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House GOP wrests narrow win in health care bill fight

May 4, 2017 at 6:50 PM EDT
The American Health Care Act squeaked through the House of Representatives Thursday with a single vote to spare, the culmination of years of promises, days of tension and hours of heated debate. As House Speaker Paul Ryan made a plea to Republicans to pass the bill, Democrats insisted the vote was rushed, short-sided and will hurt millions of Americans. Lisa Desjardins reports.

HARI SREENIVASAN: The White House, and House Republicans, are celebrating tonight. Today, they pushed through a bill to remake the health care system, something they failed to do back in March. The vote was 217 to 213.

Lisa Desjardins begins our coverage.

PRESIDENT DONALD TRUMP: Make no mistake: this is a repeal and a replace of Obamacare, make no mistake about it. Make no mistake.

LISA DESJARDINS: A dramatic day ended at the White House as President Trump and House Republicans celebrated wrestling out a hard-fought first win in the fight over the affordable care act.

PRESIDENT DONALD TRUMP: We’re going to get this passed through the Senate. I feel so confident. As much as we’ve come up with a really incredible health care plan, this has brought Republican Party together.

LISA DESJARDINS: Just an hour earlier, the Republican’s American Health Care Act squeaked through with a single vote to spare. As the vote count was read, supporters erupted in cheers.

MAN: The bill is passed and without objection, the motion to reconsider is laid upon the table.


LISA DESJARDINS: Twenty Republicans and every Democrat voted “no”. Democrats, who’ve said support of the bill would cost Republicans their seats, responded with taunts of “hey, hey, goodbye.”

DEMOCRATIC MEMBERS: Hey, hey, goodbye!

LISA DESJARDINS: It was the culmination of days of tension and hours of heated debate. House Speaker Paul Ryan, who just six weeks ago was forced to pull an earlier version of the bill, made an emotional plea.

REP. PAUL RYAN, R-Wis., Speaker of the House: A lot of us have been waiting seven years to cast this vote. Are we going to meet this test? Are we going to be men and women of our word?


REP. PAUL RYAN: Are we going to keep the promises that we made?


REP. PAUL RYAN: Or are we going to falter?



LISA DESJARDINS: Democrats summoned emotion too, insisting the vote was rushed, short-sighted and will hurt millions of Americans.

REP. NANCY PELOSI, D-Calif., House Minority Leader: Does Trumpcare protect seniors and families?


REP. NANCY PELOSI: Does Trumpcare — is Trumpcare good for our veterans?


REP. NANCY PELOSI: Is there any caring in Trumpcare at all?


LISA DESJARDINS: Just 24 hours earlier, a vote, much less passage, was uncertain. In the end, enough conservatives and a few moderates got on board to put the bill over the top. How did Republicans get those votes?

Two changes. First, a rescue amendment from New Jersey Republican Tom MacArthur. It allows states to waive out of essential benefits like hospital care, spending caps and requirements surrounding pre- existing conditions. States can only drop those things if they show it would improve the market. That brought some conservative votes, but raised other concerns about people with pre-existing conditions.

The answer? Another amendment, from Michigan’s Fred Upton, to add $8 billion to a $115 billion pot of money states can use to help the highest-risk patients. Democrats today called that amount a pittance.

REP. JIM MCGOVERN, D-Mass.: It is a lie. It is a lie. And let’s be honest about it: this does not cover people with pre-existing conditions and to come on a floor and say it does, to try to fool people — well, you may get away with it in the short term, you may get a headline. But I’ll tell you, people will figure out soon enough.

LISA DESJARDINS: Republicans countered, charging their opponents were ill-informed.

REP. DOUG COLLINS, R-Ga.: I believe probably the reason they won’t vote for it is they don’t understand it, because pre-existing conditions are covered. If you have coverage now, nothing in our bill, no matter what would come from the state or anyone else, would lose the pre-existing conditions. But I guess it’s just easier to talk your talking points.

LISA DESJARDINS: The bill would have sweeping other effects. Repealing Obamacare taxes and adding tax credits of a few thousand dollars, based on age and income.

But the most dramatic changes may be to Medicaid. The bill would cap benefits and phase out the expansion, for estimated cuts of $880 billion over a decade. That’s one reason the Congressional Budget Office concluded it would mean 24 million more uninsured Americans.

CROWD: Shame! Shame! Shame!

LISA DESJARDINS: As House members debated the measure inside the capitol, protesters gathered outside. The bill now goes to the Senate where it faces an extensive potential makeover and concerns from members of both parties.

As for House Republicans, they left the Capitol en masse, with smiles, headed to a one-week recess.

HARI SREENIVASAN: Lisa will be back, as we explore the politics and particulars of the Republican bill, after the news summary.