More than a week has passed since the majority of House Republicans voted to repeal and replace the Affordable Care Act with a narrow vote of 217 to 213.

Now the bill has passed to the hands of the Senate, and since then, constituents of Berrien County have been calling on their local representatives for more answers. 

On May 11, more than 100 people marched outside of Rep. Fred Upton’s (R-Mich.) Kalamazoo and St. Joseph offices. News channels capturing the protest showed people chanting. Some carried signs that read, “Fred, you let us down.”

Congressman explains decision

Before House members cast their votes on May 4, Upton had initially expressed opposition to the bill, H.R. 1628, because of a loophole

that would allow states to seek a waiver to exempt themselves from providing coverage for those with pre-existing conditions.

“I have always said that we need to protect those with pre-existing illnesses,” Upton said in a phone interview Friday. “Every family generally has somebody that has some pre-existing diagnosis. My family is no exception. At that point, I said I could not support the bill without addressing that situation.”

After Upton expressed his concerns with the bill, he said he had a conversation with President Donald Trump.

“The president called me. He was pretty gruff,” Upton said. “I was gruff back, I guess you could say.”

Upton said a fellow colleague and Missouri congressman, Billy Long (R-MO), expressed the same viewpoint to the president. Long suggested a meeting with Trump to discuss the bill.

Eventually an amendment was agreed upon, which could allow $8 billion for a high-risk pool to be established in states that might seek a waiver from essential health benefits, which includes pre-existing conditions.

Upton said he spoke with Gov. Rick Snyder, who said Michigan would not be one of the states to waive the benefits, should the bill become law.

“But there may be some others [states] that do and I want to make sure that those individuals with a pre-existing illness are not left unprotected,” Upton said.

Nonetheless, some here in Berrien County do not see it that way.

He expressed dissatisfaction with the protests that occurred last week, referring to them as “goon tactics.” Upton said protestors who filled the sidewalks had not conveyed their message in an appropriate way and had banged on the office windows in St. Joseph, where he said a family lives on the upstairs floor. He also said some protestors had threatened his staff.

Citizens speak out

Eric Lester, a member of the Berrien County Democratic Party, criticized Upton for changing his stance on the issue.

“Yesterday, Upton proclaimed that he was opposed to the Republican plan because it would not provide sufficient protection for people with pre-existing conditions,” Lester stated in a press release. “Today, he met with Trump at the White House and offered a woefully inadequate amendment to that terrible bill.”

Lester additionally expressed concern that if the bill becomes law, millions could lose their health insurance.

The Congressional Budget Office, which conducts nonpartisan analysis for Congress, and the Joint Taxation Committee estimated in a March 23 letter addressed to House Speaker Paul Ryan that under the American Health Care Act, 14 million more people would be uninsured under the bill than under current law in 2018. This number would rise to nearly 20 million in 2020 and 24 million by the year 2026.

“Health insurance is indeed a human right,” Lester said. “If we have a right to life, then we have a right to health care.”

Lester’s sentiment was shared by fellow Berrien County Democratic Party member Larry Feldman. Feldman, a practicing psychiatrist, said he feared that people with mental illness, including those struggling with addiction, would not be covered. Feldman said he worries Michigan’s opioid epidemic would become even more severe. 

“I am concerned about how all of us would be affected if this truly awful bill becomes law,” Feldman said. “It would be horrible for people with serious mental illness and people with drug and alcohol problems.”

The Berrien County Democratic Party will host a public meeting regarding the AHCA at 10 to 11:30 a.m. on May 20 at the St. Joseph Public Library, 500 Market St., in St. Joseph. Three physicians and a nurse will be present.

Next steps

Upton in turn criticized ObamaCare and cited the high cost of premiums, which he said are expected to increase this fall by 40 to 50 percent in a number of states. Upton added that some insurance companies, including Aetna and Humana, will be pulling off the ObamaCare Exchanges in 2018, creating fewer choices for those seeking coverage.

“We will do all that we can to lower premiums,” Upton said. “I would like to see premiums decrease and not jump double digit increases across the country. Time will tell whether that will happen or not, but we know by the current course that doing nothing is simply not acceptable.”

The CBO has projected that a decrease in premiums by approximately 10 percent for single policyholders under nongroup insurance could occur, but this would not happen until approximately 2020. Until then, the CBO projected that premiums under the proposed amendment would still see a rise for those in nongroup markets.

The CBO plans to release new estimates for the recently passed bill on May 22.

Upton also said that should $8 billion not be enough to cover those with pre-existing conditions, he would advocate for more.

“It is my sense that we have more than enough money to cover them with this $8 billion,” Upton said. “But if it appears we need more, I will be the first in line to say, ‘let’s get to work and let’s take care of them.’”

Meanwhile, the bill has a long way to go before it is enacted.  Upton said he expects that the Senate will start from scratch and learn from the bumps that the House experienced in the past couple of weeks.

“This is a long ways from getting done,” Upton said. “We will know more information as the weeks move forward and knowing that the Senate is going to have a different bill.”

As far as a time frame, Upton said it could take a number of months for a decision to be reached.

Upton encouraged people with thoughts on the bill to speak out by calling his office.

Upton encouraged those interested in expressing their feedback to call his assistant at (517) 455-7657 or send an email at tom.wilbur@mail.house.gov.

“We welcome input from folks,” Upton said.