U.S. House Republicans on Thursday sent a resounding message to the Senate on health care: It’s your problem now.
By a narrow margin of 217-to-213, House Republicans approved a major revision to the health law known as Obamacare, keeping a pledge to voters that they would try and repeal the law they unanimously opposed when it was passed in 2010.
The measure provides a political boost for President Donald Trump and House Speaker Paul Ryan, R-Wis., but it could be short-lived. The bill is extremely unpopular with many Americans because of forecasts that say it could lead to as many as 24 million people losing health coverage.
Rep. Tim Ryan, D-Niles, said the “political calculation” for House Republicans was, “We got rid of it, it’s not our baby anymore; it goes to the Senate and we keep our promises and if the Senate doesn’t pick it up, we blame the Senate.’ ”
Convinced that the bill will wreak political devastation among congressional Republicans in next year’s election, House Democrats in the chamber waved at GOP lawmakers and sang a rousing chorus of “Na Na Na Na, Na Na Na Na, Hey Hey, Hey, Goodbye” as the tally became final.
Republicans Mike Turner of Dayton and Sen. Rob Portman, R-Ohio, emerged as vocal critics of the bill. Turner joined David Joyce of Russell Twp. as the only Ohioans to break with their party and vote against the measure, and Portman made clear that he would vote against the bill in its current form.
Within moments of passage, Portman rushed out a statement declaring his opposition to the current House version. Although he said “the status quo” under Obamacare is “unsustainable,” he made clear the Senate would have to modify the House’s new restrictions on Medicaid, the joint federal and state program that provides health coverage to low-income people.
Gov. John Kasich relied on expanded Medicaid eligibility and hundreds of millions of federal dollars included in Obamacare to provide health coverage to more than 700,000 low-income people in Ohio.
Portman said he fears “this bill does not do enough to protect Ohio’s Medicaid expansion population, especially those who are receiving treatment for heroin and prescription drug abuse.”
“We have an opioid crisis in this country, and I’m going to continue to work with my colleagues on solutions that ensure that those who are impacted by this epidemic can continue to receive treatment,” Portman said.
Congress “must take responsible action that lowers health care costs,” Portman said, “but these changes must be made in a way that does not leave people behind.”
Sen. Sherrod Brown, D-Ohio, a vociferous opponent of the House GOP bill, said he agreed with Kasich that “we cannot allow Washington politicians with taxpayer-funded health insurance to rip coverage away from Ohioans who are battling cancer, getting regular checkups for the first time or finally getting treatment for their opioid addiction.”
Passage in the Senate, where Republicans hold a slim 52-48 margin, is not at all assured. And because the bill makes changes in the structure of Obamacare, Senate rules may force Republicans to round up 60 votes to completely overhaul the law.
Speaking at the White House Rose Garden, Trump predicted, “We’re going to get this passed” in the Senate and “as far as I’m concerned, your premiums, they’re going to start to come down.”
But Trump and Ryan had to bludgeon wavering Republicans to support the bill, even though everyone seemed to agree the Senate would either dramatically revise their bill or would not agree on any measure.
“This fight to fix our health care system isn’t over,” said Rep. Pat Tiberi, R-Genoa Twp., who supported the bill.
Turner said the bill would “leave our most vulnerable citizens with inadequate health coverage.
“I cannot support a health plan to replace Obamacare that puts my constituents’ health benefits at risk,” he said in a statement.
Rep. Joyce Beatty, who grew up in Dayton and now represents a district that includes Columbus, voted against the measure along with her three fellow Ohio Democratic colleagues in the House. She denounced the Republican bill as “misguided” and “a prescription for disaster for more than 129 million Americans with pre-existing conditions.”
Several Republicans said they voted for the bill knowing it would undergo further changes.
“Our job in the House isn’t to run the Senate,” Rep. Warren Davidson, R-Troy, said. “Our job is to do things in the House.”
Lawmakers had wrangled in recent days over the Republican plan to water down Obamacare’s requirement that insurance companies not charge higher premiums for people with pre-existing conditions, which can include high blood pressure or more serious medical issues.
At the demand of conservatives, the bill was modified to allow states to ask the federal government to exempt them from some of those rules. For example, the insurance company could charge a higher premium if a person with a pre-existing condition bought a policy in the exchanges and let it lapse for more than 63 days.
Davidson, the newest member of the state’s delegation, had opposed an earlier version of the bill but said he backed this version because it more directly deals with the high cost of insurance.
“No matter how sick you are you can buy insurance,” he said, though he admitted that the cost of such insurance could increase in price by up to 30 percent. “The reality is that’s a protection.”
The revised bill would also allow states to ask the federal government to exempt insurance companies from being required to provide insurance with a minimum package of benefits. The bill would not directly affect those who receive their insurance through employers or through Medicare.
Conservatives contended by changing the mandates, the price of insurance would decline. But Democrats have feared that people with pre-existing conditions will be unable to afford health insurance.
In addition, the bill infuriated abortion-rights advocates by prohibiting Medicaid dollars for Planned Parenthood clinics even though the organization does not use federal money for abortion services.
This is the second time the House has tried to pass a bill undoing the 2010 law. An earlier attempt failed to muster the votes, and House leadership chose to pull the bill rather than see it fail on the floor.
The Republicans rushed to vote on the bill without receiving guidance from the non-partisan Congressional Budget Office, which calculates the cost and impact of a bill. The move was lambasted by Democrats who chanted “Score! Score! Score!” on the floor Thursday — a reference to having the bill’s costs “scored” by the CBO.
The CBO in March concluded the original House Republican bill would increase the number of uninsured Americans by 24 million by the year 2026.
Rep. Bill Johnson, R-Marietta, speaking on the House floor, said the 2010 bill “resulted in millions of policy cancellations and millions of Americans losing their coverage because of the broken promises.”
“We didn’t hide in a back room to do what we’re going to do,” Johnson said during Thursday’s floor debate, to derisive laughter from Democrats in the chamber.
Rep. Jim Renacci, R-Wadsworth, who is running for governor of Ohio, said it was important to advance the bill to the Senate, where it will undergo further debate.
“The good thing is at least we’ll be able to finally hear how the Senate feels and what their issues are,” he said. “I’m a big supporter of learning from the process and hopefully making things better.”
Washington Bureau Chief Jack Torry contributed to this story.
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