Representative Fred Upton, a Republican from Michigan, right, listens during a House Energy and Commerce Committee subcommittee hearing on the U.S. public health response to the Ebola outbreak in Washington, D.C., U.S. (Photographer: Andrew Harrer/Bloomberg)

If GOP Can't Get This Lawmaker, Obamacare Repeal May Be Dead

(Bloomberg) -- Representative Fred Upton helped guide dozens of Obamacare repeal measures through the House in recent years, but he has deep reservations about the GOP’s current bill.

“I’m not comfortable with it and I told the leadership that,” he said Friday, in a vivid illustration of the continuing obstacles to the GOP effort to resurrect its stalled repeal plan.

Until five months ago, Upton, a Michigan Republican, chaired the Energy and Commerce Committee, which has jurisdiction over much of health care policy. Now, he’s not ready to support the current bill and said the most recent revisions have made it worse.

Skepticism from Upton and other Republican moderates led GOP leaders to abandon an effort to hold a vote on the bill this week. Leaders say they’re still hopeful it can be passed next week.

Majority Leader Kevin McCarthy and other House leaders downplayed the delay, saying they’d never publicly said there would be a vote this week. "We’ve been making great progress, and when we have the votes we’ll vote on it," he said.

House Speaker Paul Ryan and other GOP leaders wouldn’t say how many more Republican votes they need to win, although several prior holdouts in the conservative House Freedom Caucus now publicly back the bill.

“Right now we know we’re in a stronger position than we were, but we don’t know for sure if we have the votes," said Representative Tom Cole of Oklahoma, who isn’t a member of the caucus.

A Bloomberg News count shows at least 16 Republicans oppose the revised measure, not including Upton. The GOP can only afford to lose 22 votes from its side and still guarantee passage.

One problem is that the recent changes made to the bill to win over the conservative holdouts have alienated some GOP moderates.

Pre-Existing Conditions

Upton, for example, said his main concern is how those revisions affect coverage for people with pre-existing medical conditions.

“The issue is potential higher costs to those with pre-existing illnesses," he said. "They’re trying to say that they still maintain access with continuous coverage but the question is what happens on the costs side of the thing.”

Under an amendment to the Republican plan, states could let insurers charge older customers more than the original bill allowed -- at least five times more than younger ones, beginning in 2018. States could also allow insurers to charge higher premiums for people with pre-existing conditions who have had a gap in coverage of at least 63 days in the prior year.

Upton said he has been talking to Representative Tom MacArthur of New Jersey, the author of the amendment, about making more changes.

"I’ll go back to the premise that Ryan has, and that is if they have the votes, they’ll move it. So, clearly they don’t have the votes," he said.

Many House Republican supporters of the measure insisted Friday that they are just a few votes shy -- and that a vote could come, for real, as early as next week.

"Oh it’s absolutely not dead -- they are very close," insisted Representative Chris Collins of New York, one of the earliest congressional Trump backers. 

Democrats have been left out of the process entirely.

House Minority Leader Nancy Pelosi on Friday called the GOP health bill "the zombie" that she says keeps getting worse. She credited mobilization against the bill from outside of Congress for slowing down the Republican effort.

Senate Minority Leader Chuck Schumer of New York asked, "How many more times do they need to fail" before working with Democrats on needed fixes to the Affordable Care Act.