The much-criticized Obamacare replacement bill passed the House Budget Committee on Thursday with one vote to spare, as three conservative Republicans broke ranks to vote against Paul Ryan’s health care proposal.
Reps. Mark Sanford of South Carolina, Dave Brat of Virginia and Gary Palmer of Alabama voted against the legislation. Combined with unified Democratic opposition, the bill was reported favorably by a vote of 19-17.
“This is the conservative health care vision that we’ve been talking about for years,” Budget Committee chairman Diane Black of Tennessee said before the vote. “To my Republican colleagues who have doubts today, don’t cut off discussion.”
The bill now heads to the House Rules Committee, and GOP leadership aims to have a vote on the House floor by March 23.
“We’re very pleased with where we are, because we are on track and on schedule,” Ryan said of the bill during a press conference on Thursday as the Budget Committee took its vote. “We made a promise to repeal and replace Obamacare. We’re going to keep our promise to the people that elected us.”
House Budget Committee members were barred from issuing amendments to the bill, making them less powerful than members of the other committees that are considering the legislation.
But on Thursday the group of 22 Republicans, some of them out of step with the party’s leadership, came one vote short of offering Ryan and House leadership a stunning political defeat.
“This bill is on life support. It passed the Budget Committee by one vote,” said Rep. Debbie Wasserman Schultz, D-Fla. “It only passed that committee by one vote because they had Republican motions that actually pulled the bill towards the right. They are going to make it harder to have the bill pass the Senate.”
Sanford, Brat and Palmer are members of the Freedom Caucus, a group of conservative lawmakers who have voiced strong concerns that the current bill does not fully repeal Obamacare. Sanford called the bill a “watered down” proposal last week.
“I’m hopeful that as the members of this Freedom Caucus move along with us that they will bring forth all these good ideas that will continue to make the bill better,” Black said after the hearing.
Brat said he got “a little bit of leaning” from Republican leadership to vote in favor of the bill but ultimately voted against their wishes.
“The problem is it’s too much politics on the leaning,” Brat said. “You’ve got to get a bill through, and no one’s raving about the beauty of the efficiency of the health care market, it’s kind of a joke. When you write a bill you should be really happy about the outcome, it’s going to make insurance markets good and health care better and hospitals better, and this bill still has a few major steps to go.”
The rest of Thursday’s Budget Committee hearing after the vote consisted of short debates about motions to potentially change the bill. Motions are not formal amendments but merely recommendations offered along with the bill as it moves through the House. Every Democratic motion failed while every Republican motion passed. A few Democrats crossed party lines to vote in favor of a motion offered by California Rep. Tom McClintock that would restructure tax credits for low-income individuals.
Other Republican motions that passed would allow states to accept block grants for Medicaid and make able-bodied adults without dependents ineligible for Medicaid.
But none of the motions are actual changes to the bill, and the Rules Committee could choose to ignore the Budget Committee’s recommendations.
During his press conference, Ryan reiterated that President Donald Trump supports his effort to repeal parts of Obamacare.
“The president has been mediating, bringing people together, sitting around a table, hashing out our differences so that we can get to a consensus document,” Ryan said. “The goal here is get to a bill that we can pass and that actually is great policy, and the president is playing a very constructive role on this.”