Republicans in the House of Representatives voted today to approve a version of the American Health Care Act, their bill to repeal and replace Obamacare. The biggest effects of the bill will be on the millions of additional Americans who would go without health insurance if a similar bill is passed by the Senate. But it could also endanger the job prospects of the Republican members of Congress who voted for it and make a Democratic takeover of the House substantially more likely in 2018.
The previous version of the AHCA — which died in the House in March before it came to a floor vote — was an exceptionally unpopular bill. Polls in mid-March had opposition outweighing support for the bill by an average of almost 15 percentage points, and the numbers were getting worse; most notoriously in a Quinnipiac poll that showed just 17 percent of Americans supporting the bill and 56 percent opposed.
The various amendments to the AHCA since then — which were mostly made to placate the Freedom Caucus and have pushed the bill further to the right — aren’t likely to make it any more popular. Some of the amendments could even affect people who receive insurance from their employers in addition to those who receive Medicaid or buy insurance on the Obamacare exchanges. Republicans are also playing with political fire to pass such a bill before the Congressional Budget Office has scored the amendments and estimated how many additional people might gain or lose coverage.