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House Passes AHCA, the ACA Repeal

By a vote of 217-213, the House passed a bill that would repeal parts of the 2010 health care law and change Medicaid from an open-ended entitlement system to one that limits states’ federal funding.

Passage fulfills a core Republican campaign promise of the past seven years. The measure, HR 1628, moves to the Senate, where supporters will face major challenges in passing it.

The legislation would replace the income- and cost-based subsidies for insurance in the health care law with an age-based tax credit beginning in 2020. It would effectively end the law’s expansion of Medicaid in 2020. It would block federal funding for Planned Parenthood for one year.

The bill would result in the loss of medical coverage for 24 million people by 2026, under a March Congressional Budget Office projection that did not take into consideration recent amendments. That analysis has not been updated. The Senate will not take up the measure until a new projection is released.

The bill would repeal taxes in the 2010 law for wealthier people with investment income, medical device manufacturers, health insurers and others. The CBO estimated the bill would reduce deficits by almost $337 billion over 10 years, under the earlier projection in March.

The House modified the original version by adding three amendments. One, by Rep. Tom MacArthur (R-NJ) would let states get waivers so they could exempt insurers from Obamacare minimum benefit rules and a ban on charging sick people higher prices. Another, by Rep. Fred Upton (R-MI) would provide $8 billion over five years to help people with medical conditions whose insurance premiums rose after a state got a waiver. The third, by Reps. Gary Palmer (R-AL) and David Schweikert (R-AZ)  would create a $15 billion federal program to help cover the costs of high medical claims.