After its first draft didn't even make it to a vote, the GOP's latest attempt at a healthcare bill passed the U.S. House of Representatives on Thursday.
The American Health Care Act – also referred to as "Trumpcare"or AHCA – passed the House by a vote of 217-213.
It 's been a controversial proposal even within the Republican party, with the GOP managing to pass it this time by making concessions to members of the hardline right House Freedom Caucus, which opposed the first draft of the act.
Nonetheless, 20 Republican representatives still voted against the AHCA on Thursday. These Republican "nay" votes didn't include Minnesota's GOP Reps. Erik Paulsen, Jason Lewis and Tom Emmer, who all voted in favor of it.
All of Minnesota's Democratic representatives voted against the bill, as did every other Democrat in the House.
The bill now goes to the U.S. Senate, where it is expected to face a tougher journey to passage.
What Minnesota's congresspeople said
Third District Rep. Paulsen had been undecided on whether to vote for the AHCA or not, But hours beforehand, his office confirmed to MinnPost he would be in favor of it.
In a statement after the vote, Paulsen said the status quo under the Affordable Care Act is "no longer acceptable" as Americans need relief from "skyrocketing costs, diminishing choices and limited access."
"This is just the latest step in reforming our health care system to be more patient-centered, and my focus remains on finding solutions that will make sure Americans have access to high quality, affordable health care."
And here's what Rep. Lewis had to say:
Democratic Rep. Keith Ellison had a different take, saying in a statement: "Calling this bill the 'American Health Care Act' is a cruel irony – 24 million Americans will likely lose their coverage.
"Hundreds of millions of people who get their insurance through their employer could see their plans slashed. Seniors and people with pre-existing conditions will be priced out of their insurance plans. And as many as one million Minnesotans who have received affordable care through the expansion of Medicaid, essential health benefits, or the exchange will be worse off."
Rep. Betty McCollum had this to say.
Why was the vote so close?
One of the reasons the bill faced pushback from moderate Republicans is because of the removal of some provisions created under the Affordable Care Act, which the AHCA is designed to replace.
As Vox reports, under the new bill, states will have the option to get waivers so they can opt out of requirements that insurers cover "essential health benefits" such as hospitalization, pregnancy and maternity care, rehabilitative services and mental health services.
They can also get waivers to the rule that says all people – whether healthy or sick – should be charged the same price for health insurance. Scrapping this requirement could see people with serious pre-existing conditions (such as cancer) experience huge hikes in their costs if they apply for insurance after having a gap in coverage.
There would be subsidies available for these people, but FiveThirtyEight notes subsidies overall are being cut under the AHCA. Same goes for the expansion of Medicaid.
The decision to vote this week also raised some eyebrows given that the Congressional Budget Office has not yet ruled on the economic impact of the new bill. When the first draft was released, the CBO found it would reduce federal deficits by $337 billion over the next decade, but at the same time would cause 24 million people to lose their health insurance.
Democrats argue the AHCA is a tax cut for the rich, mainly because the money the government will save compared to the Affordable Care Act will be used partially to fund the tax cut plan President Donald Trump revealed last month. That tax cut plan includes a 4.8 percent income tax cut for the nation's richest, as The Atlantic reports.
Republicans in favor of the plan however say it will create more choices for consumers and lower prices overall, while retaining some of the protections put in place under Obamacare, Yahoo explains.