House Republicans plan to vote Thursday on the American Health Care Act bill, their long-stalled Affordable Care Act change measure, setting up a high-stakes test given the continuing doubts about whether they have enough votes to guarantee passage.
“We’re going to pass it,” House Majority Leader Kevin McCarthy told reporters Wednesday evening, adding that “we have enough votes.”
The decision comes after several weeks of agonizing over how Republicans would deliver on seven years of promises to repeal Obamacare, as well as intense pressure from the White House to hold the vote. Even so, a number of GOP moderates remain opposed or undecided, adding significant suspense to the Thursday vote.
A key momentum shift came Wednesday morning, when Representative Fred Upton reversed his earlier opposition and embraced the bill after a meeting with President Donald Trump. He told reporters that he would vote for the measure once a new amendment he helped devise is added that would boost funding for people with pre-existing conditions.
“I think it is likely now to pass in the House,” Upton said at the White House.
It remains unclear whether Upton’s reversal swayed many other holdouts. A White House official Wednesday night said they had at least 218 votes, which would be enough to ensure passage.
Several moderates, including Representatives Charlie Dent of Pennsylvania, Leonard Lance of New Jersey and Ileana Ros-Lehtinen of Florida, said Wednesday they remain opposed even with the latest changes.
“I’m still a no,” Lance said, adding that Upton’s amendment isn’t enough to resolve his concerns about coverage for people with pre-existing conditions.
Upton’s amendment, which he said would be posted later Wednesday, would provide $8 billion over five years to reduce premiums and other costs for those with pre-existing conditions who have a gap in coverage and reside in states that received waivers from some of Obamacare’s requirements under another provision in the bill.
Representative Walter Jones of North Carolina said he remains opposed to the bill, and that some Republicans were talking privately about how little money was actually being added under Upton’s amendment.
‘Hard to Believe’
He said one colleague told him he finds “it hard to believe members would change their vote for $8 billion.”
Jones said he talked to his state’s insurance commissioner, who gave him an estimate of up to 100,000 North Carolinians ending up in the high-risk pool, which would lead to additional costs of as much as $1.5 billion.
“Just in North Carolina,” he said. “So, all the money they’re talking about, I’m just talking about one state.”
Even so, Upton’s reversal gave new energy to the GOP bill, which on Tuesday appeared to be well short of the votes needed for passage, with a number of moderates opposed.
Since no Democrats are expected to vote for the bill, Republicans can only lose 22 members of their party if everyone in the House casts a vote.
Even if the bill makes it out of the House, it remains well short of the 50 votes it would need in the Senate. A number of senators are unhappy with an earlier Congressional Budget Office estimate showing it would result in 24 million more people without insurance within a decade and skyrocketing premiums for lower-income people, particularly those over the age of 50.
At least eight Senate Republicans have expressed significant reservations about different elements of the bill, including the recent changes related to pre-existing conditions, and GOP leaders can only afford to lose two votes.