House Republicans Finally Pass An Obamacare Repeal And Replacement

MOMENTOUS DAY IN AMERICA AS HOUSE REPUBLICANS VOTE TO REPEAL THE AFFORDABLE CARE ACT.

According to our friends over at Huffpost.

After years of promis­es and months of delays, House Republicans passed their ver­sion of an Obamacare repeal and replace­ment Thursday, muscling the far-right leg­is­la­tion through their cham­ber by fever­ish­ly pres­sur­ing mod­er­ates in the clos­ing days.

Republicans passed the bill 217 – 213, with 20 Republicans vot­ing “no” and not a sin­gle Democrat vot­ing in support.

But what seems like a vic­to­ry for House Republicans may ulti­mate­ly be their down­fall.

Democrats were of two minds about Republicans advanc­ing the bill, which would gut some of Obamacare’s most pop­u­lar pro­vi­sions (includ­ing pro­tec­tions for peo­ple with pre-exist­ing con­di­tions as well as the Medicaid expansion).

On one hand, Democrats des­per­ate­ly want­ed to pro­tect President Barack Obama’s sig­na­ture law. On the oth­er hand, Democrats believe ― per­haps cor­rect­ly ― that this extreme­ly con­ser­v­a­tive bill can’t pass the Senate, and that House Republicans may have just hung a pro­found­ly unpop­u­lar leg­is­la­tion around the necks of some of their most vul­ner­a­ble members.

As Minority Leader Nancy Pelosi (D‑Calif.) told Republicans dur­ing her floor speech before the vote, Democrats plan to tat­too every pro­vi­sion of this bill to the fore­heads of Republicans. “You will glow in the dark,” Pelosi said.

While Republicans were cheer­ing as they crossed a pass­ing thresh­old, Democrats began singing to their coun­ter­parts a pop­u­lar anthem, “Na-na-na-NA, na-na-NA, hey, hey, hey! Goodbye!

A num­ber of vul­ner­a­ble Republicans also held off on vot­ing for the bill until it was clear lead­er­ship need­ed their vote. Of par­tic­u­lar note, Carlos Curbelo (R‑Fla.), Darrell Issa (R‑Calif.), and Peter Roskam (R‑Ill.) all wait­ed to see if their votes would be need­ed before they sup­port­ed the bill. Ultimately, lead­er­ship need­ed all of them.

When Democrats passed the health care law in 2010, many mem­bers knew it was com­ing at the expense of their seats. They did it, how­ev­er, because it was pol­i­cy they deeply believed in, pro­tect­ing mil­lions of sick and poor Americans while grow­ing the num­ber of insured in the coun­try to record highs.

Republicans marched off this poten­tial polit­i­cal cliff know­ing their bill would unin­sure mil­lions, under­mine pro­tec­tions for the sick and poor, and prob­a­bly face lit­tle chance of becom­ing law ― and they did it with­out a revised score from the Congressional Budget Office.

But at least it’s off their plate.

That was the think­ing among many mem­bers who just want­ed to advance the process to the Senate and ful­fill a promise that every Republican ran on: To repeal and replace Obamacare.

As long as we get anoth­er vote on the con­fer­ence report, which we will, then there’s all kinds of ways to block [it] in the future if it doesn’t work out.Rep. Daniel Webster (R‑Fla.)

A num­ber of the last remain­ing hold­outs on the GOP health care leg­is­la­tion said in the clos­ing days that they just want­ed to move on. One vul­ner­a­ble Republican, Rep. Martha McSally of Arizona, told mem­bers in a closed door meet­ing on Thursday that they just had to “get this fuck­ing thing done,” accord­ing to mem­bers and aides present.

Rep. Daniel Webster (R‑Fla.), one of the last Republicans to flip from no to yes, changed his posi­tion after he got assur­ances from President Donald Trump, Vice President Mike Pence, and Speaker Paul Ryan (R‑Wis.) that they would address Webster’s con­cern about Florida hav­ing to pick up a claw­back in fed­er­al fund­ing for seniors in nurs­ing homes, even though that fix isn’t in the leg­is­la­tion and lead­ers haven’t agreed on what they’ll do.

We got sev­er­al on line,” Webster said Thursday. “We’re work­ing on those, we’re going to get some scores and so forth before we actu­al­ly com­mit, and I’m will­ing to do that.”

Pressed that he was, in essence, vot­ing to pass the leg­is­la­tion before he knows what will ulti­mate­ly be in it, Webster said he was just advanc­ing the process.

There’s plen­ty of votes between now and the end. This is for this vote,” he said.

As long as we get to a process,” Webster added. “As long as we have a con­fer­ence, as long as the Senate has to vote, as long as we get anoth­er vote on the con­fer­ence report, which we will, then there’s all kinds of ways to block [it] in the future if it doesn’t work out.”

Republicans are also vot­ing on this lat­est leg­is­la­tion with­out a CBO score, a fact Republicans either shrugged off or denied, claim­ing that an ear­li­er score was sufficient.

We already had the Congressional Budget score when we did the main bill,” Rep. David McKinley (R‑W.V.) told reporters Thursday morn­ing. “These are amend­ments that only per­fect­ed, [and] do not add costs.”

McKinley added that the CBO score could “only get bet­ter” with the lat­est amend­ments, but when pressed how he knew that, McKinley ignored the question.

The amend­ments that McKinley believes will improve the leg­is­la­tion were crit­i­cal to get­ting the bill over the fin­ish line. The first amend­ment, which brought rough­ly 20 Freedom Caucus mem­bers who were vot­ing no to yes, would allow states to opt out of the Obamacare pro­vi­sions ensur­ing that peo­ple with pre-exist­ing con­di­tions are charged the same amount as healthy peo­ple, as well as the pro­vi­sions man­dat­ing that insur­ers cov­er 10 Essential Health Benefits ― things like lab ser­vices, mater­ni­ty care, and emer­gency room visits.

That amend­ment, worked out between mod­er­ate leader Rep. Tom MacArthur (R‑N.J.) and Freedom Caucus Chairman Rep. Mark Meadows (R‑N.C.), was key to reviv­ing health care talks, after the first ver­sion of the bill was pulled from the floor at the end of March.

That MacArthur and Meadows’ amend­ment will be dif­fi­cult for the CBO to score, as they’ll have to pre­dict whether states opt out of those Affordable Care Act pro­vi­sions and set up a high-risk pool for sick peo­ple. (One of the con­di­tions of a state waiv­ing those reg­u­la­tions is that it estab­lish­es a high-risk pool.)

Republicans argue the high-risk pools are a suf­fi­cient pro­tec­tion for those peo­ple with pre-exist­ing con­di­tions, though, his­tor­i­cal­ly, those pools have been under­fund­ed and peo­ple in them have paid much high­er pre­mi­ums and deductibles. The Center for American Progress esti­mat­ed ear­li­er this week that the Republican health care bill under­funds the high-risk pools by $200 bil­lion over 10 years.

In a small bow to mod­er­ates, GOP lead­ers agreed to accept an amend­ment that would add $8 bil­lion over five years for states that waive those Obamacare reg­u­la­tions to help peo­ple fac­ing high­er pre­mi­ums. Upton, who was a “no” vote on the bill ear­li­er in the week, said lead­er­ship told him $5 bil­lion would cov­er the costs of those high­er pre­mi­ums and he got $8 bil­lion, though Upton doesn’t know where those fig­ures came from and the Center for American Progress esti­mates it would only cov­er the costs of about 80,000 peo­ple ― a tiny por­tion of the peo­ple who could be affect­ed by the change.

Either way, that amend­ment brought Upton and fel­low Energy and Commerce mem­ber Rep. Billy Long (R‑Mo.) back to a “yes” vote, and it was lat­er treat­ed as a key rea­son­ing for Reps. David Young (R‑Iowa,) Jeff Denham (R‑Calif.), and David Valadao (R‑Calif.) ― three poten­tial­ly vul­ner­a­ble Republicans who had been hold­ing out ― to flip to a “yes” vote.

Those three mem­bers were key to lead­er­ship mov­ing ahead, but there were dozens more Republicans who said they were unde­cid­ed about the leg­is­la­tion that lead­er­ship had to win over.

While this bill’s pas­sage will be treat­ed as a vic­to­ry for Paul Ryan and Donald Trump ― and, at least in the short-term, it is ― Republicans have chief deputy whip Rep. Patrick McHenry (R‑N.C.) to thank for shoring up sup­port among many doubt­ful mem­bers. McHenry worked the floor fran­ti­cal­ly in the week lead­ing up to the vote, con­vinc­ing fence-sit­ting Republicans to help lead­er­ship out by vot­ing “yes.”

Of course, Meadows and MacArthur were also instru­men­tal in reviv­ing the bill, and Trump’s force of char­ac­ter may have helped per­suade some mem­bers not to cross him. But on the president’s first real leg­isla­tive bat­tle, he showed that he can lose and he can “win” ― if you believe Republicans pass­ing any bill at any cost con­sti­tutes a win ― as long as he most­ly stays out of the spe­cif­ic negotiations.
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