The GOP plan to replace Obamacare passed 217 to 213, just one vote over the required 216.
Ahead of the vote, House Speaker Paul Ryan took the floor and said, “We can continue with the status quo or we can put this collapsing law behind us and end this failed experiment.”
Last minute deals were crucial to passing the legislation, including an $8 billion addition for people with pre-existing conditions.
Democrats in the House chamber were hopeful the risky vote would swing the 2018 election in their favor.
The bill will likely undergo significant changes before being appearing before the Senate.
However, the Senate vote will not require any Democrats to pass the bill, as a procedural mechanism will allow the bill to pass with just 51 votes instead of the usual 60-vote threshold.
Here are the key measures in the House bill, provided by NBC News:
- Mandates: It guts the IRS requirement in Obamacare that people with purchase health insurance or face a fine.
- Tax credits: The bill replaces subsidies for people to purchase insurance in the individual market in the Affordable Care Act based on income with refundable tax credits based on age. The impact is that it will provide more people with assistance but with fewer dollars, especially for the older Americans.
- Medicaid: The Medicaid expansion is frozen immediately and in two years the states can start to adopt either a block grant for the program or a new formula based on population instead of need. In an attempt to make the bill more conservative, work requirements have been added for most able-bodied recipients who aren’t pregnant or caring for a child under 6.
- High risk pools: The bill provides $130 billion to states over ten years for high risk insurance pools to cover the most expensive to insure. A new amendment by Rep. Fred Upton of Michigan adds an additional $8 billion to assist people with pre-existing conditions.
- State waivers: States can obtain waivers so insurers don’t have to offer robust benefits packages that include maternity care and mental health coverage. Waivers can also be obtained to charge sicker people and people with pre-existing conditions more. Those people would most likely then go into the high risk insurance pools.
- Taxes: It repeals every Obamacare tax including the .9 percent tax on couples making more than $250,000 and a 3.8 percent tax on investment income.
- Health Savings Accounts: The measure increases the allowable contribution limits of Health Savings Accounts
- Other: It keeps the Obamacare provision that people under the age of 26 can stay on their parents’ insurance.
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