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POLITICS

House Clears Path for Repeal of Health Law

By THOMAS KAPLAN and ROBERT PEARJAN. 13, 2017
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House members left the Capitol after morning votes on Friday in Washington. Credit Al Drago/The New
York Times
WASHINGTON The House cleared the way on Friday for speedy action to repeal the Affordable Care
Act, putting Congress on track to undo the most significant health care law in a half-century.

With a near party-line vote of 227 to 198, the House overcame the opposition of Democrats and the
anxieties of some Republicans to approve a budget blueprint that allows Republicans to end major
provisions of President Obamas health care law without the threat of a Democratic filibuster in the
Senate.

President-elect Donald J. Trump, Speaker Paul D. Ryan and other Republican leaders now face a much
bigger challenge: devising their own plan to ensure broad access to health care and coverage while
controlling costs. While their party is far from a consensus on how to replace the health care law
under which more than 20 million Americans have gained health insurance they will need votes from
Democrats in the Senate to enact a robust replacement plan.

Republicans have argued that Americans have been crushed by soaring premiums and other unintended
effects of the law, which was adopted without any Republican votes.

Continue reading the main story

This is a critical first step toward delivering relief to Americans who are struggling under this law, Mr.
Ryan said, adding, This experiment has failed.

Democrats warned that repeal of the health law would cause hardship for millions of Americans and
create chaos in insurance markets and in the health care system, which accounts for about 18 percent of
the nations economy.

If we go down this path, we wont have repeal and replace, said Representative John Yarmuth of
Kentucky, the senior Democrat on the House Budget Committee. What well have is repeal and repent
because were going to owe a huge apology to the American people for the damage that we cause.

Representative Suzan DelBene of Washington, a Democrat, said, Theres still no plan for what comes
next, threatening massive disruption to the entire health care system.

In the days before the House vote, some conservative Republicans, as well as moderates, expressed
discomfort about signing off on the budget blueprint without having a clearer picture of how and when
Republican leaders planned to replace the health care law. Nine House Republicans ended up voting
against the budget measure on Friday. No Democrats voted for it.

Share Your Experience With the Affordable Care Act

The Times would like to hear from Americans who purchased health insurance under the Affordable
Care Act.

The Senate approved the same measure early Thursday by a vote of 51 to 48. The House and Senate
votes this week essentially procedural steps represented the first of several moves that
Republicans plan to make as they work to unwind the health care law.

In the coming weeks, they say, they will try to devise a replacement, working closely with Mr. Trump
and his choice to lead the Department of Health and Human Services, Representative Tom Price of
Georgia.

Four committees two in the Senate, two in the House will write language repealing major
provisions of the 2010 health law. The resulting legislation can be passed with simple majorities in both
chambers, and will be immune to a Democratic filibuster in the Senate.

Then, Republicans say, they will pass one or more free-standing bills to replace selected provisions of
the Affordable Care Act. In the Senate, where Republicans hold 52 seats, they will need help from
Democrats to reach the 60 votes necessary to approve such legislation.

Mr. Trump voiced support this week for repealing and replacing the health care law essentially
simultaneously, though it remained to be seen if Republicans in the Senate can win enough Democratic
support to adopt a replacement for the existing health care law, given the need to reach 60 votes.

In the House debate on Friday, Republicans and Democrats offered wildly differing views of health care
and health insurance.

Representative Jason Lewis of Minnesota, a first-term Republican, said he had firsthand experience with
the Affordable Care Act.

Minnesotans have seen their health insurance choices shrink while their premiums, co-pays and
deductibles skyrocket, Mr. Lewis said. I should know. For the last, in fact, over five years, Ive been in
the individual market, and my own insurance premiums have nearly tripled, and Ive gone through three
insurers. Minnesotans have seen a 50 to 67 percent increase in the premium cost this year alone.

The House Democratic leader, Representative Nancy Pelosi of California, who helped engineer passage
of the health law, defended it on Friday, saying that every American benefited.

The Republicans are feeding their ideological obsession with repealing the A.C.A. and dismantling the
health and economic security of hard-working families, Ms. Pelosi said. For six years, she said,
Republicans have had the chance to put forth an alternative, but weve seen nothing.

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Echoing their colleagues in the Senate, Democrats asked how Republicans planned to go about replacing
the Affordable Care Act a complex, arduous task, as Democrats know from their own experience
developing and passing the health law in the first place.

When you put pen to paper, all hell is going to break loose on your side, said Representative Peter
Welch, Democrat of Vermont.

Democrats also tried to draw attention to what they said would be the devastating consequences of
repealing the health care law.

Over and over, after a Republican member spoke out against the law, Mr. Yarmuth offered several data
points specific to the members home state, including how many people would lose their health
coverage.

Republicans, though, were eager to deliver on a central campaign promise. The public has rendered
judgment on this health care law, said Representative John Shimkus of Illinois.

The differing views among House members on Friday foreshadowed the acrimony that is all but certain
in the weeks to come, as Republicans press ahead with their repeal efforts over Democrats strenuous
objections.

So far, lawmakers have shown some creativity in trying to explain the wisdom or lack of wisdom in
moving forward with a repeal.

On Friday, Representative Drew Ferguson of Georgia, a freshman Republican, likened the health care
law to a goat that had been let loose in a persons home.

Now for six years, that goat has been messing in and destroying my house, he said. I want to
renovate my house, but before I can, I have to get the goat out of the house before it does any more
damage. It makes no sense to start fixing up my house until we get the goat out.

Voting for the measure on Friday, Mr. Ferguson said, would get rid of the goat.

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A version of this article appears in print on January 14, 2017, on Page A1 of the New York edition with
the headline: House Clears Path for Repeal Of Health Law. Order Reprints| Today's Paper|Subscribe

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