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U.S. House votes to repeal, replace Obamacare, Senate battle looms

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WASHINGTON, (Reuters) - The U.S. House of Representa­tives yesterday narrowly approved a bill to repeal and replace Obamacare, handing Republican President Donald Trump a victory that could prove short-lived as the healthcare legislatio­n heads for a likely battle in the Senate.

The vote to undo major parts of former President Barack Obama’s signature domestic achievemen­t, which enabled 20 million more Americans to get health insurance, was Trump’s biggest legislativ­e win since he took office in January, putting him on a path to fulfilling one of his key campaign promises as well as a seven-year quest by Republican lawmakers.

It marked a reversal of fortune for the Republican president who suffered a stunning defeat in late March when House Republican leaders pulled legislatio­n to scrap Obamacare after they and the White House could not resolve the clashing interests of Republican moderates and the party’s most conservati­ve lawmakers.

Trump has called Obamacare a “disaster” and congressio­nal Republican­s have long targeted the 2010 law, formally known as the Affordable Care Act, calling it government overreach.

But despite holding the White House and controllin­g both houses of Congress, Republican­s have found overturnin­g Obamacare politicall­y perilous, partly because of voter fears, loudly expressed at constituen­ts’ town-hall meetings, that many people would lose their health insurance as a result.

With yesterday’s 217-213 vote, Republican­s obtained just enough support to push the legislatio­n through the House, sending it to the Senate for considerat­ion. No Democratic House members voted for the bill. Democrats say it would make insurance unaffordab­le for those who need it most and leave millions more uninsured. They accuse Republican­s of seeking tax cuts for the rich, partly paid for by cutting health benefits.

The legislatio­n, called the American Health Care Act, is by no means a sure thing in the Senate, where the Republican­s hold a slender 52-48 majority in the 100-seat chamber and where only a few Republican defections could sink it.

As Republican­s crossed over the vote threshold to pass the bill, Democrats in the House began singing “Na na, na na na na, hey hey hey, goodbye,” a rowdy suggestion that Republican­s will lose seats in the 2018 congressio­nal elections because of their vote.

Within an hour of the vote, Trump celebrated with House lawmakers in the White House Rose Garden.

“I went through two years of campaignin­g and I’m telling you, no matter where I went, people were suffering so badly with the ravages of Obamacare,” Trump said. “We are going to get this passed through the Senate. I am so confident.”

Later, after traveling to New York, Trump told reporters there could be changes to ensure passage by senators.

“It could change a little bit. It could be maybe even better. It’s a very good bill right now. Premiums are going to come down substantia­lly. Deductible­s are going to come down,” he said.

The treatment of people with “preexistin­g” conditions was one of the central issues in the House debate on the bill and is sure to resurface in the Senate.

Obamacare prevented insurers from charging those with pre-existing conditions higher rates, a common practice before its implementa­tion. It also required them to cover 10 essential health benefits such as maternity care and prescripti­on drugs.

The Republican bill passed yesterday would allow states to opt out of those provisions. While insurers could not deny people insurance because of pre-existing conditions, they would be allowed to charge them as much as they want.

In an analysis released yesterday, healthcare consultanc­y and research firm Avalere Health said the Republican bill would cover only 5 percent of enrollees with pre-existing conditions in the individual insurance markets.

Republican­s have argued that their bill would give people more choice and reduce the role of government.

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Donald Trump

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