The House is debating and expected to vote Thursday afternoon on the latest Republican measure to repeal and replace the Affordable Care Act.
The bill includes last-minute amendments designed to draw votes from the most conservative House Republicans in the House Freedom Caucus as well as from their more moderate counterparts.
GOP leaders are hoping the third time is the charm for their measure. The original bill was pulled from the floor in March when it became apparent it would not pass. And last week, they considered but then decided not to risk another vote.
Republican members had their arms twisted by President Trump in phone calls, and attended a last minute pep rally Thursday morning, in which GOP House leaders reportedly told them it was “time to live or die by this day.”
The measure, known as the American Health Care Act, is not expected to receive any support from Democrats, and so Republicans will have to come up with the necessary 216 votes to pass the bill and send it on to the Senate on their own.
House Minority Leader Nancy Pelosi calls the measure “a monstrosity,” and said “Republicans have made Trumpcare even more dangerous and destructive than the last time they brought it to the floor.”
House members will be voting on a bill without any knowledge of how many Americans will be affected, or the measure’s price tag. That’s because the Congressional Budget Office, the official scorekeeper, hasn’t had a chance to analyze the amended bill. But the CBO estimated an earlier version of the measure would mean 24 million people could lose their insurance.
But we do know the bill would cut taxes imposed by the Affordable Care Act, and slash funding for Medicaid, which was expanded under the ACA, by more than $800 billion. It would also allow states to seek waivers for many of the patient protections in Obamacare, including for those with pre-existing conditions.
The measure does provide $8 billion for states to set up high-risk pools to cover people with pre-existing conditions who were unable to find affordable coverage on the open market. That last-minute addition was key to winning support from some House Republicans were concerned about coverage for pre-existing conditions. But critics say it’s woefully short of the amount of money actually necessary to guarantee affordable coverage.
An array of medical groups, led by the American Medical Association, oppose the measure. In a statement, AMA President Andrew Gurman said “None of the legislative tweaks under consideration changes the serious harm to patients and the health care delivery system if AHCA passes. Proposed changes to the bill tinker at the edges without remedying the fundamental failing of the bill –that millions of Americans will lose their health insurance as a direct result of this proposal.”
The retirees’ group AARP also opposes the GOP bill.
But passing the measure would be a step toward keeping one of President Trump’s central campaign vows, and fulfilling Republicans’ long stated goal of overturning Obamacare, as the Affordable Care Act is also known.
Whether the Senate will go along is another story. Few Senate Republicans have expressed any interest in the House plan, and it’s expected to be significantly altered if it reaches that chamber. And polls have shown the GOP measure to be extremely unpopular with voters, potentially placing at risk the political careers of lawmakers who back it.