Yesterday, by a vote of 217 to 213, the U.S. House of Representatives approved H.R. 1628, the American Health Care Act (AHCA), to repeal and replace the Patient Protection and Affordable Care Act (ACA). The House action follows committee markups by the House Ways and Means Committee, the Energy and Commerce Committee, and the Budget Committee, as well as a postponed House floor vote. After House Leadership pulled the bill from floor consideration on March 24, President Trump, Vice President Pence, and the House Republican Leadership spent weeks negotiating an agreement that would secure enough Republican votes for passage. The House adopted H.Res. 308, a rule enacting several policy amendments, and the AHCA was approved with only Republican support. All House Democrats and 20 House Republicans voted against the AHCA. Immediately prior to the AHCA vote, the House voted 429-0 to approve H.R. 2192, a bill to ensure that the AHCA state waiver provisions will apply to Members of Congress and congressional staff.

The Congressional Budget Office (CBO) estimate for the AHCA’s impact on the federal deficit and on health insurance coverage was not available prior to the House vote. A March 23 CBO score for an earlier version of the AHCA estimated the bill would provide $150 billion in deficit reduction over 10 years and would result in 14 million individuals being uninsured in 2018, increasing to 24 million in 2026.