House narrowly passes Obamacare repeal, see how local Republican - Cincinnati News, FOX19-WXIX TV

House narrowly passes Obamacare repeal, see how local Republicans voted

Speaker Paul Ryan has been spear-heading the Obamacare replacement plan. (Provided, House Speaker's Office) Speaker Paul Ryan has been spear-heading the Obamacare replacement plan. (Provided, House Speaker's Office)
President Trump takes a victory lap in the Rose Garden. (Provided, White House) President Trump takes a victory lap in the Rose Garden. (Provided, White House)

Republican House leadership barreled ahead on a healthcare repeal for the third time since President Donald Trump took office, passing the controversial American Healthcare Act (AHCA) and coming through on a seven-year promise to dismantle the Affordable Care Act on Thursday. 

With only one vote to spare, the measure squeaked by with a 217-213 vote with all Democrats voting in unison against. The passed measure heads to the Senate chamber where it is expected to encounter major hurdles. 

The bill's passing kicked-off celebrations with Trump and conservative lawmakers taking a victory lap  in the Rose Garden despite the measure not having projections on how many people will be left uninsured or its economic impacts. 

"I'm doing OK. I'm the president, can you believe that?" Trump said in a speech following the vote. "This has really brought the Republican Party together.”

The milestone marks the first major legislative victory for Trump and House Speaker Paul Ryan in the new administration after weeks of uncertainty. But despite the victory, it is difficult to find Republicans publicly defending the bill on social media or TV. However, Democrats and liberal activists are fired up. 

The GOP wants to get rid of the Affordable Care Act. What's taking so long? 

The previous measure was torpedoed by the Freedom Caucus, an alliance of the House’s most conservative legislatures, largely because Ryan and Trump's previous attempts were not conservative enough. 

But courting conservative lawmakers created a new snag over whether-or-not people with pre-existing conditions could have guaranteed access to healthcare, as current federal law mandates. The new measure carries an amendment that allows states to waive the requirements which could skyrocket premiums, potentially pushing back moderate Republicans and legislatures in competitive races coming up. 

"It's very disappointing," Sen. Sherrod Brown said. "They voted against Gov. Kasich's wishes and despite all of them getting government subsidized healthcare. It's not morally right."

Eliminating safeguards for those with pre-existing conditions could violate a campaign promise made by President Donald Trump and Vice President Mike Pence. 

"Donald Trump and I will protect Americans with pre-existing conditions so that they're not charged more or denied coverage just because they've been sick." Pence said at a Pennsylvania rally on Nov. 1.

Rep. Thomas Massie (R-Newport) is one of the most vocal critics of the AHCA, saying it is "worse than Obamacare." He has become one of multiple Republican lawmakers that have become increasingly hostile to President Trump and Speaker Ryan's performance with repealing the 2010 healthcare law. 

"The AHCA [American Healthcare Act] is like a kidney stone- the House doesn't care what happens to it, as long as they can pass it," Massie tweeted about the Ryan's healthcare proposal Wednesday. 

Rep. Brad Wenstrup (R-Columbia Tusculum) was lukewarm about the original healthcare plan that failed to make it to the House floor in March, saying it "wasn't able to complete the mission" of terminating the current federal mandates. However, he was game for the updated AHCA. 

"As the bill stands now, I support it as a significant step towards a more market-orientated system," Wenstrup said. "It's time to get the ball rolling and send this bill to Senate." 

After not backing the AHCA in its original form, Rep. Steve Chabot of Ohio's 1st District voted yea after being won over by the bill eliminating federal mandates.

Other legislatures in the Tri-State that backed the bill are Rep. Luke Messer of Indiana's 6th District, Rep. Steve Stivers of Ohio's 15th and Rep. Warren Davidson of Ohio's 8th.

Davidson is quick to say the bill "falls short" on the Republican Party's promises. However, he says the AHCA is the first step for conservatives to rein in control of healthcare policy. 

"Far more needs to be done, and we must not rest until we have accomplished the mission," Davidson said. 

Senate rules could kill the bill

On the Senate side, fears of pulling healthcare away from voters so close to the midterms are raising serious doubts the conservative bill can reach the president's desk without major overhauls. 

It isn’t just constituent concerns and squeamish Republicans that could halt the bill, the Senate’s reconciliation process must follow a strict set of rules that could sink the House GOP's plan for being a budget measure instead of legislation. 

Congress has the authority to pass measure that only impacts the budget with a simple majority. However, anything policy-related requires a filibuster-proof 60-vote. Republicans lack the vote needed to pass healthcare legislation, so they are going through the backdoor as a budget measure.

Terminating pre-existing healthcare coverage could be a violation of Senate rules. If so, the Senate would then need to amend the bill, kicking it back to the House. The House would need to approve of the changes which could crumble Republican support.

The party has generally been lukewarm about the leadership's plans to repeal and replace Obama's healthcare law and the president has largely been missing-in-action rallying support behind the bill. 

Some Republicans are crossing their fingers the Senate can patch up some of the AHCA's shortcomings. 

"This is a first step in fixing the issues of the high out-of-pocket costs of health care premiums and the bureaucracy of the ACA, though it is not a perfect bill," Rep. Steve Stivers (R-Upper Arlington) said following the bill's passing. "As the bill goes to the Senate and continues in the legislative process, I hope it will continue to improve to provide affordable access to quality care for the American people."

What's the impact if it becomes law? 

Republicans are moving forward on a vote in lieu of a Congressional Budget Office score, meaning there are no official numbers on how the proposal will impact the economy. The quick move without lawmakers having a sense on how much the bill would cost signals leadership is concerned the CBO would project a grim outlook for a second time. 

The last CBO score of the AHCA reported roughly 24 million more Americans would be uninsured over the next decade if the House Republican alternative to the Affordable Care Act (ACA) passed. At least 14 million people will be booted off of healthcare within a year of the bill's passing. In total, the CBO's report estimates 52 million in the U.S. would have been uninsured in 2026 under the original bill. 

"Mr. President, your party is trying to throw 24 million people off of healthcare today," Sen. Bernie Sanders (I-Vt.) tweeted Thursday afternoon. "Are you still concerned?" 

Many heavy-hitting Senate Republicans said they have major issues with the AHCA as proposed in March.

Senators Rand Paul (R, Ky.) and Ted Cruz, (R-Texas) said they would not support anything short of a full Obamacare repeal.

Rob Portman (R-Ohio), Lisa Murkowski (R-Alaska), and Shelley Moore Capito (R-W.Va.), were concerned about the bill gutting protections of Medicaid beneficiaries and booting too many people off healthcare. 

“I’ve already made clear that I don’t support the House bill as currently constructed because I continue to have concerns that this bill does not do enough to protect Ohio's Medicaid expansion population, especially those who are receiving treatment for heroin and prescription drug abuse," Portman said in a written statement Thursday. 

In its original form, the AHCA would severely impact the number of insured Americans that were gained over the implementation of the ACA in 2010. According to the report, 48.3 million were uninsured before former President Barack Obama's healthcare law was passed. 

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