House Republicans mustered just enough votes to pass their health-care bill Thursday, salvaging what at times appeared to be a doomed mission to repeal and partially replace Obamacare under intense pressure from President Donald Trump to produce legislative accomplishments.
The 217-213 vote sends the American Health Care Act to the Senate, where it has little chance of being passed in its current form by fellow Republicans spooked by reports the plan would cause millions to lose health insurance. Trump wrote on Twitter that he was watching the floor debate shortly before the vote.
"What protection is Obamacare if there is no health care plan to purchase in your state?" House Speaker Paul Ryan said, referring to insurance companies’ decisions to drop coverage in some states. "We can put this collapsing law behind us and this failed experiment. "
Minority Leader Nancy Pelosi said the measure’s tax cuts would create a massive transfer of wealth from working families to the rich. Addressing moderate Republicans in a fiery floor speech, she said that if they vote for the bill, "You have every provision of this bill tattooed to your forehead. You will glow in the dark on this one."
House GOP leaders and Trump lobbied members furiously, with the president summoning holdouts to meetings at the White House. Leaders agreed to revise the bill to attract conservatives who thought the plan didn’t go far enough to gut Obamacare, as well as moderates worried about harming people with pre-existing conditions. Ryan pleaded with fellow Republicans during a closed-door meeting this week to pray about the measure.
Six weeks earlier, Republicans suffered an embarrassing setback when Ryan had to abruptly cancel a vote on the bill amid opposition from the party’s conservative and moderate wings. Ryan and Trump initially said they were giving up for the time being, but the White House soon resumed pressuring for a vote as Trump neared his 100th day in office.
Town Halls
Voters have confronted lawmakers at town hall meetings across the U.S. in recent weeks with concerns about losing health insurance under the GOP plan, giving some moderate Republican lawmakers jitters about backing the measure.
The Republican measure would repeal a key piece of former President Barack Obama’s Affordable Care Act -- the requirement that individuals get health insurance and that most employers provide it to their workers. It would wind down an expansion of Medicaid insurance for the poor and eliminate $1 trillion in taxes on the wealthy, insurers and drugmakers used to fund the law.
Republicans say their plan would allow a market-based system that would let people make more health-coverage decisions for themselves. It would replace Obamacare subsidies with tax credits based primarily on age that phase out for people with incomes above $75,000.
An amendment that gained crucial support for the bill from the conservative House Freedom Caucus lets states get waivers from some of Obamacare’s consumer protections. States could allow insurers to charge higher premiums to people with pre-existing conditions if they’ve had a gap in coverage as long as the state provides people priced out of commercial insurance with assistance, such as a so-called high-risk pool. States also could get waivers from a requirement that insurers provide health benefits deemed essential, such as maternity care.
House leaders gained the last few votes from reticent moderates this week by agreeing to another $8 billion over five years for the high-risk pools.
The 217-213 vote sends the American Health Care Act to the Senate, where it has little chance of being passed in its current form by fellow Republicans spooked by reports the plan would cause millions to lose health insurance. Trump wrote on Twitter that he was watching the floor debate shortly before the vote.
"What protection is Obamacare if there is no health care plan to purchase in your state?" House Speaker Paul Ryan said, referring to insurance companies’ decisions to drop coverage in some states. "We can put this collapsing law behind us and this failed experiment. "
Minority Leader Nancy Pelosi said the measure’s tax cuts would create a massive transfer of wealth from working families to the rich. Addressing moderate Republicans in a fiery floor speech, she said that if they vote for the bill, "You have every provision of this bill tattooed to your forehead. You will glow in the dark on this one."
House GOP leaders and Trump lobbied members furiously, with the president summoning holdouts to meetings at the White House. Leaders agreed to revise the bill to attract conservatives who thought the plan didn’t go far enough to gut Obamacare, as well as moderates worried about harming people with pre-existing conditions. Ryan pleaded with fellow Republicans during a closed-door meeting this week to pray about the measure.
Six weeks earlier, Republicans suffered an embarrassing setback when Ryan had to abruptly cancel a vote on the bill amid opposition from the party’s conservative and moderate wings. Ryan and Trump initially said they were giving up for the time being, but the White House soon resumed pressuring for a vote as Trump neared his 100th day in office.
Town Halls
Voters have confronted lawmakers at town hall meetings across the U.S. in recent weeks with concerns about losing health insurance under the GOP plan, giving some moderate Republican lawmakers jitters about backing the measure.
The Republican measure would repeal a key piece of former President Barack Obama’s Affordable Care Act -- the requirement that individuals get health insurance and that most employers provide it to their workers. It would wind down an expansion of Medicaid insurance for the poor and eliminate $1 trillion in taxes on the wealthy, insurers and drugmakers used to fund the law.
Republicans say their plan would allow a market-based system that would let people make more health-coverage decisions for themselves. It would replace Obamacare subsidies with tax credits based primarily on age that phase out for people with incomes above $75,000.
An amendment that gained crucial support for the bill from the conservative House Freedom Caucus lets states get waivers from some of Obamacare’s consumer protections. States could allow insurers to charge higher premiums to people with pre-existing conditions if they’ve had a gap in coverage as long as the state provides people priced out of commercial insurance with assistance, such as a so-called high-risk pool. States also could get waivers from a requirement that insurers provide health benefits deemed essential, such as maternity care.
House leaders gained the last few votes from reticent moderates this week by agreeing to another $8 billion over five years for the high-risk pools.
