After eight years of railing against the Affordable Care Act, dozens of symbolic repeal votes, and weeks of struggling to put together a viable alternative despite controlling every lever of government, Republican House leaders said late Wednesday afternoon that they have finally secured the votes needed to pass their own health care overhaul. It is expected to be a nail-biter of a vote, and last-minute defections are possible.
House Majority Leader Kevin McCarthy came out of a closed door leadership meeting around 7 p.m. Wednesday night to announce that they had locked up the votes to pass the bill and would bring it to the floor on Thursday.
“I think we have enough votes,” he told reporters. “It’s a good bill. As you know, we already debated a large portion of this. We’re going to pass it.”
The final bill text has not yet been released to the public, and there has been no independent analysis of the cost of the bill or its impact on health coverage. Yet the House plans to forge ahead with a markup in the Rules Committee late Wednesday night and a floor vote on Thursday.
The clincher appears to be an amendment proposed by Rep. Fred Upton (R-MI) that provides an additional $8 billion over five years for states to subsidize high-risk insurance pools for people with pre-existing conditions. Upton shocked GOP leaders by coming out against the bill this week, as did staunch Trump ally Rep. Billy Long (R-MO), but the votes of the two influential members were won back with the $8 billion amendment.
Still, many moderates remained deeply uncomfortable with the core policies of the bill—including massive cuts to Medicaid and the rollback of several patient protections— forcing GOP leadership and the White House to struggle for days to secure enough support to get the bill through the House. It faces even more tenuous prospects for passage in the Senate.
Senate Minority Leader Chuck Schumer (D-NY) warned House Republicans earlier in the day that the bill faces steep political and procedural barriers on its journey to Senate passage—as it remains unknown whether the legislation qualifies for a fast-track, filibuster-proof vote under the rules of reconciliation.
“To my moderate Republican colleagues in the House, I ask, why would you risk a yes vote for a bill that is devastating to your constituents and has virtually a minuscule chance, probably no chance of becoming law?” Schumer said on the Senate floor.
Yet Republican backers of the bill in the House waved away these questions and concerns. “I think the House should do what we think is the best public policy, send it to the Senate, and let the Senate deal with it,” Rep. Joe Barton (R-TX) told TPM. “If we wet our pants every time someone raises the question of the Byrd Rule, we’d never get anything done over here.”
Wednesday’s announcement comes after a long series of false starts, canceled votes, defections, late-night meetings to win back defectors, threats from President Trump and his staff to back primary challengers to the defectors, and hastily thrown together amendments aimed at bridging the arguably un-bridgeable gap between the GOP’s hardline Freedom Caucus and the moderate Tuesday Group.
Most members of the Freedom Caucus dropped their opposition to the effort once they extracted several major concessions—including a provision allowing states to waive Obamacare’s rules that ensure essential benefits are covered by all health care policies and that protect people with pre-existing conditions from being priced out of the market.
Other holdouts were won over with promises of future votes on their separate pet issues.
And though many Republicans said over the past few weeks that they needed more information on the potential impact of the American Health Care Act before deciding whether to support the measure, the House plans to rush forward with a Thursday committee markup and floor vote with no outside analysis of how the bill will impact the federal deficit and how many people could lose their health insurance if it passes.
The Congressional Budget Office reported in March that the original GOP health care bill would reduce the deficit by more than $300 billion over a decade. But lawmakers have made several major, costly changes to the bill since then, and are not seeking an updated score.
When asked by TPM why the House did not want the CBO’s analysis, Rep. Bill Johnson (R-OH) repeated the inaccurate talking point that the non-partisan government office is not to be trusted. “You’re talking about the same CBO that underestimated how much Obamacare was going to cost?” he snarked.
Asked if Republicans wanted an alternative analysis of the bill, he asked, “Who’s going to do that analysis?” Johnson then waved away the suggestion that Congress is preparing to vote on the bill blind to its potential impacts on millions of people, snapping: “We know the impact on coverage and cost. We’ve been working on this for seven years.”
This post will be updated as more information becomes available.