ALAN FRAM and ERICA WERNER
WASHINGTON (AP) — Relieved Republicans muscled their health care bill through the House on Thursday, taking their biggest step since Donald Trump took office toward dismantling former President Obama’s health-care overhaul. Victory only came, though, after Republicans had resolved divisions within their own party – divisions that had nearly sunk the proposal six weeks ago.
Beaten but unbowed, Democrats insisted Republicans will pay at election time for repealing major provisions of the law. They sang the pop song “Na Na Hey Hey Kiss Him Goodbye” to the GOP lawmakers as the end of the voting neared.
The measure skirted through the House by a thin 217-213 vote, as all voting Democrats and 20 mostly moderate Republican holdouts voted no. A defeat would have been politically devastating for President Trump and Speaker Paul Ryan, R-Wis.
Adoption was a product of heavy lobbying by the White House and Republicans leaders, plus late revisions that nailed down the final supporters needed. Leaders rallied rank-and-file lawmakers at a closed-door meeting early Thursday by playing “Eye of the Tiger,” the rousing 1980s song from the “Rocky III” film.
“Many of us are here because we pledged to cast this very vote,” Ryan said. He added, “Are we going to keep the promises that we made, or are we going to falter?”
The bill now faces an uncertain fate in the Senate, where even GOP lawmakers say big changes are likely. In a statement, Senate Majority Leader Mitch McConnell, R-Ky., called the House vote “an important step” toward repealing Obama’s law and said, “Congress will continue to act on legislation to provide more choices and freedom in health care decisions.”
Republicans have promised to erase President Barack Obama’s law since its enactment in 2010. This year — with Trump in the White House and in full control of Congress — is their first real chance to deliver.
But polls have shown the public isn’t necessarily enamored of the repeal effort. Democrats — solidly opposing the bill — have said Republicans will pay a price in next year’s congressional elections.
“You vote for this bill, you’ll have walked the plank from moderate to radical,” said House Minority Leader Nancy Pelosi, D-Calif., warning Republicans that voters would punish them. “You will glow in the dark on this one.”
Ryan had previously canceled a vote in March on the health-care bill because disgruntled conservatives said the proposal was too meek and GOP moderates said its cuts were too deep.
Then, last week, Ryan abandoned a second attempt at a vote. As late as Tuesday, The Associated Press had counted 21 GOP opponents of the bill — one short of the number that would kill the measure if all Democrats voted no.
Over the past few weeks, the measure was revamped to attract most hard-line conservatives and some GOP centrists. In a final tweak, leaders added a modest pool of money to help people with pre-existing medical conditions afford coverage, a concern that had given rise to a near-fatal rebellion among Republicans in recent days.
The bill would eliminate tax penalties that Obama’s law hits people with for not buying coverage and would erase tax increases that the Affordable Care Act imposes on higher-earning people and the health industry. It would reduce spending on Medicaid, a program for low-income people, and let states impose work requirements on Medicaid recipients.
It would turn Obama’s subsidies for millions buying insurance into tax credits that rise with consumers’ ages. At the same time, it would retain Obama’s requirement that family policies cover grown children until they turn 26.
But states could get federal waivers freeing insurers from other Obama coverage requirements. With waivers, insurers could charge people with pre-existing illnesses far higher rates than healthy customers, boost prices for older consumers to whatever they want and ignore the mandate that they cover specific services like pregnancy care.
The bill would block federal payments to Planned Parenthood for a year, a step deemed a triumph by many anti-abortion Republicans.
GOP candidates including Trump put repealing Obama’s statute at the top of their campaign pledges, contending it’s a failing system that’s leaving people with rising health care costs and less access to care.
Democrats defended Obama’s law, one of his crowning domestic achievements, for expanding coverage to 20 million Americans and forcing insurers to offer more generous benefits. They said the GOP measure would toss millions off coverage while delivering tax cuts to the wealthy.
The nonpartisan Congressional Budget Office estimated in March that the GOP bill would end coverage for 24 million people over a decade. That office also said the bill’s subsidies would be less generous for many, especially lower-earning and older people who are not yet 65 and qualify for Medicare.
A CBO estimate for the latest version of the bill was not ready before the House’s vote on Thursday.
Earlier this week, moderates objected that constituents with pre-existing conditions could effectively be denied coverage by insurers charging them exorbitant premiums.
But GOP leaders seemed to win over a slew of wavering lawmakers after adding $8 billion over five years for state high-risk pools, which are aimed at helping seriously ill people pay expensive premiums. That money came on top of the $130 billion that the bill would provide to states to help customers, although critics said those amounts were insufficient.