CAPITOL HILL – At first, Republicans didn’t succeed in repealing Obamacare, but they tried again last week – and were successful.
The Republicans’ American Health Care Act (AHCA) passed 217-213, with 20 Republicans breaking ranks to vote against the bill alongside the entire chamber’s Democrats, including Prince George’s County’s representatives Steny Hoyer (D-5) and Anthony Brown (D-4).
“This bill is a disgrace,” Brown said. “We are kicking 24 million Americans off their health insurance; increasing costs for veterans, seniors and middle class families; ending Medicaid as we know it; and eliminating protections for 326,000 people in Maryland’s Fourth District with pre-existing conditions. No matter how many band-aids the GOP puts on TrumpCare, we are now forcing Americans – who might get sick or ever need our healthcare system – to fend for themselves while we give the wealthy a huge tax cut.”
The bill would repeal many requirements in the Affordable Care Act (ACA), also called Obamacare, including the individual mandate for people to purchase insurance, the requirement for many employers to provide insurance coverage, the medical device tax and the expansion of Medicaid. The amended bill also allows states to request waivers from essential health benefits, age ratings and community ratings if they can demonstrate that the waiver would result in lower premiums, increase options or stabilize the insurance market.
The House also passed a companion measure that would get rid of a loophole exempting members of Congress and their staff from AHCA. The vote was 429-0, with two members not voting (including Hoyer).
AHCA was initially debated March 24, but pulled from consideration because Republican leadership did not have enough votes to pass it. The remaining 41 minutes of debate was conducted May 4 prior to the vote. The bill was moved to the floor without an updated Congressional Budget Office (CBO) score, a decision which many Democrats lambasted.
“Forcing a vote without a CBO score shows Republicans are afraid of the facts,” said Minority Leader Nancy Pelosi (D-Calif.-12).
Hoyer gave an impassioned speech on the House floor detailing many of the reasons Democrats oppose the AHCA.
“This vote is a simple one. It is a vote to kick 24 million Americans off of their health insurance coverage – I don’t say that, the CBO says that, which is perhaps why we don’t have a CBO report on the amendment – it includes seven million people who are covered through their employers. It is a vote to make coverage unaffordable for one in four Americans with pre-existing conditions and ration care through high risk pools. It is a vote to impose an age tax on older Americans – some $1,700 to $14,600; that’s quite a hike. It’s a vote to force Americans to pay more for less,” he said. “I urge my colleagues: come to your senses. Defeat this bill.”
Democrats presented each Republican who spoke in favor of the bill with numbers of people in their state who would lose insurance or the amount premiums would increase, while Republicans countered with stories of Obamacare insurance markets with declining numbers of insurers participating. Republicans rejected Democratic numbers, with Rep. Greg Walden (R-Ore.-2) even saying “I don’t buy that” and calling it “fear-mongering.”
Speaker of the House Paul Ryan (R-Wis.-1) said the bill was the fulfillment of a promise his party made to voters. He and Republicans argued that AHCA will give Americans more flexibility in choosing healthcare plans, lower taxes (the bill replaces subsidies to purchase insurance with tax credits) and fix problems with insurers pulling out of the Obamacare insurance marketplaces.
“(If) we continue the status quo under Obamacare, we know what that looks like. It means even higher premiums, even fewer choices, even more insurance companies pulling out, even more uncertainty and more chaos,” he said. “This is a crisis, and it is happening right now. What protection is Obamacare if there is no health care plan to purchase in your state?”
Republicans also argued that people may not be “kicked off” their plans because the states may choose not to apply for the waivers from ACA requirements, and that the “age tax” cited by Democrats is just the reverse of the “young tax” in ACA, since young and healthy people are subsidizing older Americans’ costs under ACA.
The bill now moves to the Senate, where some Republicans have already come out against it. Democratic Rep. G.K. Butterfield (N.C.-1) said the House vote was meaningless in light of that.
“You know and I know this bill will not see the light of day in the Senate. This is a political stunt to save face with your right-wing base,” he said. “You will lose your opportunity to serve in this house and you will ultimately lose the majority.”
Some Democrats on the floor broke into a taunting refrain of the song, “Na na na, hey hey-ey, goodbye,” directed at their Republican colleagues after the vote, implying the vote would cost them their seat in the 2018 election.
Hoyer articulated that sentiment in his floor remarks as well.
“Republicans now control all of our government. Whatever happens to our health care system will be their responsibility. They will be held accountable for what happens. Today, Americans will have the opportunity to see exactly where their representatives stand,” he said. “I recommend, as a political strategist who is concerned about 2018, that you once again withdraw this bill.”