The repeal and replacing of Obamacare has officially begun.
The Republican-led House of Representatives on Thursday narrowly passed the American Health Care Act — aka Trumpcare or the AHCA — after over six years of promising to do away with President Obama's health care reform.
Voting 217-213, the House sent to bill to the Republican-controlled Senate and went over to the White House for what President Trump called "a big press conference at the beautiful Rose Garden." Speaker Paul Ryan said that the passage of the bill was a fulfillment of their promises to voters and would usher in a "new era New era of reform based on liberty and self determination."
Democrats, confident that the health care law is bad policy and will hurt Republicans political chances in 2018, chanted "Na na na na, na na na na, hey hey hey, goodbye," after the vote. House Minority Leader Nancy Pelosi seemed to take relish in the Republican vote, telling an assembled crowd outside the Capitol that "we want [the Republicans] to define themselves."
But despite such a confident posture, Democrats were caught by surprise Wednesday night when House Republican scheduled the vote on a bill that had not been scored by the Congressional Budget Office and had not had the legislative text released either.
At a hastily planned rally outside the Capitol with a few hundred people, a representative of MoveOn.org explained that they would have "thousands" if not for the short notice. Trumpcare "died right here on the floor," Pelosi said in a speech before the vote, adding that it had risen from the dead like a "zombie" and "even more scary."
While the White House and congressional Republicans originally suggested they would move on to other legislative priorities like tax reform following the defeat of the first Trumpcare bill, a few congressional Republicans continued to quietly negotiate a compromise over the last six weeks to bring on board the conservative House Freedom Caucus.
Once the House Freedom Caucus signed on to the new bill last week, House Republican leaders and the White House turned their attention to gaining the support of moderates. Republicans leaders told moderates that the bill would almost certainly change and become less conservative after Senate Republicans amend it. The final product would ultimately be different than what they are voting on now, they argued according to aides from Republican moderates.
The bill will indeed be changed in the Senate if it has any chance of passing with their small 52-vote majority. Many Republican Senators have already expressed concerns over the deep cuts in Medicaid in the current bill and the CBO will have to score the bill before they can vote. That CBO score is expected next week and will likely show dramatic premium hikes for the elderly and those with pre-existing conditions, according to experts.
With such a small margin for error, however, it's unclear if a bill that can pass in the Senate could also pass in the House.
Republican Sen. Lindsey Graham of South Carolina tweeted Thursday:
Senate Health Committee Chairman Sen. Lamar Alexander indicated that his chamber sees the House bill as a first draft. "The Senate will now finish work on our bill, but will take the time to get it right," he said, in a statement.
Rep. Mark Meadows of North Carolina, the chair of the conservative House Freedom Caucus, told reporters that he expected the bill to change because "the upper chamber had a personality" and he saw this bill as merely a "foundation." While any changes to moderate the bill could theoretically make it unpalatable to moderates, Meadows expressed confidence that problems could be worked out because "ultimately we have to put something on the president's desk."
If they do, President Trump seems eager to sign it.