Kansas First District Rep. Roger Marshall spoke with constituents in the Big First district on Saturday in McPherson. This was the second in his nine-location listening tour through the district this month.

“I’d like to make this time as constructive as possible and give as many people a chance to state all they want to state,” Marshall said. “I’ll do more listening than in a normal town hall.”

About 80 people attended the town hall-style meeting Saturday, many of which shared personal stories, concerns and skepticism about the Republican plan to repeal and replace the Affordable Care Act.

The freshman congressman is at the center of two key issues constituents are interested in — agriculture and health care. Marshall is a member of the House Agriculture Committee, which is working toward the 2018 Farm Bill, as well as the GOP Doctors Caucus, which is a group of 16 lawmakers with health care backgrounds who roll back the ACA.

Marshall asked four experts on agriculture to speak first, followed by time for questions, then two experts to spoke on health care with time for questions afterward.

The issue: Health Care

Though the time was initially split between agriculture and health care, comments from the public focused heavily on the Affordable Care Act and what might replace it.

“Health care is broken. Doing nothing is not an option,” Marshall said. “Doing nothing is something financially we can’t do.”

Marshall indicated that he thinks that decentralizing health care would be preferable to having the federal government controlling it.

“I think the government typically messes it up, and I’d like to push things back to more locally controlled instead of the federal government trying to micromanage it,” Marshall said. He called the Republican proposal to replace the ACA a new book on health care, and the plan is the first chapter of that story.

“It’s not all-encompassing and not perfect,” Marshall said. “I covet your wisdom and your prayers trying to get it right, but rest assured this is taking up most of my waking hours. In the meanwhile, I’m trying to get a farm bill done and working on trade.”

What the experts think

The primary concern for professionals in medicine was that constituents would have increased access to care.

“I don’t think we should be satisfied ever that what we have now is the right answer. We ought to have change,” said Dr. Tyler Hughes of McPherson. “What I approve of is that the Republicans are starting somewhere and moving forward incrementally.”

However, constituents were more worried about potential increases in costs.

What constituents think

Many in the audience urged Marshall to slow the process and be sure that the new plan is in the best interest of constituents.

“To your credit, you are listening, but the issue is who you listen to,” said David Norlin of Salina. “It will take courage, and we’re counting on you, to not listen to moneyed interests.”

Michelle Neal, of Salina, said she had read the entire 123-page bill, which she brought to the meeting and pointed to the section describing a 1.45 percent tax.

“If this passes the way it is, it is going to increase my family’s tax burden by $6,916,” she said. “That is more than our annual food budget, sir. That is my concern.”

Neal also voiced concerns with the bill repealing the net investment income tax, which is a funding mechanism for the ACA, and a tax on people who use tanning beds.

“If you want to slide this kind of crap past Kansans, don’t tell us to read the bill,” Neal said.

Jay Warner, of McPherson, pointed out that Marshall’s survey of the Big First district may not tell the whole story. A pie chart Marshall had displayed showed that 80 percent of people reported cost increases in health care since the implementation of the ACA. Warner said he had purchased his own health insurance for 30 years as he farmed.

“Do you want to know how many times in that 30 years before the Affordable Care Act my health care costs did not increase?” Warner asked Marshall, who laughed and asked, “Zero?”

Warner, who works with Circles of McPherson County, a program that aims to help lift people out of poverty, said he is most concerned about people who can’t afford insurance premiums.

Duane Schrag, of Abilene, said that the ACA made having health coverage possible for many Americans, including for himself.

“I’m acutely aware that Americans were told by the president that the replacement would be much better. I take that to mean at least better coverage and more people would be covered by it — and he insisted that it would be far cheaper. I’m not opposed to replacing the ACA if that’s what you do. Everything I’m reading now suggests that is not going to happen,” Schrag said. “I sincerely hope that what you support is something that moves us further down the road of making it more accessible, better coverage and costing us less. That’s kind of magical, but that’s what we’ve been promised.”

The final question for Marshall was from someone who asked him to explain a comment he made about Jesus and the poor, which made national news last week. Marshall said the comment “came out bad” and was taken out of the context of a 45-minute interview focused on Medicaid. Marshall said he felt an obligation to care for orphans and widows, especially.

“My statement was the poor are always going to be with us, but you cannot write an entire health care plan for just that group of people,” Marshall said. “I think my life’s work would say that I’ve been a person that’s done so much to help the poor, those on Medicaid. For probably 10 of the 25 years I was in Great Bend, I was the only doctor who would accept Medicaid for OB patients within about 60 to 70 miles.”

The issue: Agriculture

Marshall explained that he hopes to improve Kansas agriculture because the industry stands at the center of many communities.

“Agriculture represents 60 percent of the economy in this district,” Marshall said. “The average farmer made $6,000 in 2015 and 2016 doesn’t look much better. It’s the first time in my professional career that I’ve seen prices in this desperate of situations. ”

Marshall asked four McPherson County producers to share what they find to be the most important issues in agriculture.

What the experts think

Kendall Hodgson of Little River and Devin Schierling of Inman were both concerned by the economic impact of a new farm bill.

“Producers are losing money coming into the year,” Schierling said. “When production agriculture is strong, so are our local communities because those dollars are reinvested.”

Hodgson pointed out that the 2018 Farm Bill could do more in the way of trade.

“Half our wheat and half our soybeans are exported — trade is a huge win for agriculture,” Hodgson said. “The one thing I ask is that there be no cuts. This 2014 bill saved $100 million. It’s too important to our country to cut.”

Allan Sents of Marquette and Tom Tolle of Lindsborg discussed changes in regulation that could benefit Kansas farmers.

Nation-wide, producers are feeling the burden of tightened immigration policy.

“We’re finding it increasingly difficult to find the right people to do the job,” Sents said.

Other legislation, like the Grain Inspection, Packers and Stockyards Administration and the Clean Water Rule, have mixed effect on producers.

“GIPSA is one small step in correcting something that has been an issue for over 20 years,” Sents said. “Scott Pruitt (administrator of the Environmental Protection Agency) indicated a willingness to work with states and allow regulation to be state driven.”

What constituents think

Several individuals expressed concern about regulation, both adding more to conserve resources and removing regulation that hinders production.

One man suggested conserving more of the Ogallala Aquifer. “It runs from North Dakota to Texas. It’s being drawn down at a tremendous rate,” he said. “Agriculture needs water to survive, although everyone in this room needs water as well. We need to look at conserving that aquifer and waste less.”

Conversely, regulation like the Waters of the United States rule, which is part of the Clean Water Rule, makes production more difficult.

“I’ve had conversations with Sen. (Bob) Dole about his intentions while writing this,” Marshall said. “The intent was for navigable streams, but it’s been interpreted to mean every puddle. But the waters in Kansas are better today than when I was growing up.”