Former Republican congressman on why it’s so hard to get bipartisan consensus on healthcare : NPR

MILES PARKS, HOST:

Without an extension of federal subsidies, Americans who purchase health insurance through the Affordable Care Act – also known as the ACA – could see their monthly costs skyrocket in January. This week, two bills to avoid those premium hikes died in the Senate. And last night, Speaker Mike Johnson unveiled a last-minute Republican plan, which Democrats called, quote, “completely unserious.”

So why is it so hard to get bipartisan consensus on health care? Former Republican Congressman Fred Upton from Michigan has spent a lot of time thinking about just that question. Back in 2017, he was part of a committee that tried and failed to come up with an alternative to the ACA. I called Upton to try to make sense of the current negotiations on the hill.

FRED UPTON: First of all, you recall just about two weeks ago, the Trump administration was going to unveil their own health care proposal that they thought was going to work, and it got shot down before it was even presented. They said, you can’t possibly do that. You can’t possibly extend the ACA subsidies. That would be wrong. And so they pulled it back. You know, we didn’t see any proposal come out from the administration.

You’ve got about 15 or 20 Republicans in the House – Brian Fitzpatrick from Pennsylvania, Don Bacon from Nebraska – and others that have been willing to say, let’s work together. Let’s find some Democrats and work together on a proposal. And they’ve been shopping with the speaker and others. They’ve actually got, I think, a fairly sound proposal. I’d be with them if I was still in the Congress. But you’ve got 15 Republicans or so that are willing to work with the Democrats to actually get something done, and they know that in the short term – the next year or two, until you get a replacement peace (ph) – you got to continue these subsidies versus fall off the cliff on January 1.

But that’s run into real – we’ll call it resentment, real opposition for sure, among the hardcore conservatives in the House. They don’t want anything to do with it. They want to repeal – you know, let’s have yet another vote to repeal Obamacare. So they’re not going to budge.

PARKS: Do you think this is going to matter in the midterms?

UPTON: It will matter. It’s going to matter big time. And for the Democrats, it’s going to play out, I think, pretty well. They’ll be able to point not only to the 20 million that are going to have pretty sizable increases in the reduction in the – of the subsidy. And without a resolve, you, the voter – you’re going to be angry. And so, you know, we’ve seen already just some of these special elections. The mayor of Miami – last week, it flipped after 30 years from a Republican to a Democrat. We’re seeing these special elections.

So yeah, the warning signs are there for a bad situation for Republicans, and this is going to add to it because Congress didn’t deal with the crisis that’s upon them, and it’s going to hit the pocketbooks of millions and millions of people.

PARKS: I also wonder if this just means that this affordability message is also not going away in terms of, is that going to be, in your eyes, the main storyline of the 2026 midterms?

UPTON: Well, it will be. I mean, you’ve got energy costs. I mean, I’m looking at electricity costs going up, certainly in my state. You know, most of the grocery store items that you see, it’s like, holy cow, it wasn’t like this a few months ago. You’ve got coffee prices that are up, and we’re all glad the tariffs are coming off on coffee and bananas, things that we don’t produce here.

So yeah, it’s going to be a tough election with affordability being one of the top issues, as well as the health care needs, and, you know, people are grousing. So there’s time. I’m still – you know, I’m a Republican. I’m still an optimist. I’m a Cubs fan. And, you know, (laughter) we’ll see what happens.

PARKS: That’s former Congressman Fred Upton, a Republican from Michigan. Thanks so much for joining us.

UPTON: You bet.

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