House Passage of American Health Care Act and Outlook for Senate Action and Discussion
The U.S. House of Representatives narrowly passed H.R. 1628, the American Health Care Act (AHCA), by a vote of 217-213 on May 4, 2017, with all Democrats and 20 Republicans opposing the bill. The legislation traversed a perilous journey in the past two months and, only six weeks ago, appeared to be in jeopardy of never coming to a vote. However, a variety of changes were made after the bill was pulled from the House floor on March 24. The legislation now moves to the Senate, where it faces a very ambiguous future.
Assuming united Democratic opposition, Republicans can afford to lose the support of no more than two of their senators. Both conservative and moderate Republicans have expressed concerns about different aspects of the House legislation. It is possible that the Senate will start fresh with its own approach to "repeal and replace" the Affordable Care Act (ACA) rather than work from the House bill.
This memorandum reviews the major policy issues that challenged and divided House Republicans (and will similarly confront Senate Republicans) in their quest to "repeal and replace" the ACA.