Robin Stone was a passionate advocate for universal healthcare in a place where few were fighting for it — until she became another tragic victim of America’s healthcare crisis.  

It’s 11:30 in the morning, and the double-paned windows dull the hum of the cicadas outside. The fan whirs overhead and the AC unit shudders in the back room, creating a slow-burning cacophony almost as suffocating as the heat. This is rural Iowa, flyover country. And on this Saturday morning, in the small town of Manchester, people are gearing up for the event of the year: the annual Delaware County Fair. 

Robin Stone, the chair of the Delaware County Democratic Party, has been thinking about this week for a while. This area swung hard for Trump in the 2016 presidential election, but still has strong Democratic roots. Robin is keen to prove that her band of aging, hardworking Democrats is not going anywhere. 

As I walk out into the street, into the hot wall of thick air and away from the AC, I see Robin already rallying her troops outside the house. At the age of 63, unfazed by the suffocating heat, she is organizing the construction of a float for the fair’s car parade. “This is our chance to show off a bit,” she tells me, with a small, satisfied smile before immediately getting back to work on the float. 

Manchester native Jim Kernan will be driving a pick-up truck, which drags the six-by-fourteen foot trailer lined with hay bales. Between the bales stands a placard that had been painted the night before by Carol Hennessy, from the neighboring town of Ryan, which reads “2020 VISION” in huge, rounded letters above a cartoonish image of the White House. Sharie Kernan, Jim’s wife, brings out a radio to play the Beach Boys during the parade. “Everyone loves the Beach Boys,” she says. Within a few hours, the float is ready to go.

At around 4:00 in the afternoon, the parade finally sets off through the streets of Manchester. Jim’s trailer is loaded with 15 people on either side of the placard, all squeezed in along the bales of hay and waving hand-sized American flags. Onlookers are seated on their front porches, under the shade of the ash trees that line the streets. Every house applauds as the float passes by. The Beach Boys CD must be on its third go-around, but no one is really listening anyway. Robin made sure to buy some candy to give to the younger parade watchers. “This way they’ll be Democrats someday,” she laughs. 

Sharie grasps Robin’s shoulder, “This is fun,” she says, “Thank you.” Robin smiles and turns back to the curb-side crowd. 

Next year, Manchester will elect a new mayor, and everyone I spoke with thinks Robin will take the top job. She is the soul of this town. As she sits atop the float, talking to her friends and smiling at the people who line the sidewalk, it makes sense. “Go Bernie!” shouts a passer-by. “No, go you!” Robin replies. Even in this conservative part of rural Iowa, Robin’s battle-hardened Democrats are always fighting for their values. It is to Robin’s credit that they always do so with a smile on their faces. 

I first met Robin Stone during a late evening with the Delaware County Party a month before the parade, in June 2019. I was in Iowa working for Elizabeth Warren’s presidential campaign, but in my free time took the opportunity to meet as many local Democrats as possible. Usually, the monthly meetings of the Democratic Party are kept indoors, to hide from the yellow heat of those muggy Iowa nights, but that night was sufficiently temperate for a meeting al fresco. 

The picnic area across the street from long-time-volunteer Carol Hennessy’s house also afforded more space for this month’s sizable attendance. The campaign for the Iowa caucuses was heating up, and most of the presidential campaigns had sent their representatives to the meeting. On one of the dozen picnic tables, Governor Jay Inslee’s guy was talking about climate policy and, on another, Governor Steve Bullock’s organizer discussed the rural economy. The Democratic faithful did not seem to really care either way; they had seen hundreds of campaign staffers pass through this town, most fresh out of college and none seen in Delaware County ever again. For the time being, the members of the local Democratic Party remained uncommitted to a single candidate and were simply enjoying the attention. 

After Robin called the meeting to order, a hush fell over the 40 or so attendees. An audacious Pete Buttigieg worker was still rattling on about Midwestern values. An older, more disciplined local promptly put him in his place. The elder Democrat reminded him that no one talks over the chair. Robin looked on silently, gave her signature slight smile, and started the meeting. 

About an hour later, after the meeting had concluded, I sat down to talk to her alone. Her short, scarlet red hair complimented her bold, red glasses, and sharply contrasted the muted fashion of most of her fellow Iowans. She seemed like a product of Provincetown or Seattle and spoke with a fluency that complimented her cheeky charm. At one point she leaned in towards me and, in defiance of party rules about county chairs endorsing candidates, said, “I’m for Warren,” followed by that smile. “I’d love to see Trump get beaten by a girl.” 

Two weeks later, Robin invited me to a debate watch party at her house. It was the first debate after six months of town halls and diner visits, and the candidates had a nation’s attention for the first time. With Sanders, Biden, and some of the more raucous candidates relegated to the second night of arguments, the show on the television was fairly tame. Robin started talking to me about healthcare policy and revealed she was already something of a local celebrity. In the midst of the Republican fight to repeal the Affordable Care Act (ACA) in 2017, Robin attended a town hall with Senator Chuck Grassley (R-IA), who had voted seven times to repeal the healthcare law. An argument ensued between the two. “You’re threatening my life,” she told him, to which the statesman looked visibly shaken. It was reported on state news the following day and made it all the way to “The Last Word” with Lawrence O’Donnell on MSNBC the week after. 

“I would be dead if it wasn’t for the Affordable Care Act,” Robin told me between bites of pizza as Beto O’Rourke soliloquized on the television. “Obama saved my life, and now all they want to do is take it all away and leave me with nothing,” she said, stating that the ACA allowed her to gain insurance for the first time. Her upset was masked by the anger in her voice. “This is why this election is so important.” 

Then, unprovoked: “You know, I’ve already booked tickets to the Democratic National Convention in Milwaukee. I figured there might be something going on, so I’d better show up.” She smiled. Robin always talked about the future as the perfect remedy to the present, ever hopeful that things would get better, if only you worked for it. Then Elizabeth Warren started speaking on the TV, and Robin hushed everyone in the room. “Be quiet, I want to hear this.” Warren was speaking in favor of universal healthcare. “Yes!” Robin exclaimed, looking through her thick, red glasses at the screen. “She’s a feisty woman—I like that.” 

As the debate wrapped up and Robin’s husband, Mark, collected the pizza plates, Robin started thinking aloud. “The trouble is, you can’t have an insurance-based system because so many people can’t afford it.” Robin paused, but nobody spoke. Over the course of the past year, it had become an unspoken rule of Democratic Party meetings not to speak about Medicare for All, as it was the topic that divided the party more than any other. But Robin didn’t care. 

“I won’t have any money left by the end of the summer, I can’t go on like this,” she said, to which her invitees sympathetically and silently looked on. Robin had type two diabetes and had lost all feeling in her legs. She had been able to gain insurance through the ACA’s protections for patients with pre-existing conditions, but countless hospital appointments and deductibles had rendered her near-bankrupt. 

“Look at this,” she said to me, holding up the healthcare.gov website on her phone, “It says ‘After you spend this amount on deductibles, co-payments, and coinsurance for in-network care and services, your health plan pays 100 percent of the costs of covered benefits.’” She paused for a second.

“That’s not good enough. After all those deductibles and copayments, I won’t have anything left.” Her husband was still clearing up from the party. He walked up to Robin, put his hand on her back, and kissed her on the head. By the time Robin had finished talking, they both had tears in their eyes. 

In late July, 2019, about a month after the debate watch party, I was in West Union, Iowa, two hours north of Manchester. A frail, octogenarian woman by the name of Dorothy Walters was telling me about her successful mayoral campaign in 1988, when she became the first female mayor of the town. 

“It was amazing,” she said, “nobody thought I would win. Hell, I didn’t think I would win. That night, I opened up City Hall to the public and threw a huge party. I called it the Mayor’s Ball,” she laughed. “Everyone came and we partied into the night. The papers weren’t very happy about it the next day, but I didn’t care, we made history!” 

Mayor Walters and I talked about her time as mayor. She only served for two years—  the best two years of her life. Then, someone in the room mentioned that the local CBS station in Waterloo interviewed Robin Stone the previous night. Mayor Walters flung her head towards them, “Robin Stone,” she said, “I love her.” 

“How do you know Robin?” I asked. “Are you kidding, she’s the girl who gave Chuck Grassley hell!” Walters said.

When I said goodbye to Robin outside her home in early August, she looked over her classic red rims and said “don’t ever stop fighting for the things that matter.” She gave me a hug, walked to her front door, and went inside. It was a thick Wednesday afternoon, and the cicadas still droned throughout the town. As I walked home, I became keenly aware of the sticky coating of insect repellent and sunscreen covering my skin, which easily picks up the dust of the Iowa summer. 

As I entered my house, passing from the outdoor hum to the hum of recycled air, I thought of Robin Stone. She looked as well as she had when I met her three months prior. Yet, something was missing from her, something she had when she beamed with joy at the Delaware County Fair. She had recently learned that she was going to be a grandmother to a baby girl due in the fall, but she was terrified that complications arising from her diabetes would catch up to her and kill her before the baby came. In these last days of the summer, money and illness haunted Robin—and the prospect of her recovery was dying with the daylight.

The next time I encountered the name Robin Stone was in late September, on her daughter Katie’s Facebook account. On top of Robin’s existing medical problems, she had collapsed and was rushed to hospital, where she was eventually diagnosed with anaplastic thyroid cancer, a particularly vicious form of cancer that requires immediate attention. Robin, Mark, and Katie were told to go to the best place for specialist care, the Mayo Clinic in northern Iowa. The Manchester general hospital could organize transport if necessary. 

Robin had insurance. There was only one problem: the Mayo Clinic was out-of-network, meaning the hospital did not accept her insurance, and officials at the hospital had demanded $16,000 just to let her in the door. Robin could not afford that. She could never afford that. Her best chance at survival was lost almost as soon as it appeared. Instead, her doctor decided that the Manchester hospital should operate to remove her thyroid as soon as possible. Manchester’s doctors and equipment were not as specialized as those at the Mayo Clinic, but the seriousness of the disease posed too great a risk to her life to wait any longer. The treatment was going to be started in early October. 

When I called Robin about a week after her diagnosis, her prospects had already taken yet another turn for the worse. Her insurance was tied to her employer: a small hospice company operating out of Manchester. But they had decided to change Robin’s healthcare coverage shortly before her operation. “They dropped me,” Robin told me over the phone, holding back tears, “they dropped one of my health insurance plans days before I was supposed to receive treatment for my cancer. Days,” she repeated. Robin was still expecting to receive treatment by the second week of October, but she would now be loaded with exorbitant, unpayable debt. Faced with a choice between that and not being treated at all, it was obvious what she had to do. 

But by then it was too late.

Robin never spoke again. Following a tracheostomy, she was reduced to typing on an iPhone screen and writing down her thoughts on a paper pad by the side of her hospital bed. She was barely able to stay awake for most of the day and, because of the risk of infection, only a limited number of guests could see her. On October 22, Senator Bernie Sanders (I-VT) shared a picture of Robin and her daughter Katie on his Twitter account, alongside the blunt phrase, “This is the human cost of our profit-driven health care system.” Robin thanked him in the replies for sharing her story. 

On October 31, she tweeted Senator Grassley farewell, saying “you won’t have to worry about me bugging you about the ACA. I have anaplastic thyroid cancer and will die soon. But there’s a whole army of activists picking up where I’m leaving off.” She finished off her tweet with the simple line, “You’re a coward.” 

Senator Grassley called her shortly after, but Robin, bedridden and unable to talk, merely listened. There wasn’t much else she could have done. She died two days later, on November 2, 2019. 

Robin was survived by her husband Mark and her daughter Katie, and 20,000 dollars worth of medical debt. Two weeks later, at 10:43 p.m. on November 16, Robin’s granddaughter, Aniya Charliann Mitchell, was born at Manchester Regional Medical Center, weighing six pounds, seven ounces. 

To her last breath, Robin Stone represented the very kindest of America. Her passion to build a better society never faltered, and her humor was as consistent as the faint smile that followed almost everything she said. The wonder of her character was completely incongruous to the tragedy she faced at the hands of America’s unforgiving and cruel healthcare crisis. 

When I asked Robin in July, 2019, what she wanted to be remembered for, she paused, thought for a second, and then replied with her classic smile. “Well, in my Twitter bio I have the words ‘unapologetically liberal.’ I think I’d put that on my gravestone.” She laughed. Then, quoting Margaret Mead, she advised: “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.”