Third Time Is The Charm: House Republicans Vote To Replace Obamacare

After more than seven years of Obamacare, House Republicans get the votes to replace health care law.

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May 04, 2017 at 2:19 PM ET

A little after 2 p.m. on Thursday, 2,599 days since the Affordable Care Act was signed into law by former President Barack Obama, House Republicans successfully voted to repeal and replace significant portions of Obama’s hallmark piece of legislation, potentially altering the future of health care for millions of Americans. 

The replacement bill, which passed by less than a handful of votes, is considered the first domino to fall in a long process that could eventually usher in the American Health Care Act. The House vote, which came after two failed attempts to get it passed since March, also signals what is the first step in fulfilling one of President Donald Trump’s most substantial campaign promises since assuming office. The bill still needs to pass the Senate — which will likely be difficult in its current form — before becoming law.

What ultimately pushed the bill to the 216-vote needed for it to pass was the 11th-hour amendment from Michigan Rep. Fred Upton, which added $8 billion to the bill to help cover the costs of people with pre-existing medical conditions. Upton, one of the more influential House Republicans who’s wanted to repeal Obamacare, initially came out against the bill, which originally sought to overturn the ban on discriminating against people with pre-existing medical conditions. Once the Upton amendment of $8 billion was implemented into the bill on Wednesday, both Upton and Missouri Rep. Billy Long, the amendment’s co-sponsor, issued their support, and calmed the nerves of other Republican lawmakers.

The replacement bill will gut some of the more important pillars in Obamacare, including the individual mandate, taxes on insurers and the wealthy, and a large portion of Medicaid’s federal support. Among the highlights in the $138 billion replacement plan is the provision that gives Americans refundable tax credits, based on their age, to purchase health insurance plans and developing more robust health savings accounts.

But there remains much uncertainty as to what health care coverage will look like for millions of Americans. Although the Upton amendment has been praised by conservatives, others, such as Karen Pollitz, a healthcare expert at the Kaiser Family Foundation, are deeply skeptical. Pollitz told The Hill that the $8 billion would only cover the costs of 1 percent of the individual market for those with pre-existing conditions. According to the Congressional Budget Office’s analysis of an earlier version of the AHCA, a projected 24 million additional people would be uninsured by 2026 compared to Obamacare. Thursday’s vote came before the CBO could give the updated AHCA plan a score to measure its impact and cost.

Heading into the vote, there was still some question as to whether the bill would pass, with at least 16 Republicans who publicly rejected it and almost another dozen who were undecided, according to Politico. One of the first real signs that the bill could pass came Wednesday from House Speaker Paul Ryan, who told a Wisconsin radio station that House Republicans had “some momentum.” On Wednesday night, California Rep. Kevin McCarthy, the House majority leader, who told the New York Times that House Republicans had indeed secured the 216 votes necessary to pass the bill, saying that it would pass.

For Republican lawmakers, such as North Carolina Rep. Ted Budd, the successful House vote was a long time coming.

“This vote marks the beginning of the end of Obamacare as we know it,” Budd told Politico on Wednesday.