By a narrow 217-213 vote, the U.S. House of Representatives passed a plan May 4 that would, in essence, replace major provisions of the Affordable Care Act (ACA), also known as Obamacare. The bill now goes on to the U.S. Senate, which has signaled it intends to significantly modify the bill.

This was the second attempt to move the bill through the House; the first attempt resulted in GOP pulling the bill for lack of support. Thursday's vote went nearly down party lines, with 20 Republicans joining with Democrats to oppose the measure. 

The bill repeals the core elements of ACA, including subsidies to help people get insurance coverage, expansion of Medicaid, taxes and mandates for people to get coverage. 

The replacement plan provides a new tax credit aimed at helping people buy insurance, though it would provide less help than ACA to low-income people.

A key component in the bill that helped to garner support from conservative House members was an amendment that allows states to apply for waivers to one of ACA’s key protections for people with pre-existing conditions. If that were repealed in a state, insurers could go back to charging exorbitant premiums to people based on their health, which could put coverage out of reach for many. 

Also, a last-minute addition of $8 billion more in funding for people with pre-existing conditions was key to winning over several on the fence moderates.

The bill now goes to the Senate, and House Members must wait to see how the Senate modifies the bill. 

Source: Mark Riso, vice president of Legislative Affairs, PHCC — National Association.