Does the House Have the Votes to Pass ACA Repeal Bill?

As part of Republicans’ fast and furious push to repeal the Affordable Care Act (ACA), there is a vote currently scheduled for Thursday in the House of Representatives on the American Health Care Act (AHCA). However, there have been serious doubts in the days leading up that there are enough votes in the House to pass the bill.

At the beginning of the week, House Speaker Paul Ryan (R-Wisconsin) announced changes to the bill aimed at getting some wavering representatives to agree to vote for the bill. The changes were mostly made to appease conservative House Republicans and include allowing states to impose work requirements on able-bodied, childless adults in Medicaid, allowing states to receive Medicaid funds in as a block grant, and speeding up the end of ACA taxes.

The Washington Post has been keeping a running vote count, and as of Wednesday evening, there were still 24 House members who have are very strongly leaning against the bill or have said they oppose it. Another 25 House members expressed serious concerns. The GOP can only afford to lose 22 votes in the House. However, the vote could be close as 11 conservatives have “indicated they’ll switch their vote from ‘lean no’ to ‘yes’” if they get some affirmation that “there will be some big changes to the bill.”

Meanwhile, Vox has taken the time to predict 4 different ways the vote could go.

First, Ryan could follow in the steps of Nancy Pelosi, who was the House speaker in 2009 and 2010 when there were major votes on the ACA. Both times Pelosi managed to convince members to vote for the bill so that there were just enough votes to get the legislation through.

However, Ryan faces a more difficult task. Pelosi only had to win over moderates. Ryan has to convince staunch conservatives and moderates to vote for the bill, and these 2 groups are opposed for very different reasons that could be difficult to reconcile.

Second, Republican leaders could choose to postpone the vote if it looks like they won’t have enough votes to get the bill through the House. That would give them time to rework the bill, which the House Freedom Caucus would prefer.

Third, they could bring the bill to the floor and leave the vote open while Ryan pressures Republicans who vote “no” to change their vote until there are enough “yes” votes to pass the bill.

Fourth, the bill goes to the floor for a vote and it simply fails to pass, no matter what tactics Republican leadership tries.

House Republicans will have to answer to the president if they don’t pass the bill. The Wall Street Journal reported that President Donald Trump met with GOP members and directed comments toward Mark Meadows (R-North Carolina) the leader of the House Freedom Caucus, and said he would make life uncomfortable for Meadows if he didn’t vote for the bill.

If the bill does pass the House, Senate Majority Leader Mitch McConnell has vowed that the Senate will vote on the bill next week, according to a tweet from Eli Yokley, a reported at Morning Consult.

NEXT WEEK for #AHCA, @SenateMajLdr says: "We will reach a conclusion on health care because we're going to Judge Gorsuch a week after that."

— Eli Yokley (@eyokley) March 21, 2017

However, the Senate faces an even bigger vote challenge. The Post’s vote count shows 6 senators are strongly leaning against the bill or have said they outright oppose it and another 16 have expressed serious concerns. While the House can afford to lose 22 votes and still pass the bill, the Senate has a much smaller margin for error: only 2 Republicans can vote against it.

The assumption leading up to the vote is that no Democrats will break ranks to vote for AHCA. During America’s Health Insurance Plans’ National Health Policy Conference at the beginning of the month, Newt Gingrich, the former House speaker, made it clear that the vote will be complete partisan.

“Legitimately, no Democrat is going to vote to repeal Obamacare,” Gingrich said. “It guarantees they’ll have an extraordinarily tough primary. And they have no vested interest. Why would they do that?”