GOP Obamacare replacement narrowly passes out of committee, after 3 Republicans defect

House Speaker Paul Ryan (Photo: Aaron P. Bernstein/Reuters)
House Speaker Paul Ryan (Photo: Aaron P. Bernstein/Reuters)

WASHINGTON — The GOP health care bill narrowly passed out of the U.S. House of Representatives Budget Committee on Thursday, after three Republicans joined all the committee’s Democrats in voting against it. The committee’s Republicans also unanimously passed several motions urging big changes to the bill that some members said needed to be made for it to pass in the House.

Three members of the conservative House Freedom Caucus — Reps. Mark Sanford of South Carolina, Dave Brat of Virginia and Gary Palmer of Alabama — voted against the overhaul of the nation’s health care system crafted by House Speaker Paul Ryan. The bill passed 19 to 17.

The three men cast the first Republican “no” votes against the bill since it was unveiled last week. The legislation has already passed out of two committees with no Democratic votes and unanimous GOP support. Since then, the Congressional Budget Office released its score of the legislation, predicting that 24 million people would lose coverage over 10 years and premiums would rise dramatically for older Americans, further stoking dissent among Republicans about the controversial bill. (The CBO predicted that premiums on average would go down in the individual market under the plan.)

After passing the bill, the committee’s Republicans passed several motions urging drastic changes to the way the legislation currently handles Obamacare’s Medicaid expansion. The GOP lawmakers unanimously recommended that the federal government stop funding the Medicaid expansion immediately — not two and a half years from now, as the Ryan legislation stipulates — and that Medicaid funds be distributed via block grants to states. They also voted to require a work requirement for childless adults without physical disabilities to receive Medicaid.

“Now is the time for leadership to step up before this gets to the floor, make an adjustment to this high match,” said Rep. Glenn Grothman, R-Wis.

In addition, five Democrats joined their Republican colleagues in passing a motion to change the bill’s tax credits, to provide more assistance to lower-income people. Rep. Tom McClintock, R-Calif., said that without the changes, “I doubt the bill will pass the Senate, and it if becomes law, I doubt it will be long before it’s repealed in the next Congress.” House conservatives have criticized the GOP leadership’s bill for not fully repealing Obamacare’s Medicaid expansion, but Republican moderates in the Senate have said they believe the government should continue funding the increased Medicaid match to states.

Budget Committee Chairwoman Diane Black of Tennessee told reporters after the markup that she believed the House leadership would be “open” to her committee’s suggested changes.

Before the vote, Black reminded her colleagues that the legislation would “rescue” their constituents from Obamacare and that Republicans had been promising to repeal and replace it for years.

“I cannot sit idly by and let this opportunity pass,” she said. “We made a promise to the American people.”

She urged her Republican colleagues to vote yes. “To my Republican colleagues who have doubts, today I encourage you: Don’t cut off the discussion.”

The committee’s ranking Democrat, Rep. John Yarmuth, D-Ky., used the CBO’s report to urge his Republican colleagues to vote no. “I don’t know what else needs to be said when 24 million people will lose their health coverage if we pass this bill,” he said.

Yarmuth said the bill was an “ideological” document that Republicans were rushing through the House so that they wouldn’t have to talk about it.

“There have been no congressional hearings on this legislation,” he said. “If I were them, I would not want to talk about this bill, either. I certainly would not want to defend it.”

Ryan says changes must be made to the health care overhaul before it can pass the House, but he has not detailed what those changes would be. House conservatives believe the bill’s tax credits create a new entitlement program, while Republican moderates in the Senate have balked at the prediction that millions would lose coverage under the plan. The bill now proceeds to the Rules Committee before it moves to the floor.

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