ended his January 14 constituent meeting early, leaving through a back door after reportedly getting many questions about the ACA from angry voters.
Many of those showing up are part of local organizations networked through national groups like Indivisible, MoveOn.org, and Our Revolution. Indivisible's action plan, written by former Democratic congressional staffers, seeks to replicate elements of the Tea Party's approach. It emphasizes a local strategy that targets members of Congress by having constituents show up at town halls and other local public events, do in-office visits, and organize mass call-ins.
"This is a nationwide movement that's very locally driven," said Indivisible's Ezra Levin. "We have 3,700 or 3,800 groups in nearly every congressional district in the country—it's not just Brooklyn and Berkeley. This isn't a slacktivism movement. We're seeing people physically do things."
The advocates have already succeeded in doing something elected Democrats failed to: bring attention to the law's widely popular components, said Dean Baker of the Economic Policy Institute. "The Democrats thought the clever thing was to not talk about [the ACA]. I know that based on talking to Democratic staffers. Their pollsters said, 'People hate it—you can't talk about it.'" Now the activists are pointing out what people will lose, he says.
That's why 70-year-old Caroline Paulson showed up for the January 15 protest at Faso's office. She carried a sign reading, "Without my affordable insulin, I will die. Save the ACA." She doesn't want to do anything to get herself arrested—as a diabetic, she'd be vulnerable if she went to jail, she says. But she vowed to do something when she saw ACA repeal coming. "Individually we're just a droplet, but collectively we can doing something. We're trying to make a tsunami here," she said.
If the repeal effort does get turned back, it will probably happen in the Senate, where Republicans only have a 52-48 majority, and some GOP lawmakers have already said they won't repeal the ACA without a replacement. "The more it looks like a slow-motion debacle, the more likely it is that Senate Republicans will get cold feet," says Will Marshall of the Progressive Policy Institute. "[The protests] are helping to illuminate the fissures in the Republican coalition." Baker believes it's "virtually certain" that local organizing efforts will have an impact.
One former Republican congressional staffer agrees that targeting legislators gets their attention. "I think that informed communication in any form gets noticed by representatives," said Emily Ellsworth, author of the book Call the Halls: Contacting Your Representative the Smart Way and a former staffer for House Republicans Jason Chaffetz and Chris Stewart. "They recognize that their constituents are watching and paying attention to the work they are doing."
But she's skeptical of tactics that don't promote a dialogue with legislators and their staff—like showing up unannounced en masse at the door of a legislators' district office, which can alarm the few staffers usually present. "If you want to have a dialogue with your representative or their staff, small in-person meetings about a specific issue will get you in the door and heard," she suggested.
And Marshall says to create lasting change, the advocates have to replicate a key part of the Tea Party's success: winning primaries, as happened when insurgent Dave Brat defeated House Majority Leader Eric Cantor in 2014. Winning elections matters—"it concentrates the mind," said Marshall.
Steven Yoder writes about criminal justice and domestic policy issues. His work has appeared in Salon, Al Jazeera America, The American Prospect, and elsewhere. Follow him on Twitter.