Last month, as the New Hampshire House of Representatives was meeting in Concord for a voting day, Rep. David Nagel was pulled aside by his colleague Rep. Jim Kofalt, a fellow Republican.
“It was kind of like ‘The Godfather,’” he said, referring to the 1972 mob crime film. “(Kofalt) came up to me and he said he wanted to have a word.”
Nagel, a Republican representing Gilmanton, assumed Kofalt wanted to discuss a bill he’d emailed him about that morning as the two went for a walk through the State House.
“I thought that’s what he wanted to talk about,” he said. “And the walk ended up in the Speaker’s Office. They never informed me at any point why they were taking me up there, and all of the sudden the doors shut.”
There, Nagel said, Kofalt, along with Republican House Speaker Sherman Packard and Deputy Speaker Steven Smith, questioned him over recent votes and stances he took in his role on the House Health, Human Services, and Elderly Affairs Committee. They wanted him to “step in line” with Republican leadership’s agenda.
“I considered it an attempt at intimidation,” Nagel said. “I don’t like to read people’s motives necessarily, but to me that’s what it seemed like.”
Outside of his work in the State House, Nagel is a doctor with decades of experience who is known nationally for his work on pain management. He was the only Republican member of the committee who’s also a doctor. Kofalt is also on the committee.
“I spent a lot of my life fighting bullies,” Nagel said. “I just basically said, ‘You know, you guys got to do what you have to do. I have to do what I have to do. I’m sorry there’s a conflict.’”
During that meeting, Kofalt told Nagel he was going to recommend Nagel be removed from the committee. A few weeks later, Nagel said, he received an email saying he was being replaced on the committee.
Nagel’s disconnect with party leadership goes back even further though. He said he’d previously declined a leadership position as clerk of the committee because it was his understanding that if he accepted, he would be expected to vote with Republican leadership at least 95% of the time. He also didn’t think the position matched his strengths, and as the only doctor in the majority, he wanted to be less restricted.
“I was fully aware that there were requirements being made of people appointed to leadership positions. There’s no way in hell I was going to live with that,” he said. “My policy is that — either side, I don’t care which side you’re on — if you vote with the party more than 90% of the time, you’re not thinking hard enough.”
Smith confirmed he was present at this meeting, but denied that the meeting was an intimidation attempt.
“Nothing of the sort,” he said.
Kofalt and Packard did not respond to multiple requests for an interview.
“The problem that we were trying to solve is when you have a member on a committee that says, ‘I don’t care what anybody else thinks because I’m right and you’re wrong,’” Smith said. “If you were working with a group of people and had one like that, wouldn’t you want to get rid of them?”
Smith confirmed that these disagreements are why Nagel was removed from his committee. He said it wouldn’t have happened if he voted closer in line with Republican leadership’s wishes.
“He straight up told us, ‘No, I know about this. I’m right and you’re wrong.’” he said. “It’s kind of hard to have a working relationship with someone who thinks that way.”
Smith said Nagel was trying “to thwart anything we were trying to do” and that he believed “since he’s a doctor he knows better than anybody else.”
“Our hope is that people think more and recognize that our opinion isn’t always necessarily correct,” he said. “Rep. Nagel was unwilling to embrace that idea.”
However, Nagel argued his views, while different from Republican leadership, were much closer in line with the views of the constituents and stakeholders they heard from during hearings. And he wasn’t the only Republican to cross the aisle and vote with Democrats on these bills.
Nagel said his opposition to several Republican-backed bills irked the leadership, including House Bill 392 — which would’ve terminated the Department of Health and Human Services’ Office of Health Equity in addition to other state divisions determined by Republicans to be too focused on diversity, equity, and inclusion efforts. House Bill 223 — which seeks to exempt certain medical providers operating within 15 miles of a critical access hospital from licensing requirements — was another.
However, Nagel said the final straw for his Republican colleagues was his opposition to House Bill 524, which seeks to eliminate the New Hampshire Vaccine Association.
“There was no way I was ever going to support that bill,” Nagel said.
The New Hampshire Vaccine Association is a nonprofit established in 2002 by the Legislature with the goal of providing universal access to vaccines for children. It purchases vaccines in bulk to be distributed to providers across the state, combining money from all insurers to get a 30% discount on vaccines. It doesn’t set or recommend policy.
The Republicans behind this bill, including its sponsor Rep. Michael Granger, argued the private sector could better fill this function. Doctors, nurses, and health insurers widely disagreed and argued the bill would result in decreased access for vaccines for children and could contribute to disease outbreaks. Testimony in the hearing for this bill was overwhelmingly in opposition.
“Everyone involved in obtaining vaccines for our state and for the children of our state is aligned in thinking this is a really good program,” Dr. Patrick Ho, president of the New Hampshire Medical Association and a psychiatrist in Lebanon, previously told the Bulletin. “There’s no reason to do away with it.”
Nagel said he “hasn’t met a person who supported the bill except the woman who introduced it.”
The bill was introduced by Laura Condon, who has a history of promoting vaccine conspiracies and has recently questioned publicly whether vaccines cause cancer and falsely asserted online that vaccines cause autism.
Nagel was removed from the Health, Human Services, and Elderly Affairs Committee the day before it voted to advance HB 524 to a floor vote. On Thursday, the full House voted narrowly, 189-181, to approve the bill. It is now being considered by the Ways and Means Committee, and the Senate and governor will also need to approve it for it to be enacted.
“The public support against this bill was astronomical,” Nagel said. “It was kind of like, ‘Who are we here for? Are we here for a small group of people or are we here for everybody?’”
Rep. Lucy Weber, the ranking Democrat on the Health, Human Services, and Elderly Affairs Committee, said she didn’t want to get involved in Republicans’ internal affairs, but did express disappointment in Nagel’s removal.
“It is extremely unfortunate that a physician with a nationally known reputation as a pain specialist, who has an enormous amount of interest in this area and who ran the only post-polio clinic that this state has ever had, was removed from our committee,” Weber said. “There is no rational reason to take one of the few Republicans with any medical training at all off the committee.”
The ordeal has left Nagel feeling unsure of his footing within the party. He noted he’s always been a moderate.
“I ran to create a bipartisan coalition to represent basically the middle, people that don’t have a voice,” he said. “I’ve said that since the day I got here.”
Asked if he was considering leaving the Republican Party, Nagel said, “I’m staying where I’m at.”
“The problem is that if you’re a moderate Republican or you’re a moderate Democrat and you leave the party because you’re disenchanted with it and you become an independent, you all of the sudden have no voice,” he said. “And what you’ve functionally done is you’ve left the parties increasingly in the hands of fewer and fewer people that are more extreme in their views. So now, by doing something that was constructive for you, you’ve created something that’s destructive for the system.”
He said a lot of people have asked him if he should be a Democrat.
“If it was purely about health care policy, sure,” he said. “I think Democrats do a much better job on issues like that, but I think on other issues Republicans do better.”
Neither the New Hampshire Republican Party nor Gov. Kelly Ayotte’s office responded to requests for comment.
In November’s elections, Republicans won a 44-seat majority in the 400-member state House and an eight-seat majority in the 24-member Senate.
“I kind of think that this is going to be a short two-year majority if they keep doing stuff like this,” Nagel said.