In New York's first Congressional district (CD1) on Long Island, activists have been shouting at Representative Lee Zeldin since Donald Trump was elected president, though it's mostly fallen on deaf ears. Still, Kathryn Szoka, active member of Progressive East End Reformers (PEER), believes their persistence is paying off. As they voiced their disapproval of the Senate GOP's plan to repeal Obamacare, they arranged for a mock funeral procession outside Zeldin's office, complete with the Grim Reaper.
In a past email exchange, Zeldin's office called the citizens who oppose him "liberal activists who hold strategy meetings for their political theater", and did not respond to requests to contribute to this article.
Szoka told VICE Impact, "We wanted to draw attention to the fact that the repeal of ACA would put a lot of constituents in CD1 at risk of losing healthcare. Representatives like Zeldin, who have their health care paid for and haven't had to face the rising premiums, don't have a true understanding of the kitchen table conversations that happen around the country."
"Two things that kept coming up were the challenges of accessing good education and healthcare. The system is not working."
Activists in this district weren't surprised when Zeldin stuck with Trump on this issue. Like many other House GOP members, he has rarely diverged from Trump's agenda.
In Pennsylvania, Republican Senator Pat Toomey has been met with consistent protests that have brought the community together.
"Tuesdays with Toomey consists of a diverse group of people who meet [weekly, in front of Toomey's office] to focus on issues they think Pat Toomey should be focusing on, but is not," said Elizabeth Fiedler, a mother who recently left her job as an NPR reporter to explore a run for state house in district 184 in South Philadelphia. Fiedler, whose family relies on Obamacare for insurance, has had countless conversations at the park and around her neighborhood because her representatives were not representing.
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"As a reporter for a decade, two things that kept coming up were the challenges of accessing good education and healthcare," said Fiedler. "The system is not working."
It's not just activists who took stances against repealing Obamacare. In Ohio, a state which went for Trump in the general election and has been seen as one of the most crucial swing states in the country, the Ohio Hospital Association took an ardent stand against the last incarnation of repeal, which had no plan for a replacement.
"The ACA should not be repealed without simultaneous replacement guaranteeing adequate coverage," said John Palmer, Director of Public Relations for the Ohio Hospital Association. "We must maintain coverage for all individuals currently insured. The AHCA would end the ACA Medicaid expansion in 2020 and cut billions of dollars from the program, jeopardizing care for millions of our most vulnerable, including children, the disabled, and those with chronic conditions."
The senators in Ohio voted, as expected, along party lines. Republican Senator Rob Portman had expressed concern about the so-called "Skinny Repeal", but voted for it anyway, citing Obamacare's failures for Ohio's families.
"Obamacare isn't working for Ohio families and small businesses, many of whom have seen their premiums and deductibles skyrocket," he said in a statement.
But activists in Ohio disagree. In mid-July, just before the vote on Repeal and Replace, several groups gathered at Portman's Cincinnati office.
"What are the implications of a vote yes?" asked Kevin LeMasters on a livestream at the overnight sit-in at Portman's office. "It means voting against the interests of the majority of working people and the poor in Ohio to get a victory for Trump while stripping away the barest protections for the most vulnerable among us."
Even with all the creative and passionate efforts of these activists, Zeldin, Toomey, and Portman voted to repeal. This didn't surprise Szoka, and it didn't discourage her either.
"This is the way democracy works," she said. "We are unhappy with what our representative is doing and we let them know about it."
The next step, when a representative is not representing, is to replace the representative. There's a subgroup of PEER that is committed solely to replacing Lee Zeldin, and a major priority in future legislation will continue to be healthcare.
"We are pleased that the repeal didn't pass in the Senate," said Szoka, "but I have no illusions it's gone away forever. We are vigilant."
Now that Obamacare is off death row, at least for now, healthcare activists are focusing their energy at the state level.
"This is the way democracy works. We are unhappy with what our representative is doing and we let them know about it."
"The New York Health Act got through the assembly twice, only to be stalled in the Senate Committee," said Katarina Mesarovich, who mobilizes healthcare activists for PEER. "I was completely unaware that New York was working on a Medicare for All bill."
This bill is an opportunity for New York to set an example for the rest of the country, if it can get through the State Senate, which consists of members of the Independent Democratic Conference (IDC), who ran as democrats but often align with Republicans on crucial votes.
"We only need one or two senators to push it through," said Mesarovich.
She's helping to organize Community Conversations, the next big initiative for local activists on Long Island to bring healthcare to all New Yorkers. By setting up tables at local hotspots, activists are spreading the word about the possibility of universal coverage in New York. Other states, like California and Nebraska, will see initiatives brought to the senate floor in their states as well.
In Pennsylvania, Pamela Delissio drafted legislation for a medicare for all single payer plan.
"This is the piece of legislation people are focusing on as far as health care access in Pennsylvania," said Fiedler. "It's one thing we can be doing right here in our state to protect ourselves from the political chaos that's happening in DC. Access to healthcare is a human right and it should not rely on the political whims of politicians who have other things on their mind other than their constituents' wellbeing."
Focusing closer to home, at a state level, is one way to build the American dream from the grassroots.
"A lot of times when something fails on the national level, states start to have their own laws. It's a pathway," explained Szoka. "Look at gay marriage. We are at a moment when the majority of people realize that healthcare is a right in our country." Find out what your state is doing -- or not doing -- to expand health care coverage by digging around on your state assembly's website. Have a similar health care scare story to tell? Give us a shout at @viceimpact.