After a failed attempt six weeks ago, Speaker Paul Ryan (R-Wisc.) and House Republicans (with periodic support from President Donald Trump) have managed to get the American Health Care Act passed in the lower-chamber of Congress by a razor-thin margin of 217-213.
All 193 Democratic members of the House of Representatives voted no against the bill that has polled at 17% support with the American public while 217 House Republicans voted in the affirmative.
The bill had 20 Republican defections, mostly from representatives in more contested and moderate districts such as Rep. Ileana Ros-Lehtinen’s Fla. 27. The exception to the rule of thumb is Rep. Thomas Massie (Ky-4). Massie was previously on record as saying the bill was “”worse than Obamacare and the state has seen an estimated 500,000 low-income Kentuckians get coverage thanks, in part, to the Affordable Care Act’s Medicaid expansion (per ABC News).
AHCA will now head to the Senate where it will face a lot of the same problems it did in the House of Representatives. Republican senators can’t afford defectors on the bill. The bill is divisive amongst conservative and moderate members of the Senate GOP who disagree about how to deal with what to do about: pre-existing conditions, essential health benefits, and Medicaid expansion.
And, to make things tougher, the bill has to lower the deficit for it to pass by a simple-majority threshold rather than the 60-vote threshold typically required for major bills. At this time, there’s no Congressional Budget Office score for the bill so that’s difficult to assess. However, as Vox pointed out in March, the initial AHCA passed by Speaker Ryan and House Republicans “would effectively kill any hope for large deficit reduction under President Trump” because it ” soaks up every conceivable cut in Medicaid, the party’s one big pool of potential deficit reduction in the Trump era, but spends most of the savings on insurance subsidies and tax cuts.”
If the bill can’t clear that threshold, and if it fails to garner 60 votes, the AHCA would again go down in a blaze of glory. If it does pass, but with significant differences from the House bill, AHCA would head to a conference committee where House and Senate members work to resolve legislative differences.
You can find the 20 Republicans who voted “no” on the bill below.
Rep. Andy Biggs (Ariz. 5)
Rep. Mike Coffman (Colo. 6)
Rep. Barbara Comstock (Va. 10)
Rep. Ryan Costello (Pa. 6)
Rep. Charles Dent (Pa. 15)
Rep. Dan Donovan (N.Y. 11)
Rep. Brian Fitzpatrick (Pa. 8)
Rep. Jaime Herrera Beutler (Wash. 3)
Rep. Will Hurd (Texas 23)
Rep. Walter Jones (N.C. 3)
Rep. David Joyce (Ohio 14)
Rep. John Katko (N.Y. 24)
Rep. Leonard Lance (N.J. 7)
Rep. Frank LoBiondo (N.J. 2)
Rep. Thomas Massie (Ky. 4)
Rep. Patrick Meehan (Pa. 7)
Rep. David Reichert (Wash. 8)
Rep. Ileana Ros-Lehtinen (Fla. 27)
Rep. Chris Smith (N.J. 4)
Rep. Michael Turner (Ohio 10)