– U.S. Rep. Erik Paulsen is defending his heavily scrutinized vote for the Republican alternative to the Affordable Care Act, calling it a necessary step to control health care costs.

“The reality is that unless we address rising cost, the market’s going to get worse for families,” Paulsen told the Star Tribune on Tuesday.

Paulsen and Minnesota’s two other Republican House members, U.S. Reps. Tom Emmer and Jason Lewis, all voted for the bill Republicans dubbed the American Health Care Act (AHCA). President Trump seized on its passage late last week as a needed legislative victory; the measure is now in the hands of the Republican-controlled Senate, which is likely to significantly rework it.

“This is not a final anything,” Emmer said on Wednesday morning. “This is just the beginning.”

While praising the measure, Emmer said he considered it “incredibly inappropriate” for Republican lawmakers to celebrate at the White House Rose Garden afterward, where Trump was on hand. “It’s about respect for your adversaries ... I thought it was wrong,” he said, saying he’s unhappy with partisanship around the issue from both sides.

Lewis, the newest Minnesotan in Congress, could be seen in the crowd present at the White House celebration that Emmer decried.

Lewis said he sees a disconnect between criticism from Democrats and some in the media toward the AHCA and the health care struggles that families and business owners have shared with him. Many are facing big premium increases under the Affordable Care Act, he said.

“I’m getting as many plaudits as I am criticisms for pushing health care reform,” he said.

Last week’s vote generated criticism toward many Republican lawmakers. For Paulsen, it’s likely to stand among the most controversial votes of his career: His western Hennepin County district has voted Democrat for president the past three elections, and after the vote several thousand people bombarded his Facebook page with mostly critical posts. Several protests cropped up outside his Eden Prairie office last Friday, as well.

Members of Congress are back home this week for a short recess. Paulsen told the Star Tribune he’s aware of the social media blowback to his vote. He said he does not plan to hold a town-hall meeting on health care in his district, as opponents of the legislation have been pressuring him and other Republicans to do.

“He needs to stand up and he needs to listen,” said Gretchen Dombrock Haynes, a constituent who said she voted for Paulsen but has serious concerns about the AHCA.

The stay-at-home mother of two from Eden Prairie worries that the bill was rushed through without an analysis by the Congressional Budget Office, and may not have enough protections for people with pre-existing conditions. Haynes wants Paulsen to hold a public meeting.

On Tuesday, Paulsen visited a school in his district and a HealthPartners neuroscience center. He said he’s holding office hours for constituents and meeting with those who agree and disagree with him.

Paulsen didn’t go public with his support for the latest version of the AHCA until the morning of last Friday’s vote. He said “there were so many rumors and changes and things being made that weren’t true that it was kind of hard to follow what really might come forward.”

As he tries to explain provisions of the measure to constituents, Paulsen said, they tell him it makes sense.

Under the legislation, citizens no longer would be subject to the Affordable Care Act requirement to buy health insurance or pay a penalty. But they would pay a 30 percent higher premium upon re-entering the health care market if they let coverage lapse for more than two months.

It would reduce federal spending on Medicaid by $880 billion over the next decade and lower matching funds to states that expanded the program under the Affordable Care Act. That means states like Minnesota with a robust safety net likely would face a steep decline in federal dollars for medical assistance programs.

The bill gives far more power to the states, allowing them to apply for waivers that exempt them from certain provisions. The AHCA forbids insurers from charging people more if they have pre-existing conditions, but under the waivers, insurers could opt to increase premiums depending on whether a person has a record of serious medical problems.

The legislation also includes a permanent repeal of a tax on medical devices, which has been an important cause for Paulsen and would be a boon to Minnesota’s medical device industry.

Paulsen said the loudest voices during the last election were President Trump’s supporters.

“Now it’s his opponents who might have concerns with certain pieces of legislation,” he said. “In the end, it’s important to listen to everybody and find consensus.”

Emmer, of the three Minnesota Republicans in Congress, represents the most safely Republican district. He didn’t publicly endorse the bill ahead of the vote, and told the Star Tribune that he wanted to read all of its 137 pages before voting.

Democratic groups are running fresh rounds of digital attack ads against Paulsen and other Republicans who could be politically vulnerable over the health care vote. At the same time, the National Republican Congressional Committee is running ads thanking Republicans for keeping their promise to ditch Obamacare and replace it with a more affordable, accessible plan.

Paulsen and Lewis said they think it’s too early to talk about the 2018 elections, although Paulsen already has drawn an opponent in Minnesota businessman Dean Phillips, a DFLer. In Lewis’ southeastern Twin Cities-area district, DFLer Angie Craig has signaled she’s likely to mount a rematch of their 2016 contest.

Lewis said Democrats are substituting partisan demagoguery and fabrications for serious debate. He has also faced pressure to hold a town-hall meeting, but said it’s not constructive to have protesters drown out voices of other constituents during an in-person event.

“It’s not my role to hold the first Democratic campaign rally of 2018,” Lewis said.