Republicans take first step toward 'Trumpcare'

By a vote of 217 - 213, Republicans managed to obtain just enough votes to push the bill through the House, sending it to the Senate for consideration. No Democrats voted in favor of the House bill.

US Vice President Mike Pence called it the beginning of the end of Obamacare, saying this was "a historic first step to repeal and replace Obamacare and finally give Americans the kind of health care they deserve."

Republican Representative Luke Messer (Indiana) said: "This is a step away from more government control of our health care and our day-to-day lives, and a return to freedom for all Americans."

No details on 'Trumpcare'

Trump - and other Republicans - had made overturning Obamacare a top priority in the 2016 campaign. The vote to repeal former US President Barack Obama's signature domestic achievement, which had enabled more than 20 million previously uninsured or underinsured Americans to get health insurance, is Trump's biggest legislative win since he took office in January. How it will be replaced remains to be seen.

Trump remarked that "what we have is something incredibly well-crafted. (…) We want to brag about this plan," without giving any details about the new plan.

Trump added we suffered with Obamacare. (…) People were suffering so badly with Obamacare," promising that premiums and deductibles "will be coming down."

"There are still many questions as to what exactly is in the bill and how it will affect people on ground," DW correspondent Maya Schwayder said on DW News.

Bill still has to pass through Senate 

In a push to pass the bill before representatives left for a week in their home districts, the House voted before the bill could be assessed by the non-partisan Congressional Budget Office (CBO), which is in charge of estimating its cost and effect on insurance rolls. The bill will reportedly be assessed by the CBO and fixes will be made before the Senate can get to vote on it.

In the Senate, where the Republican majority is narrow, lawmakers said the bill would face much greater scrutiny and skepticism. Republican Senator Bob Corker of Tennessee told reporters that the health care measure would spend "at least a month" in the Senate before a vote. Minority Leader Nancy Pelosi, the top Democrat in the House, criticized the bill, saying she expected it to be changed by the Senate.

Many changes, no alternative

Passed in 2010, Obama's Affordable Care Act paved the way to ensure universal health care in the United States. It set forth a mandate for everyone to buy insurance or pay a penalty, expanded Medicaid, the government insurance program for the poor, and also provided income-based tax credits to help the poor buy insurance.

The Republican bill, called the American Health Care Act, is designed to repeal most of the taxes which pay for Obamacare, undo the expansion of Medicaid, and revoke the penalty for not purchasing insurance, among other things.  

Republicans blamed Obamacare from the start for driving up health care costs and spent years working to repeal it. While private insurance companies also showed their disagreement with Obamacare, every major medical group, including the American Medical Association, American Hospital Association and the American Association of Retired Persons (AARP) opposed the Republican bill introduced by the Trump administration.

Pre-existing conditions as a bargaining tool

Republicans found that overturning Obamacare - which they have criticized as a manifestation of government overreach since its inception - proved to be an uphill battle, with many moderate Republicans refusing to support Trump's vision earlier on, afraid that it would leave too many people with pre-existing medical conditions unable to afford health coverage.

A number of skeptical Republican lawmakers got behind the bill after President Trump proposed a compromise, which would add $8 billion over five years to help cover the cost for people with pre-existing illnesses who could otherwise not afford insurance without Obamacare.

However, health care consultancy and research firm Avalere Health believes that the Republican bill featuring Trump's compromise could only cover 5 percent of enrollees with pre-existing conditions.

ss/sms (AP, AFP, Reuters, dpa)