Approximately six weeks after failing to garner enough support for the American Health Care Act (AHCA), Republicans pushed a newly revised version of the bill through the US House of Representatives today (May 4).
The health-care bill is designed to repeal and replace aspects of the existing legislation commonly known as Obamacare. It passed the House with a total of 217 “yes” votes to 213 “no” votes.
“This bill delivers on the promises that we have made to the American people,” House speaker Paul Ryan said just before the vote, to cheers from the Republican side of the House. “A lot of us have been waiting seven years to cast this vote, many of us are here because we pledged to cast this very vote.”
The bill will now advance to the Senate, where resistance is expected to be stiff.
House minority leader Nancy Pelosi called the AHCA a “stupid bill” that deconstructs government, and warned that Republicans would suffer in the polls because of the vote. “From what I hear Republican Senators saying, they don’t have any interest in passing this bill as it is,” she added.
While the latest version of the plan has not yet been evaluated by the Congressional Budget Office, many experts believe the bill will result in millions losing their health insurance coverage. The CBO reported that the earlier draft of the bill would have led 24 million more Americans to find themselves uninsured by 2026.
As written, the AHCA would also cut taxes for wealthy Americans and could weaken benefits for the 49% of Americans who receive health insurance from their employers.
The House’s version could also end up hurting people with pre-existing conditions. A new amendment (pdf), known as the MacArthur amendment, allows states to request permission to opt-out of several Obamacare restrictions, including its popular ban on discriminating against people with pre-existing conditions. (Before Obamacare, everything from a C-section to acne could potentially be considered a pre-existing condition by insurance companies.)
According to estimates from the liberal think tank Center for American Progress, under the new bill people with pre-existing conditions could incur hefty surcharges—up to $140,000 a year in the case of metastic cancer.
President Trump has objected to this analysis of the bill, however, telling CBS host John Dickerson that the AHCA would in fact protect Americans with pre-existing conditions.
Over the past two months a fierce debate raged over the details of the bill, and House leaders have spent the last few days scrambling to secure the required majority. Republicans gained some last-minute momentum, however, after representatives Billy Long and Fred Upton agreed to switch their “no” votes following a meeting with the president.
Trump made health care a primary talking point of his presidential campaign, promising to craft “much better health care, at a much less expensive cost.” As a result, the GOP’s inability to drum up enough support to even bring the original AHCA to a House vote in late March was viewed as a failure for both House speaker Paul Ryan and president Trump.
The victory today may help repair some of that political damage, although the fight over the AHCA is far from over. Following the vote, many Congressmen will be heading home for a recess, where conservative members may be forced to defend their votes to angry constituents.