Measure allows Congress to act without threat from Democrats
WASHINGTON — The House gave final approval Friday for speedy action to repeal the Affordable Care Act, putting Congress on track to undo the most significant health care law in a half century.
By a vote of 227-198, the House approved a budget blueprint that allows Republicans to obliterate major provisions of President Barack Obama’s health care law without the threat of a Democratic filibuster in the Senate.
President-elect Donald Trump, Speaker Paul Ryan and other Republican leaders face a much bigger challenge: devising their own plan to ensure broad access to health care and coverage while controlling costs. While their party is far from a consensus on how
to replace the health care law — under which more than 20 million Americans have gained health insurance — they will need votes from Democrats in the Senate to enact a robust replacement plan.
Republicans have argued that Americans have been crushed by soaring premiums and other unintended effects of the law, which was adopted without any Republican votes.
The vote, coming a week before Trump’s inauguration, places Republicans squarely in position to accomplish their longheld goal of dismantling Obama’s signature domestic achievement.
“This is a critical first step toward delivering relief to Americans who are struggling under this law,” House Speaker Paul Ryan of Wisconsin said, adding of the health care law, “This experiment has failed.”
Democrats warned that repeal of the health law would cause hardship for millions of Americans and create chaos in insurance markets and in the health care system, which accounts for about 18 percent of the nation’s economy.
“If we go down this path, we won’t have repeal and replace,” said Rep. John Yarmuth of Kentucky, the senior Democrat on the House Budget Committee. “What we’ll have is repeal and repent, because we’re going to owe a huge apology to the American people for the damage that we cause.”
“There’s still no plan for what comes next, threatening massive disruption to the entire health care system,” said Rep. Suzan DelBene, D-Wash.
In the days before the House vote, some conservative Republicans as well as moderates expressed discomfort about signing off on the budget measure without having a clearer picture of how and when Republican leaders planned to go about replacing the health care law. Nine House Republicans ended up voting against the budget blueprint Friday. No Democrats voted for it.
The votes this week — essentially procedural steps — represented the first of several moves that Republicans plan to make as they demolish the law that Obama so frequently lauded.
In the next few weeks, they say, they will try to devise a replacement, working closely with Trump and the man he has chosen to lead the Department of Health and Human Services, Rep. Tom Price, R-Ga.
Four committees — two in the Senate, two in the House — will write language repealing major provisions of the 2010 health law. The resulting legislation can be passed with simple majorities in both chambers and will be immune to a filibuster in the Senate.
Then, Republicans say, they will pass one or more free-standing bills to replace selected provisions of the Affordable Care Act. In the Senate, where Republicans hold 52 seats, they will need 60 votes to pass such legislation and will therefore need help from Democrats.
Trump voiced support this week for repealing and replacing the health care law nearly simultaneously, though it remained to be seen how Republicans in the Senate would be able to win over enough Democratic support to put in place a robust replacement for the existing health care law, given the need for those 60 votes.
Democrats tried to draw attention to what they said would be the devastating consequences of repealing the health care law.
Republicans, though, were eager to deliver on a central campaign promise. Rep. John Shimkus, R-Ill., said no one should be surprised that Republicans were moving swiftly to repeal the health law because they won control of the House in 2010, the Senate in 2014 and the White House in 2016 with promises to do just that.
“The public has rendered judgment,” Shimkus said.