The bill before the U.S. Congress to repeal and replace the Affordable Care Act, popularly known as “Obamacare,” has American residents in Japan worried, with some saying the nullification would prevent them from returning home.

The Japan Times conducted an online straw poll from late June through last week of U.S. citizens living in Japan about the health care bill, with just over half saying the Republicans-sponsored Obamacare replacement plan would discourage them from moving back to the U.S. The majority of the other respondents replied the bill doesn’t affect their future because they plan to live in Japan, but they were largely critical of the repeal, saying it would worsen their access to U.S. health care.

If passed, the bill, nicknamed “Trumpcare,” and now being debated in the Senate, could strip 22 million people of health care coverage by 2026, according to a recent report published by the nonpartisan Congressional Budget Office. It also calls for deeper cuts to Medicaid, a health care plan mainly for the poor in subsequent decades.

Jim Rion, a 39-year-old freelance Japanese-to-English translator in Yamaguchi Prefecture, who has lived in Japan for over 13 years, says the health care situation in the U.S. began to worry him long before Obamacare was signed into law by then-President Barack Obama in 2010.

“I have a wife and a son, and if your child gets sick, you’ll do anything you can to help, but your options are a little more limited in the United States,” said the Kansas native by phone. “That was a concern all along, but now that (there is an) idea that they are taking all of that away — that they’d like to not only repeal Obamacare but cut the Medicaid expansion and remove lots of people already on Medicare, it seems to be a really serious problem.”

Medicare is the federal health insurance program for people who are 65 or older and also covers certain younger people with disabilities.

He said he appreciates the free medical care for children provided by the city of Hikari, where he lives, comparing it to the financial headaches his siblings in Kansas get when their children get sick.

“I’ve never had to pay for medicine for my son,” he said. “My brother and sister both have children in the States, and it’s very very difficult for them to decide when to go to the doctor and if they could afford it, and if their insurance deductibles are acceptable, and things like that.”

Rion, who is a permanent resident in Japan, said health care is a major factor in deciding where he will live in the future.

“I have a permanent residency but I’m not a citizen of Japan,” he said. “There are limitations (to my rights). I can’t vote. … And I think in the future, if I ever did want to go back to the United States I could not do it, not with a family, without huge improvements in the availability of health care. That’s scary.”

The concern was shared by a 25-year-old English teacher in the Tokai region who suffers chronic migraines and some mental illnesses, including ADHD. Before coming to Japan two years ago, she was covered by her parents’ medical insurance. She said that, if she goes back, she won’t be able to afford insurance on her own without the current Obamacare protections.

“My parents are actually Republicans,” said the woman, who declined to be named, citing the possibility that going public would jeopardize her chance of getting insurance in the U.S. “They are conservatives, but they were happy about Obamacare because they had been very worried about me before then, because they were worried that, after I grow up, whether I would be able to afford health insurance.”

She said she is looking into going to graduate school in Japan so she can continue her career here.

“I’d probably stay in Japan or I would move to another country that has better health care,” she said. “I wouldn’t return home except for holidays. I’d be basically living outside the U.S.”

Lindsay Nelson-Santos, a 40-year-old university teacher originally from California who has lived in Japan on and off for 13 years, likewise said she is “horrified” by the bill.

“It continues to boggle my mind that so many people in the U.S. genuinely believe that becoming ill is some kind of moral failing, and that expecting a portion of your own tax payments to assist you in covering the ridiculously high costs of health care is selfish or irresponsible,” she said, noting that she plans to live in Japan. “Japan’s health care system certainly isn’t perfect, but I still count it as a huge blessing that I don’t worry about someday being bankrupted by health care costs here if I should get cancer or another illness with very high treatment costs.”

Just one respondent in the survey, which received 21 valid responses, seemed to have a different perspective. “Government should stay out of health care, period,” a man in his 30s who could not be reached for a follow-up interview wrote in a response. “P.S. Taxation is theft.”

A matter of Health covers current research, technology or policy issues relating to health in Japan.

In a time of both misinformation and too much information, quality journalism is more crucial than ever.
By subscribing, you can help us get the story right.