Updated on May 4 at 3:47 p.m. ET
For House Republicans, the burden of an unfulfilled campaign promise had simply become too much to bear alone.
And so on Thursday, after an embarrassing early failure and weeks of fits and starts, a narrow GOP majority passed legislation to partially repeal and replace the Affordable Care Act that even many of its supporters conceded was deeply flawed. The party-line vote was 217-213, with 20 Republicans voting against. The bill now goes to the Senate, where its fate is uncertain at best.
The American Health Care Act scraps the Obamacare mandates that people buy health insurance and that employers provide it, eliminates most of its tax increases, cuts nearly $900 billion from Medicaid while curtailing the program’s expansion, and allows states to seek a waiver exempting them from the current law’s crucial prohibition against insurers charging higher premiums to people with pre-existing conditions. Conservatives complained that the bill did not fully repeal the 2010 law, while moderates blanched at its cuts to Medicaid and its weakening of its most popular consumer protections.