House Passes American Health Care Act with 217 Votes

House Passes American Health Care Act with 217 Votes

Corey Uhden, Politics Contributor

When House Republican leadership pulled the American Health Care Act before the vote on March 24th, most observers assumed that they would move on to other matters. The following Tuesday, Republican leaders emerged from their regular conference meeting signaling that the members weren’t about to abandon that effort just yet. In the following weeks, Republican lawmakers continued to negotiate over the details of the legislation until a breakthrough moment in late April when Freedom Caucus Chairman Rep. Mark Meadows and co-chairman of the moderate Tuesday Group Republicans, Rep. Tom MacArthur, unveiled the so-called MacArthur Amendment

The MacAuthur Amendment would allow states that wanted to lower premiums or increase the number of people insured to pursue limited waivers so that they could exempt health insurance options from covering certain essential health benefits if and only if the state established a federally-funded high risk pool or a similar system to cover the cost of insurance for customers with pre-existing conditions. While many opponents portrayed the amendment as scrapping guarantees for customers with pre-existing conditions, the editors of The National Review explain that “insurers could consider health status only in the case of people who have not been continuously insured, and even then could consider health status only for each person for a one-year period.”

Conservatives, including the Freedom Caucus, hailed the provision as a victory for federalism and flexibility and began pressing for another vote. As reporters raced around the capital gauging support for the bill, Rep. Fred Upton, a Michigan Republican, announced his opposition to the amendment. But on Wednesday, Upton sought and received the president’s endorsement for $8 billion to subsidize insurance costs for anyone that would face higher premiums because of their conditions. It wasn’t long after Upton, Rep. Billy Long of Missouri, and Rep. Michael Burgess of Texas returned from the White House that House Majority Leader Kevin McCarthy announced the vote for the following day. 

The vote began just after 2:00pm EST after impassioned floor speeches from minority leader Nancy Pelosi and Speaker Paul Ryan. The final vote was 217 in favor, 213 against, including 20 Republicans, a razor-thin vote with just enough to pass it. 

Republicans then went off to the White House to “celebrate” their long-awaited legislative victory with a photo-op and a news conference with President Trump while the bill heads off to the Senate. The Republicans have just completed step one of the health care do-over dance. As The National Review’s Senior Politics Editor Jim Geraghty tweeted “it’s the Senate’s problem now.” 

You can follow the author on Twitter @CACoreyU 

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