Today on the Hill: AHCA House Floor Vote Scheduled, Latest Whip Count Suggests Passage

After weeks of wrangling, an initial failure before the Easter recess, and the addition of two amendments to placate both the conservative and moderate wings of the party, the House is scheduled to hold a floor vote today on the American Health Care Act (AHCA) (H.R. 1628). While the vote will likely be very close, Republican leaders have expressed a high degree of optimism on passage and the fact that a floor vote has been formally scheduled signals that they are confident they will have the votes. With unanimous Democratic opposition, the bill can survive 22 Republican defections and still pass on a simple majority in the lower chamber. Whip counts from various media outlets suggest that between 16 and 20 Republicans remain in the “no” column, although that number may continue to change throughout the morning. A vote series on the legislation is expected between 1:15 PM and 3:00 PM this afternoon.

The dramatic turnaround comes after two moderate Republican skeptics of the bill – Reps. Fred Upton (R-MI) and Billy Long (R-MO) – met with Republican leaders and President Trump at the White House yesterday to craft a new amendment designed to mitigate the effects possible state waivers to Affordable Care Act (ACA) community rating rules would likely have on the affordability of insurance for individuals with pre-existing conditions. The Upton amendment, as the change is now known, would provide $8 billion between 2018 and 2023 to pay the continuous coverage penalties imposed on individuals with pre-existing conditions in states that have waived the ACA community rating rules. Combined with the MacArthur amendment, which set up the state waiver process and persuaded the conservative House Freedom Caucus to support the legislation, the bill looks set to gain the approval of enough conservatives and moderates to secure passage.

Last night, the House Rules Committee set the parameters of floor consideration, determining that the bill will be considered under a closed rule that provides for one hour of debate, divided equally between the control of Democrats and Republicans. It waives all points of order against consideration of the bill and effectively incorporates the following four amendments into the measure:

1. MacArthur – create a state option to obtain waivers from ACA essential health benefits provisions and community rating rules;
2. Upton – includes $8 billion from 2018 to 2023 to pay the continuous coverage penalties imposed on individuals with pre-existing conditions by the MacArthur Amendment;
3. Palmer-Schweikert – adds $15 billion for invisible high risk pools (analogous to reinsurance); and
4. McSally – adds $15 billion for maternity and mental/behavioral healthcare.

In the upper chamber, senators will take their turn in considering the $1 trillion omnibus (H.R. 244) that provides government funding for the remainder of the fiscal 2017 year. Despite last-minute objections from Sen. Lindsay Graham (R-SC), the bill is likely to be approved and avoid any possibility of a government shutdown when the current continuing resolution expires tomorrow. According to Senate Democrats’ official floor schedule, it is “expected that an agreement will be sought to complete work on the bill during Thursday’s session.” Senate approval today would send the bill to the White House for President Trump’s signature