By Jon Kelvey for the Carroll County Times.

More than 150 people packed the St. Paul’s United Church of Christ fellowship hall Thursday night for an often boisterous town hall meeting on the future of the Affordable Care Act, also known as Obamacare.

While Republican lawmakers have long been critical of President Barack Obama‘s signature legislative achievement and President Donald Trump has promised to repeal and replace the law, the ACA has also seen its fair share of criticism from supporters and those on the left. Thursday’s event, organized by local progressive advocacy group Carroll CAN, was billed as a nonpartisan opportunity to discuss the law’s flaws, its virtues and its future.

That discussion began with a panel made up of local and regional health professionals and advocates: Tammy Black, executive director of Westminster-based community health clinic Access Carroll; Ed Singer, health officer at the Carroll County Health Department; Gary Honeman, assistant administrative director at Carroll County Youth Services Bureau; and Francine Hahn, a former navigator with the Maryland Health Connection, made up the local panelists. Kalie Potter, regional director regional manager for the Door to Healthcare, and Dr. Margaret Flowers, former Green Party candidate for the Senate seat now occupied by Sen. Chris Van Hollen, were the more regional representatives.

In opening remarks and in response to prepared questions, most of the panelists were in agreement — there was much to like about the Affordable Care Act, but some things it needed to do better.

“The uninsured rate has dropped by more than one-third since the [Affordable Care Act] was put in place,” Singer said. “There are, however, some flaws in the system.”

Singer’s concerns centered around the financial sustainability of the program, due to a lower than expected number of young, healthy people signing up for insurance, as well as the lack of effective coverage. Many people, he said, have purchased a lower-tier insurance plan only to find they cannot afford their deductibles if they develop a chronic condition such as cancer.

“The other thing we have had a huge problem with is the opioid crisis,” Singer said. “Low-level plans require a special waiver and it’s often difficult to get these clients into treatment to begin with.”

Hahn, who helped people sign up for insurance as a navigator, said it was gratifying to see people get insurance, especially through the expansion Medicaid programs to cover low-income people who otherwise could not afford insurance, an experience she shares with Black.

“We had [a] significant number of people who were the first people in their entire family’s history to ever have insurance,” Black said of enrolling patients at Access Carroll. “Ever. They didn’t know what to do with it.”

But even Hahn, who enthusiastically supported the health care law, said there were problems that needed to be addressed, such as what navigators called “the family glitch.”

When considering whether a family was still eligible to purchase a tax subsidized plan when one parent was offered insurance through an employer, the test was whether the cost of the employer plan was affordable for just one parent, not the entire family. This sometimes leaves one parent out in the cold.

“She has affordable health insurance,” Hahn said, “Dad is going to have to pay full price on the health exchange.”

Flowers, rather than critiquing any one piece of the Affordable Care Act, attacked it as an insufficient compromise and that the best fix would be to expand Medicare coverage to all citizens — a single payer national insurance model such as in Canada.

“Private health insurance companies … are actually financial institutions that are investor-owned and have a responsibility to investors to provide as much profit to investors as possible,” she said. “We have to understand that private health insurance is not here to pay for our health care — they are an obstacle.”

That was a view apparently shared by many in the crowd, who gave Flowers loud applause, if not the emissaries of elected representatives in attendance.

Sens. Ben Cardin and Chris Van Hollen sent representatives who expressed their bosses’ support for the Affordable Care Act, and Karen Robb, from Van Hollen’s office, noted the senator is in favor of a single-payer model even if not actively pursuing it at the moment.

A staff member from Rep. Jamie Raskin‘s office told the crowd that the congressman not only supports a single-payer system, but that he has signed on to support HR 676, a bill in the House of Representatives that would enact such a system, to thunderous applause.

A representative of Rep. Andy Harris told the crowd she was there to listen and would take down the information of anyone interested in communicating with the congressman.

The crowd, when the time came for a question-and-answer session, were not so circumspect or bipartisan.

“When we call the police, we don’t have any expectation that when we call 911 we will have to show our Visa card,” said Mel Brennan, who lives in Westminster.

He felt there was a certain hypocrisy to accepting tax-supported public safety but not public health. “Nobody is a socialist that supports a community fire department.”

Kevin Zeese, of Baltimore, used the mic to attack Van Hollen and Cardin for not pushing harder for a single-payer system, given that they had asserted, in statements by their representatives, that they believed health care to be a human right.

“A human right is not compatible with a commodity,” he said.

And then there was Kelley Gordon, of Hampstead, whose grandson Rhett was born with cystic fibrosis and whose family lives with anxiety that the protections of the Affordable Care Act will be repealed.

She recognized, she told the crowd, that the Affordable Care Act was not enough, but even she had concerns about single payers — she’s been calling Canadian officials trying to understand how that system would work for her grandson and she’s not certain yet what it would look like.

What Gordon asked was that elected officials take a look.

“There are working systems all over the globe,” she said. “Our leaders have got to look around the world. … And do what’s right to protect people like my beautiful little grandson.”

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