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House GOP ObamaCare replacement bill squeaks by

May 4, 2017

After fits and starts and embarrassing setbacks, House Republicans notched a significant victory Thursday, passing their bill repealing and replacing major portions of Obamacare on a narrow 217-213 vote.

The vote was the result of seven weeks of intense negotiations within the conference and with the White House, bringing hesitant members on board through a combination of arm-twisting and amendments to the legislation.

Ultimately, the vast majority of the Freedom Caucus, who were frustrated the original bill wasn’t conservative enough, and a significant number of moderates who were wary of the effect on their constituents’ coverage, supported the bill. Twenty Republicans voted against it, as did all Democrats.

In remarks at the White House, Speaker Paul Ryan thanked a number of the lawmakers and administration officials for getting the bill out of the House, and thanked Trump and Vice President Mike Pence for their hands-on effort.

“Today was a big day, but it is just one step in this process,” Ryan said. “An important step. We still have a lot of work to do to get this signed into law. And I know that our friends over in the Senate are eager to get to work.”

The mood for Republicans was jubilant in the Capitol Thursday – Rep. Mark Walker, the chairman of the conservative Republican Study Committee, said it was “a lot of energy and excitement today, not a sigh of relief.”

But there’s also the realization that while this fixes longstanding internal divisions within the House GOP conference for now – and secured a vote on their seven-year pledge to vote to repeal and replace the Affordable Care Act – this was just the latest shot in an ongoing battle.

“I’m a Hoosier and it’s race season so I would say we all recognize that while today is a very important step, it’s also a start of our true goal here, which is to repeal Obamacare and replace it with something better,” said Rep. Luke Messer, a member of party leadership. “We’ve got to get it through the Senate as well and signed on the president’s desk.”

Democrats, who were jubilant when Republicans failed to pass their health-care legislation in March, made their displeasure at Thursday’s outcome known.

“They have this vote tattooed on them. This is a scar they will carry,” Minority Leader Nancy Pelosi said at a news conference before the vote. “It’s their vote. It’s not the Senate vote; it’s their vote they are taking. That is really a poor choice — cowardly choice, I might add. Why would they vote for it, if they don’t think it’s worthy of support because the Senate will change it?”

Indeed, there are major hurdles in the Senate, where there is concern not just about some of the amendments to the legislation – including waivers allowing states to bypass certain Obamacare regulations on pricing for those with pre-existing conditions and required “essential” health benefits – but also about the underlying bill. Some Republicans in the Senate are pushing for more funding for the tax credits meant to help individuals afford health insurance, and an easier transition away from the Medicaid expansion built into the ACA.

The Senate will also wait for the nonpartisan Congressional Budget Office to review the final House legislation. While the CBO’s initial review estimated as many as 24 million people could lose insurance, the House voted on the new bill without an updated review, which could reset the politics of the legislation and keep it from reaching Trump’s desk.

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