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March 8, 2017

The House GOP has an ACA repeal bill—but do they have the votes?

Daily Briefing

House Speaker Paul Ryan (R-Wis.) on Tuesday said he can "guarantee" that the House GOP's latest proposal to repeal and replace the Affordable Care Act (ACA) will get the 218 votes needed to pass in the House, but members of the House Freedom Caucus have said that might not be the case.

Ryan's comments

Ryan said the bill is at "the beginning of the legislative process" and will go through the regular committee process. The bill, he added, will "have the 218" votes need to pass through the chamber when it reaches the House floor. "I can guarantee you that," he said.

House Freedom Caucus pushes back

However, members of the House Freedom Caucus on Tuesday said the repeal and replace plan currently does not have the votes necessary for approval in the House.

After a caucus meeting, several members indicated that they would not support the legislation, though the caucus as a whole did not take a formal position on the proposal. Rep. Mo Brooks (R-Ala.) said, "Right now, [Ryan] does not have the votes to pass this bill unless he's got substantial Democratic support."

Similarly, Caucus Chair Mark Meadows (R-N.C.) said, "I don't know that there is a bill at this point that has the necessary 218 votes to coalesce around, and so we got more work to do as the Freedom Caucus to come up with a solution."

According to The Hill, members of the caucus will push their own legislation to repeal and replace the ACA.

House GOP bill also could face barriers in the Senate

Even if the Ryan-supported plan passes the House, it still could face barriers in the Senate, where Republicans have a smaller majority, The Hill reports.

Senate Republicans would seek to advance the legislation through the budget reconciliation process, which allows bills related to spending and revenue to pass by a simple majority of 51 votes, without being subject to a filibuster. Republicans lack a filibuster-proof majority in the Senate, but hold 52 seats in the chamber. As such, Republicans can only afford to lose two of their votes for the bill to pass, assuming the vice president breaks any resulting tie in their favor, The Hill reports.

Are the ACA exchanges really in a death spiral? We asked the experts.

According to The Hill, several GOP senators have voiced concerns about the legislation. Sen. Rand Paul (R-Ky.), for instance, said the bill likely will not pass because it is too similar to the ACA. "Th[e] House leadership plan is Obamacare Lite. It will not pass. Conserva[t]ives are not going to take it," he tweeted.

Further, some senators have expressed concern about the legislation's proposed changes to Medicaid.

GOP Sens. Shelley Moore Capito (W.Va.), Cory Gardner (Colo.), Lisa Murkowski (Alaska), and Rob Portman (Ohio) in a letter to Senate Majority Leader Mitch McConnell (R-Ky.) wrote, "We will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states."

Further, Molly Reynolds, a congressional analyst with the Brookings Institution, said some moderate senators who support Planned Parenthood might oppose the bill because it would cut off most federal funding for the organization. Sen. Susan Collins (R-Maine) and Murkowski have objected to such language.

Trump tries to quash opposition

President Trump, who has called the House GOP's new ACA repeal and replace legislation "wonderful," on Tuesday acted to quash some opposition to the bill, Politico reports.

For example, Trump tweeted that he was "sure that [his] friend [Paul] will come along with the new and great health care program because he knows Obamacare is a disaster!"

Separately, Trump during a meeting with 20 House GOP whips said he would use his power to support passage of the bill, vowing to summon opponents of the measure to the White House.

Rep. Dennis Ross (R-Fla.), who attended the meeting, said Trump confirmed that "he will do what's necessary and will have our backs" (Quigley, Politico Pro, 3/7 [subscription required]; Hellman, The Hill, 3/7; Shelbourne, The Hill, 3/7; Phillips, "The Fix," Washington Post, 3/7; Bolton, The Hill, 3/7; Sarvansky, The Hill, 3/7; Bade/Cheney, Politico, 3/7; Everett, Politico Pro, 3/7 [subscription required]).

What you need to know about the House GOP's repeal and replace plan

Our experts have dug into the GOP's new plan to understand how it will affect you, including its potential big changes to the individual insurance market and Medicaid program. 

Join us for a webconference on March 17 to learn the details and hear how you can prepare for changes to the ACA. Our last webconference on the politics of health reform filled up in record time, so reserve your spot today.

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