GOP healthcare plan clears second vote in House

March 9 (UPI) -- Congressional Republicans' proposal to replace the Affordable Care Act cleared its second major hurdle in the House on Thursday, setting up an imminent vote by the chamber's budget authorities.

The House Energy and Commerce Committee approved the American Health Care Act in a party-line vote of 31-23 Thursday afternoon, about nine hours after it was given a green light (23-16) by the House Ways and Means Committee. Both panels are responsible for any legislation to repeal and replace the 2010 law known as Obamacare.

Both approvals followed a marathon 27-hour session of testimony and discussions in the House about the GOP proposal, which has been criticized by Democrats and conservatives. Democrats, and some Republicans, oppose the bill because it reduces the number of people who will be covered. Conservatives say it doesn't sufficiently roll back ACA provisions.

"We've just passed historic legislation that will help Americans finally have access to affordable healthcare," the Ways and Means Committee wrote on Twitter Thursday. "We are delivering on our promise to bring relief from Obamacare and empowering Americans to make their own healthcare decisions."

The bill is also criticized for not explicitly addressing its cost. Earlier Thursday, Senate Majority Leader Mitch McConnell, R-Ky., said a Congressional Budget Office report next week will show the proposal's impact on the federal deficit.

"I think we need to know that," he said, adding that the report could be released Monday.

The legislation will next seek approval in the House Budget Committee. If it passes there, the bill should receive a full House vote within the next couple of weeks. After that, it would need Senate approval before heading to President Donald Trump's desk.

The AHCA's prospects in the full House and Senate, though, are unclear. The bill only won approval in committee by seven and eight votes, respectively, although it broke strictly along party lines.

House Speaker Paul Ryan promised this week that the bill will have the necessary 218 House votes to advance to the Senate.

"We as Republicans have waited seven years to do this," the speaker said Thursday. "This is the closest we will ever get to repealing and replacing Obamacare. The time is here. The time is now. This is the moment."

The AHCA can only afford to lose 21 GOP votes if it's going to pass the House, but it could lose more if Republicans can't assuage conservatives who are unhappy with it.

"House health-care bill can't pass Senate [without] major changes," Sen. Tom Cotton, R-Ark., tweeted Thursday. "To my friends in House: pause, start over. Get it right, don't get it fast."

"GOP shouldn't act like Dems did in [creating the ACA]. No excuse to release bill Monday night, start voting Wednesday. With no budget estimate!" he added. "What matters in long run is better, more affordable health care for Americans, NOT House leaders' arbitrary legislative calendar."

House Minority Leader Nancy Pelosi, D-Calif., a staunch opponent of GOP efforts to repeal the ACA, has said Republicans are trying to push the proposal through quickly -- and without advice on what it would cost or how many would be covered -- so the public can't get a good look at it.

"Republicans are rushing to hold votes before the Congressional Budget Office can detail the devastating consequences of their bill, both in terms of less coverage and higher costs," she said.

"I would think that people would want to know if their constituents would lose their insurance before they vote for this bill today," Rep. Diana DeGette, D-Colo., added.

Republicans answered by saying the CBO's analysis will be available before the bill comes up for a full House vote.

While lawmakers in Congress grapple with the bill's development, Trump said Thursday that everything is moving along smoothly.

"Despite what you hear in the press, healthcare is coming along great," he wrote in a tweet. "We are talking to many groups and it will end in a beautiful picture!"

"[The AHCA] wants everybody to have access to [health] coverage. That just did not happen under 'Obamacare,'" senior White House adviser Kellyanne Conway told Fox News Wednesday. "I'll call it 'Trumpcare' ... but I didn't hear President Trump say to any of us, 'Hey, I want my name on that.'

"This is serious stuff. This isn't about branding according to someone's name. This is serious business."

Wednesday, a group of organizations representing hospitals and nurses said they could not support the AHCA "as currently written," for multiple reasons -- including an estimated "substantial reduction in the number of Americans able to buy affordable health insurance or maintain coverage under the Medicaid program."

The organizations -- including the America's Essential Hospitals, American Hospital Association, the Association of American Medical Colleges, the Catholic Health Association of the United States and the Children's Hospital Association -- said maintaining deep provider reductions while also reducing coverage would reduce their ability to provide care to people who will become uninsured and those without adequate insurance.

"We are very concerned that the draft legislative proposal being considered by the House committees could lead to tremendous instability for those seeking affordable coverage. Furthermore, we are deeply concerned that the proposed Medicaid program restructuring will result in both the loss of coverage for current enrollees as well as cuts to a program that provides healthcare services for our most vulnerable populations," the organizations wrote in a letter sent to lawmakers. "As a result, we cannot support the American Health Care Act as currently written."

Other organizations, including the libertarian Cato Institute and the FreedomWorks and the Club for Growth conservative groups, have also criticized the plan.