Upton voted a dozen times in support of repealing the Affordable Care Act

Jon Hoadley, a Democrat seeking to represent western Michigan’s 6th congressional district, is attacking his Republican opponent, Rep. Fred Upton, for his voting record on health care.

"He voted a dozen times to kick thousands of Michigan families off their health insurance and eliminate protections for preexisting conditions," an ad from Hoadley states.

The basis of Hoadley’s attack is Upton’s consistent opposition to the Affordable Care Act, or Obamacare, which barred insurance companies from discriminating — in pricing and coverage — against people with preexisting medical conditions, such as cancer survivors and kids with diabetes as Hoadley’s ad notes.

The ACA also introduced federal subsidies for Americans to buy coverage in the individual insurance market and for states to expand Medicaid coverage to more low-income Americans.

In 2019, more than 500,000 Michiganders were covered under plans purchased in the individual market, according to an estimate from the nonpartisan Kaiser Family Foundation. And today, a little more than 800,000 are covered under the ACA’s Medicaid expansion.

A repeal or overturning of the ACA, and the loss of its protections, would put that coverage at risk, experts say.

In the five years that followed the ACA’s passage, Upton voted 12 times for bills, budget resolutions and amendments that called for repealing the law. 

More recently, Upton has spoken out against Republican efforts to repeal the ACA without a replacement. "You simply cannot take what would be millions of people off coverage without a backup plan ready to go," he told The Detroit News in April 2019.

That month, he was one of only eight Republicans who supported a resolution urging the Trump administration to end its effort to overturn the ACA. The U.S. Supreme Court will hear oral arguments next month on a case supported by the administration asking the court to invalidate the law.

Hoadley’s claim includes recovered COVID-19 patients among those whose coverage would be at risk, but Upton’s votes to repeal the ACA came years before the pandemic. 

Upton spokesperson Josh Paciorek said, "Fred believes we must forge a bipartisan path to ensure all Americans have access to quality, affordable care while always protecting preexisting conditions."

Nonetheless, Hoadley’s ad gives an accurate count of Upton’s votes from 2011 to 2015 and their potential impact. 

The Hoadley ad cites 12 times that Upton voted to repeal or defund the ACA. Here's how they break down:

• Upton voted three times to repeal the ACA without a replacement. Once in 2011, again in 2012 and a final time in 2013. 
• In 2015, Upton voted for a bill to repeal the ACA that directed House lawmakers to propose an alternative.
• Upton supported budget resolutions in 2011, 2012, 2013 and 2014 that assumed savings from repealing the ACA and allowed ACA funding to be redirected to pay for other federal spending
• Upton voted four times during budget negotiations in 2012 and 2015 directing lawmakers to repeal the ACA.

Under the ACA, millions of Americans buy their health insurance through the individual market or receive coverage through the ACA’s expansion of Medicaid. If the law is repealed or struck down by the Supreme Court, many could face higher costs for health insurance, lose automatic coverage or become unable to afford coverage.

A New York Times analysis says as many as 21 million people would be at risk of becoming uninsured.

They would also lose protection under ACA provisions that bar discrimination against people with preexisting medical conditions. President Donald Trump’s executive orders pledging to preserve these protections have no legal effect, experts say.

About 54 million Americans had a preexisting condition in 2018 that would likely leave them uninsurable in the individual insurance market if the ACA were repealed, according to a 2019 analysis from the Kaiser Family Foundation. That includes 29% — just over 1.7 million — of Michiganders under 65. 

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The implementation of the ACA’s major protections helped insure thousands of Michiganders in the individual market soon after Upton cast his first vote to repeal the law in 2011. 

By the time the preexisting condition protections kicked in in 2014, Upton had voted to repeal the ACA four times and supported three budget resolutions that assumed savings from the law’s repeal. 

Karen Pollitz, a senior fellow at the Kaiser Family Foundation said that votes cast before 2014 may not have led to immediate coverage losses. But she said Congress relies on estimates from the Congressional Budget Office that measure the impact of legislation over the next 10 years. 

In 2014, nearly 550,000 Michiganders were insured by plans purchased in the individual market, the Kaiser Family Foundation estimates, up 74,600 from the previous year. The number was 511,700 last year.

In mid-2014, Michigan’s expanded Medicaid program covered roughly 58,000. Today, it covers more than 800,000. 

An analysis this year from the nonpartisan Center for American Progress estimates that repealing the ACA would result in 827,000 Michiganders losing their insurance.

A Hoadley ad states that Upton "voted a dozen times to kick thousands of Michigan families off their health insurance and eliminate protections for preexisting conditions," citing his votes to repeal or defund the Affordable Care Act.

Four of those votes were for legislation that would have repealed the law. The eight other votes cited by the campaign laid the groundwork for repealing the ACA, but would have required additional action from lawmakers.

Repealing the ACA would have jeopardized health coverage for Michiganders covered under plans purchased in the individual market and the state’s Medicaid expansion program.

We rate this claim Mostly True.