David Hansen tried to get the words out. "I lost my health care," he began to say, his voice unexpectedly cracking, barely audible in the din of a people-packed and sweltering warehouse in Nicholasville, Kentucky. At 59, a US Navy veteran and registered Republican, Hansen lowered his head, unable to look at Democrat Amy McGrath, the congressional candidate headlining this political event in the small town outside Lexington.
A retired US Marine and a decade and a half his junior, McGrath put her hand on his shoulder.
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Hansen had voted for Trump in 2016. He also voted for the Republican congressman for Kentucky's 6th Congressional District, Andy Barr. But Hansen's fortunes changed in 2017 after he had a stroke, an event so debilitating, he said, he couldn't work, losing his health care coverage. He said he now pays for outside insurance, even though he's entitled to get service from the Department of Veterans Affairs, because he said the care there is so poor.
"There's 535 people up there and they're not doing anything," he said of the members of the House and Senate.
Hansen's struggles illustrate why health care is among the top issues in the midterm elections, dominating political ads, particularly among Democrats, who are attacking Republicans over their efforts to repeal and replace Obamacare. In August, a CNN Poll conducted by SSRS found that 81% of voters considered health care important to their vote, including nearly half (48%) who said it was "extremely important."
"Congress isn't doing anything," Hansen reiterated, frustration woven into every word. "They need to fix the health care program because it's broken. They have to get off their high horse and just do it."
Some of the same politically insurgent reasons he voted for Trump are why he's at a McGrath rally. "She's not a politician," said Hansen, pointing out the national Democrats didn't back McGrath in the primary. "She's also been in the military. She knows what it means to honor her commitments."
McGrath leaned over to Hansen and said the words that sealed his support for her. "I'm going to work very hard. That's all I can promise you."
The issue of health care has made Hansen a Democratic voter in the upcoming midterm elections. And in this ruby red area of Kentucky, it seems he is not the only one. Indeed, there are some signs of a blue wave in a corner of the Bluegrass State.
To the standing-room crowd that came to see her in a district Trump won by 16 percentage points, McGrath raised her fist in the air, punctuating her pledge to voters.
"This election is about the soul of our country," she said into a microphone, applause reverberating against the walls of the warehouse. "We need to stand up and be a part of this and move our country in the direction that you know America is.
"Health care is a right for all Americans. Education is a right. I'm doing my part for my country right now. I'm doing the best that I can and I'm gonna work my ass off for you!"
People stood up, waving "Amy McGrath" fans and stomping their feet. Two days later, McGrath opened up rural offices in Irvine and Campton, both towns with populations of less than 2,500. Her campaign is pushing deeper into rural Kentucky than any other national Democrat has before, say local organizers, driven by the promise to protect and fix health care.
Kentucky expanded Medicaid under Obamacare, adding nearly half a million people to Medicaid rolls. Approximately 1.4 million people receive Medicaid benefits in Kentucky in 2018, about one-third of the state's population, according to the state's Cabinet for Health and Family Services. While most of the funding to cover the program comes from the federal government, state officials calculate the state's budget will be potentially $300 million short by 2020.
Incumbent Barr, who won his last election by more than 20 points, is running neck-and-neck with McGrath, according to a recent New York Times/Siena College poll. Barr has won his previous races promising to repeal and replace Obamacare. Now Democrats are turning that health care issue against incumbents like Barr.
Along with her core issue, McGrath has a soaring and patriotic biography to impress the electorate. By age 12, she knew she wanted to fly military fighter jets, only to be told that a federal law prohibited women from combat roles. She wrote letters to members of Congress, including her own US senator, Mitch McConnell, who she said never replied. During her senior year in high school, the exclusion was lifted, and McGrath took advantage.
She graduated from the Naval Academy and flew combat missions for the US Marine Corps in both Afghanistan and Iraq. She retired as a lieutenant colonel and after the 2016 election, again felt the need to serve, this time in Congress.
She had given birth to her third child just months earlier, she had never run for office and her own party already had its own favorite: Lexington Mayor Jim Gray.
Undeterred, McGrath introduced herself in a campaign ad that went viral and turned her into a national darling of progressives eager to fund a new generation of politicians. She took an anti-party establishment, anti-Washington message into all 19 counties of her district and upset the Democratic favorite, winning the primary.
"The Democratic national party didn't really want me, if you haven't noticed," she said to more than one rally. "The cool thing about that is, I don't owe them anything. I just owe you guys."
Running with Trump
If McGrath is working to step out of the lane of her party, Barr is running to stay on pace with Trump. At the Powell County Parade, Barr stood between two banners, "Veterans for Barr" and "Re-elect Congressman Andy Barr" before leading his supporters.
"OK, say it with me everyone. 1, 2, 3: Make America great again!" chanted Barr. The congressman then started jogging down the parade route, smiling and shaking hand after hand, pausing often to talk to the people watching. Barr may be a three-time incumbent, but the affable, sixth-generation Kentuckian clearly enjoys the campaign.
"He's a very common person," said Eddie Barnes approvingly. "He'll sit here and talk to anyone, doesn't matter if he's rich or poor," said Barnes, a Powell County resident and retired police officer working the parade. He's the kind of voter who has re-elected Barr twice in this formerly Democratic district and who could stomp any nascent blue wave here. "He's a good person and we don't have a problem with him."
On the days CNN followed Barr at campaign events, he made multiple stops, from high school students at a military academy to the Central Kentucky Right to Life Walk. His schedule was packed hour by hour, taking only Sunday off to go to church with his family.
At each stop, he underscored conservative values, like limiting access to abortion, and what a Democratic victory would mean to conservative ideology. "You couldn't have a more important congressional election that will make a difference in the future of the US House of Representatives," said Barr at the Right to Life event. "You have an opportunity to make a profound difference in the cause for life in November."
Barr understands while Trump is not on the ballot, the President hangs over his race. "There are suburban Republicans who are maybe dissatisfied with the President's personality but there's people, like in this part of the district, who are very supportive of the President," said Barr on the sidelines of the Powell County parade.
Expecting a good report
While health care and tariffs may hang in the balance of critical issues for Kentucky, Barr is betting conservative ideology will bring his base to the ballot box. Barr's attack ads have called McGrath "too liberal for Kentucky," using audio recordings in which she calls herself a "feminist" and "pro-choice."
"There are fundamental differences between me and my opponent. I'm a conservative and she's a liberal," said Barr. "At the end of the day, we trust the voters. Every two years they give us a report card and we're hearing good things," Barr said.
Donald Storm is one of those supportive voters. Storm is a retired major general in the Kentucky Army National Guard. While he said McGrath's service makes him proud as a fellow veteran, he added, "Talk is cheap."
"Andy has spent a lot of his political time and capital and his staff has helped veterans and families," said Storm. "It's all about what he's done, what he's proven and where he comes down on people. I think that's going to make him a winner."
On the opposite end of the political spectrum there are those who believe the grassroots are growing, they are blue not red, and they are being boosted by McGrath.
"On most days, it feels like Republicans in Irvine outnumber Democrats 5 to 1," said Miller, a registered Democrat, with McGrath at the opening of a rural campaign office in Estill County. "But not today," she said, as chants of "Amy, Amy" broke out all around.