WASHINGTON – In a major victory for President Donald Trump, the House has voted to dismantle the pillars of the Affordable Care Act and make sweeping changes to the nation’s health care system.
The bill now heads to the Senate where it faces daunting challenges because of the same ideological splits between conservative and moderate Republicans that nearly killed it in the House.
After a dramatic week of negotiations, lobbying from Trump and Republican leaders, the vote ended with 217 GOP lawmakers backing the measure. Twenty Republicans opposed it, as did all House Democrats.
Republicans immediately boarded buses to the White House, where they will appear with Trump in a celebratory moment.
Democrats were unable to stop the GOP vote aimed at President Barack Obama’s signature legislative achievement. But after the final vote was cast, they chanted “nah nah nah nah hey hey hey goodbye” to their Republican colleagues, with a few members waving, as they believe the vote will lead to many GOP lawmakers losing their seats in the November 2018 midterms.
Thursday marks a political milestone — one that has painfully eluded Trump and House leaders for months. The controversial health care bill delivered Trump the biggest political defeat of his short presidency in March, when the legislation had to be yanked from the House floor because it simply didn’t have enough support.
Under pressure from an antsy Trump looking to score a big political victory, Republican leaders tried again last week, hoping to to get to 216 votes ahead of the President’s symbolically important 100-day mark in office. That effort, too, failed.
Before the vote on the House floor, Ryan made the case that Republicans had no choice but to work to put Obamacare — what he called a “failing law” — behind them. “Let’s give people more choices and more control over their care.”
“Let’s return power from Washington to the states,” Ryan said.
“A lot of us have been waiting seven years to cast this vote.” Ryan said. Many lawmakers, he added are “here because they promised to cast this vote.”
Republican Congressman Darrell Issa (SR-49) voted in favor of the bill. He released this statement:
“Today, we made good on our promise to repeal and replace Obamacare. Let’s stop pretending Obamacare is going to fix itself or that somehow, someday, it’s going to get better. Today’s vote gives a voice to the victims of Obamacare, the millions of Americans who are paying higher premiums, receiving less coverage and for whom the status quo offered no end in sight. Obamacare is doing real harm to California’s families and struggling businesses, and constituents are counting on me to deliver real relief. Obamacare was a failure from the get-go. Now is the time to make it right.”
Republican Congressman Duncan Hunter (CA- 50) votes for the bill.
“Any mechanism that gets us closer to fully repealing Obamacare and alleviating the pressures it’s created is a step in the right direction and this bill begins the process of creating a new marketplace with greater protections for patients, families and businesses.”
Democrat Congressman Juan Vargas (CA-51) voted against the bill.
“Today is a disappointing and scary day for millions of Americans. House Republicans voted to take away health care from 24 million people, increase out of pocket costs for families, undermine individuals living with pre-existing conditions, and force seniors to pay more for their health care. In Congress, we should be working to increase access to quality, affordable health care for all Americans, not turn back the clock on progress. If we want to lower costs and make health care accessible for every American, Trumpcare is not the answer. Vargas represents California’s 51st Congressional District which includes the southern portion of San Diego County, all of Imperial County and California’s entire US/Mexico border. Vargas was first elected to the U.S. House of Representatives in 2012 and is currently serving his third term in Congress. He serves on the House Financial Services Committee.”
Democrat Congressman Scott Peters (CA-52) voted against the bill.
“This vote takes us one step closer to going back to a system where families go bankrupt over an unexpected illness and our emergency rooms are filled with mothers seeking basic care for their children. I’ve opposed this reckless healthcare repeal bill every step of the way because it will rip coverage away from millions of Americans, increase out-of-pocket costs for working families and seniors, and undermine protections for many Americans with pre-existing conditions. There are real steps we can take together to fix what’s not working in our healthcare system. Instead, today the House passed a bill that is opposed by doctors, nurses, hospitals, patients, and seniors because it would make the problems in our healthcare system worse, not better. But this is not over. I will keep fighting to stop this terrible plan from becoming law and get to work on real healthcare reform to make healthcare more affordable and accessible for American families.”
Democrat Susan Davis (CA-53) voted against the bill.
Democrats ready for 2018 fight
Democrats, for their part, are poised to hold the health care bill over the heads of Republicans next year.
As anxious reporters stood outside of Ryan’s office Wednesday night, waiting for guidance on whether there would be a vote Thursday morning, Democratic Rep. Elijah Cummings approached the group to joke that he had a “breaking” announcement.
Republicans had the votes on their health care bill, Cummings said. His punchline: And Democrats will take back the House in 2018.
As originally introduced, the GOP bill would leave 24 million fewer people insured by 2026 than under Obamacare, the non-partisan Congressional Budget Office said. There will not be a new CBO report before Thursday’s vote on the legislation.
“Do you believe in what is in this bill?” she said Thursday. “Some of you have said … well, they’ll fix it in the Senate. But you have every provision of this bill tattoos on your forehead you will glow in the dark on this one.”
The remark was met with cheers and applause.
“You will glow in the dark,” she repeated. “So don’t walk the plank.”
What’s in the bill?
The GOP health care bill would eliminate Obamacare taxes on the wealthy, insurers and others, and get rid of the individual mandate imposed by Obamacare, officially known as the Affordable Care Act. Instead of the Obamacare subsidies that are tied to income and premiums, the GOP plan would provide Americans with refundable tax credits based mainly on age to purchase health insurance.
The legislation would also allow insurers to charge higher premiums to those in their 50s and early 60s, compared to younger consumers.
It would also significantly curtail federal support for Medicaid and allow states to require able-bodied adults to work. After 2020, states that expanded Medicaid would no longer receive enhanced federal funding to cover low-income adults, and those that hadn’t expanded would be immediately barred from doing so.
And it would allow states to relax some key Obamacare protections of those with pre-existing conditions, which are among the health reform law’s most popular provisions. States could apply for waivers to allow insurers to offer skimpier policies that don’t cover the 10 essential health benefits mandated by Obamacare. Also, insurers would be able to charge higher premiums to those with medical issues if they let their coverage lapse. States requesting waivers would have to set up programs — such as high-risk pools — to protect insurers from high-cost patients.
An eleventh-hour amendment that helped seal the missing GOP votes would add $8 billion over five years to fund high-risk pools and go toward patients with pre-existing conditions in states that seek waivers under the Republican legislation. The legislation already included $130 billion in the fund.
However, the GOP bill doesn’t touch one another beloved piece of Obamacare — letting children stay on their parents’ insurance plans until the age of 26.