House to vote on ACA repeal, replacement bill: 5 things to know

The House of Representatives is rapidly approaching a vote Thursday on the American Health Care Act, which will repeal and replace much of the ACA.

Here are five things to know about what's happening on the Hill.

1. A vote is scheduled for midday, according to multiple news sources. The Washington Post reports lawmakers want to finish the decision ahead of a recess that begins Thursday afternoon and lasts until May 16.

2. The scheduled vote indicates Republicans are confident they have the support needed to pass the bill. Assuming no Democrat votes for the bill, Republicans can only afford to lose a maximum of 22 votes. The Washington Post estimates 20 Republicans currently oppose or are leaning toward opposition and 36 are undecided. Another estimate from The Hill's "Whip List" puts the opposition at 17 Republican representatives in opposition, 50 unclear or undecided and 33 yes or leaning toward yes votes.

3. The bill is gaining support after Republicans made two amendments to the AHCA. The latest amendment was proposed this week by Reps. Fred Upton, R-Mich., and Billy Long, R-Mo., and four other Republican co-sponsors, according to The Washington Post. Dubbed the Upton amendment, the latest adds an additional $8 billion over five years for state-based high-risk pools established by a previous amendment. The previous amendment, named the MacArthur amendment for its sponsor, Rep. Tom MacArthur, R-N.J., allows states to file for waivers to opt out of the ACA's community rating rule. This rule prohibits payers from charging higher premiums to enrollees based on factors like age, gender or pre-existing conditions. However, if states opt out of the community rating, they would be required to set up a safety net, such as a high-risk pool, for people with pre-existing conditions.

4. The bill would repeal a good portion of the ACA. In addition to the provisions included in the MacArthur and Upton amendments, major changes under the AHCA would include a rollback of Medicaid expansion, restructured subsidies and a reduction in taxes created under the ACA, such as the surtax on investment income for high-earners.

5. In the end, the vote could be another fruitless political exercise. Even if the bill passes in the House, it will likely face greater scrutiny in the Senate, according to The Washington Post. Other reports confirm this take. Politico reported senators "have signaled little interest" in the AHCA thus far. GOP senators told The Hill they doubt the bill would pass in their chamber, but they are keeping quiet so House Speaker Paul Ryan, R-Wis., can have a win.


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