The U.S. house of representatives, under its speaker, Paul Ryan,
finally passed the repeal of Obamacare, and replaced it with a
new plan for healthcare insurance. The vote was 217-213, two
votes more than necessary to pass the legislation.
An earlier version failed to gain enough support among the
members of the Republican majority, and was not even
brought to a vote. The reaction to this failure was considerable,
including censure from GOP President Trump who had
promised the repeal in the 2016 campaign.
The Affordable Care Act (ACA), or Obamacare as it was known,
was pushed through Congress in 2010 when the Democrats
held the majority in both the U.S. house and senate. The plan
incurred early and consistent criticism, and was a major
reason for Democratic election defeats in the mid-term votes
of 2010 and 2014. After it went into full effect, it fiscal viability
quickly came into question, as costs rose and major insurance
companies abandoned the plan.
The revised GOP plan is considered by its advocates as a notable
improvement over the earlier conservative version, although
20 Republicans voted ‘no” on the final measure. All Democrats
The legislation now goes to the U.S. senate where Republicans
have only a 52-48 majority. Some moderate GOP senators are
known to be unhappy with the legislation, and conventional
wisdom is that it will not pass there.
Even if the plan does pass the U.S. senate, any changes that
body makes must then go to conference (and, possibly,
reconciliation) and passage before it is sent to the president’s
desk for signing.
But immense pressure will now be on Republican senators to
okay the new legislation in advance of the 2018 mid-term
elections when conservatives have a rare opportunity to make
significant gains. Next year, only two GOP incumbent senate
seats are considered vulnerable, while 8-10 Democratic
incumbent seats are thought to be at risk. Should the GOP
senate majority fail to pass an Obamacare repeal bill, that
electoral opportunity could well be lost as national Democrats
would likely campaign against a “do-nothing” Congress
controlled by their opposition. GOP senate failure might also
harm efforts by the Trump administration to gain enough
votes for its next priority, tax reform.
Senate Majority Leader Mitch McConnell, who skillfully
guided the supreme court nomination of Neil Gorsuch to
confirmation, now has perhaps an even greater challenge
with the healthcare legislation just sent to the U.S. senate.
Speaker Paul Ryan, whose star had dimmed significantly after
the first effort to repeal Obamacare failed, has regained much
momentum, and President Donald Trump has achieved a
major short-term victory. Mr. Trump has also had a hard
lesson in the Washington, DC legislative process, and it will
be instructive to observe what he has learned in the months
ahead as he tries to play a key part in transforming his
Republican majority into a cohesive and cooperating
A true victory in healthcare insurance reform only takes place
when final legislation lands on the president’s desk and he
Copyright (c) 2017 by Barry Casselman. All rights reserved.