Republicans in the U.S. House of Representatives on Thursday passed an Obamacare repeal bill that many admitted they had not read and had not yet been assigned a price tag.
What we know about the revised American Health Care Act (AHCA) is that, like its predecessor, which House Speaker Paul Ryan (R-WI) dramatically yanked from the floor in March after it failed to garner enough votes, it still endangers guaranteed essential health benefits and funding for Planned Parenthood.
By late April, Rep. Tom MacArthur (R-NJ), co-chair of the “moderate” Tuesday Group, negotiated an agreement with House Freedom Caucus Chair Mark Meadows (R-NC). The MacArthur amendment would allow states to waive essential health benefits and, in some cases, charge higher premiums for preexisting conditions, according to Vox’s Sarah Kliff.
The agreement still proved divisive in the GOP conference, especially after Kliff reported that the amendment exempted congressional representatives’ insurance. MacArthur pledged to fix the loophole in separate legislation, which the House passed immediately prior to the AHCA vote.
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The legislation appeared all but dead after a high-profile defection from Rep. Fred Upton (R-MI), the most recent former chair of the health-care policy-setting House Energy and Commerce Committee.
Upton subsequently met with President Trump at the White House on Wednesday and agreed to support the bill with the addition of the Upton amendment providing an $8 billion infusion for “high-risk pools” that may subject people with preexisting conditions to much higher premiums.
House Minority Leader Nancy Pelosi (D-CA) scoffed at the GOP offering.
“What you would need is probably about $200 billion dollars over the next 10 years. What they’ve done is $8 million over 5 years. If you divide that by the number of people who have a pre-existing medical condition, you get about $200 or $300 each,” she told reporters during a Wednesday morning press conference. “It’s a joke. It’s a very sad, deadly joke.”
Advocates warned the Republicans’ AHCA would return the United States to the days when domestic violence, sexual assault, Cesarean sections, and postpartum depression were considered preexisting conditions.
And the tax credits Republicans have proposed to help people pay for health insurance plans could be “largely unusable” in states like California and New York that require plans to cover abortion care, according to a report in the Hill.
The whip count remained in flux Wednesday night despite assurances from GOP leaders that they had the 217 votes needed for passage. Ultimately, the House voted 217-213 mostly along party lines to pass the bill. Twenty Republicans and all 193 Democrats voted against it. One Republican didn’t vote.
The votes appeared to come together Thursday morning during a closed-door meeting of the full House GOP conference, where frustration over the fledgling efforts boiled over.
Republican leaders welcomed the conference by playing the “Rocky” theme song and projecting an image of World War II General George S. Patton.
“It’s time to live or die by this day,” leaders reportedly told their rank-and-file members.
Republicans appeared to quickly fall in line. Rep. Martha McSally (R-AZ) rallied her colleagues to get this “fucking thing” done, lawmakers and aides confirmed to the Associated Press.
But Republicans indicated that they weren’t clear on the implications of the health-care bill.
Rep. Dave McKinley (R-WV) berated a reporter who asked if he had read the bill and seen a score, or price tag, from the Congressional Budget Office (CBO), according to an account from HuffPost’s Matt Fuller.
It’s impossible to gauge the full consequences of the repeal bill without a CBO score, though Vox‘s Kliff attempted to do so in an explainer that touched on the dire consequences for Medicaid beneficiaries.
The CBO, the independent, nonpartisan number crunchers for Congress, determined that the prior version of the AHCA could strip 24 million people of health insurance. That was before Republican leaders eliminated essential health benefits and piled on other conservative sweeteners to gain the support of the House Freedom Caucus.
Presumably, the CBO’s finding that Republicans intend to defund Planned Parenthood, and only Planned Parenthood, still stands. Stripping the health-care organization of Medicaid reimbursements even for one year could amount to a death sentence for people with low incomes who rely on Planned Parenthood’s affiliates for care. The CBO confirmed that doing so will disproportionately hurt the poor and rural.
“In a callous move that imperils women’s health and economic security, the House of Representatives today passed the [AHCA], an atrocious and damaging bill that would strip health coverage from 24 million people, raise health care costs for millions more, gut Medicaid and deny millions of people access to preventive and potentially life-saving care at Planned Parenthood health centers,” Debra L. Ness, president of the National Partnership for Women & Families said in a statement. “President Trump’s best day in office so far is America’s worst.”