To reach Oakhurst, Calif., drive away from the green fields of the Central Valley, past miles of pistachio trees showing their spring buds and up toward the snow topped peaks of the Sierra Nevada.聽
Here, just a few miles from the entrance to Yosemite National Park, is the Sweetwater Steakhouse, a local watering hole where no one is shy about their opinions of President Obama鈥檚 signature initiative.
Paul Ruffino, 55, is an uninsured Libertarian and conflicted over what role the government should play in remaking the health insurance system (Photo by Sarah Varney/NPR).
鈥淥bamacare is absolutely horrible, horrible, horrible,鈥� Joe Stern, owner of a local water-conditioning company, says as he sips a glass of pinot noir. 鈥淚t should be struck down immediately.鈥�
By 5 o鈥檆lock on most weekday evenings, the Sweetwater bar is hopping, and locals, like Stern, stop by to josh and jest. Stern is a registered Republican. He鈥檚 66 years old and covered by Medicare, a program Stern says he is thankful for. Before he qualified for the federal program, Stern, who is single, used to pay $670 a month for insurance 鈥� more than $8,000 a year.聽聽
鈥淚 thought it was pretty brutal,鈥� he says, 鈥渂ut I was still against Obamacare by far.鈥�
Oakhurst caps the eastern end of Madera County, a largely conservative and agricultural region where unemployment runs stubbornly high, at 14.7 percent, and 32 percent of people have no health insurance.聽
By and large, conservative voters in the county despise the federal health law鈥檚 mandate that all Americans have health coverage, and many suspect the health insurance system isn鈥檛 really all that broken.聽
Reflecting a common sentiment, Stern says, 鈥淚 don鈥檛 know of anyone that was left on the street to bleed to death. I don鈥檛 know anyone that is really left out.鈥�
It鈥檚 not that Stern doesn鈥檛 know people who don鈥檛 have insurance. He cheerfully introduces his friend, Mary Westover, who is sitting next to him at the bar. Westover is a registered Republican and a self-employed artist and businesswoman who says she can鈥檛 afford health insuance. She鈥檚 been uninsured for 17 years 鈥� she hasn鈥檛 had a pap smear in all that time 鈥� 聽and is among the聽 who are uninsured and opposed to the health law.
Westover, too, is against the individual mandate but wasn鈥檛 aware the federal government would give subsidies to people like her 鈥� whose incomes are below 400 percent聽of the federal poverty level 鈥� to buy a policy. That鈥檚 once that part of the law kicks in, in 2014.
鈥淚f it were subsidized, if it were made, you know, manageable, I would want that,鈥� she says, adding that she doesn鈥檛 know how people who can afford it 鈥渃an sit there and say that we shouldn鈥檛 have that 鈥� because there are a lot more of us, than them.鈥�
Although many here in Madera County say they want the U.S. Supreme Court to throw the federal law 鈥� and all of its big government mandates 鈥� out, they are struggling to reconcile their political ideologies with the basic need for health insurance and protection from financial calamity.
Paul Ruffino, the manager of Chateau du Sureau, a five-star, luxury inn overlooking the mountains of Yosemite, is uninsured for the first time in his life.聽聽
鈥淚t鈥檚 probably when I need it the most,鈥� he says, sitting in the inn鈥檚 salon, with its frescoe-painted ceilings and roaring fire.
Ruffino says the health insurance policies he鈥檚 looked at are expensive and won鈥檛 cover his pre-existing conditions. Still, he says it was his decision to leave a previous job in Southern California that came with insurance and move to Oakhurst. As a Libertarian (the GOP is too liberal, he says), he doesn鈥檛 think he should have help in getting insurance: 鈥淒o I make the government responsible for my choices? I made the choice. I knew beforehand.鈥�
Ruffino seems torn between his unsparing self-reliance and a sense that the insurance industry is unfair. He thinks the insurance companies should not be allowed to pick out only the healthy and leave guys like him behind. He says there is a role for government in setting some of the rules, but he鈥檚 uncertain just how far he wants to go.聽
鈥淒oes there come a time when government has to get involved and at what levels? But when you are distrustful of the system in whole it makes it difficult, he says. 鈥淚 go back and forth. I ping-pong on this issue all the time.鈥�
It doesn鈥檛 surprise Oakhurst insurance agent Doug Macaulay that many people are torn.
Macauly, who is also Republican, says people get mad at the insurance companies, but they don鈥檛 see 鈥淥bamaCare鈥�, as they derisively call it, as the answer: 鈥淵ou鈥檙e complaining over here that you don鈥檛 have health insurance and you can鈥檛 buy it. And over here [the government is] trying to provide you with it but that鈥檚 the worst thing ever. So there seems to be a disconnect in the thinking there.鈥�