PHOENIX — The U.S. House of Representatives passed a bill Thursday that would replace the Affordable Care Act, commonly referred to as Obamacare.
The bill will head to the Senate, where it faces an uncertain future.
The bill eliminates tax penalties former President Barack Obama’s law which has clamped down on people who don’t buy coverage and it erases tax increases in the Affordable Care Act on higher-earning people and the health industry.
It cuts the Medicaid program for low-income people and lets states impose work requirements on Medicaid recipients.
It transforms Obama’s subsidies for millions buying insurance — largely based on people’s incomes and premium costs — into tax credits that rise with consumers’ ages.
It retains Obama’s requirement that family policies cover grown children until age 26.
But states could get federal waivers freeing insurers from other Obama coverage requirements. With waivers, insurers could charge people with pre-existing illnesses far higher rates than healthy customers, boost prices for older consumers to whatever they wish and ignore the mandate that they cover specified services like pregnancy care.
The bill would block federal payments to Planned Parenthood for a year, considered a triumph by many anti-abortion Republicans.
Earlier this week, moderates objected that constituents with pre-existing conditions could effectively be denied coverage by insurers charging them exorbitant premiums. At least a dozen of them said Wednesday they would oppose the legislation, including GOP Reps. Charlie Dent of Pennsylvania, a moderate leader, Leonard Lance of New Jersey and New York’s Dan Donovan.
One Arizona Republican voted no on the bill.
But GOP leaders seemed to win over a raft of wavering lawmakers after adding $8 billion over five years for state high-risk pools, aimed at helping seriously ill people pay expensive premiums. That was on top of $130 billion already in the bill for states to help customers, though critics said those amounts were insufficient.
GOP candidates, including President Donald Trump, have made repealing Obama’s statute an epitome of their campaign pledges, claiming it’s a failing system that’s leaving people with rising health care costs and less access to care.
Democrats defended Obama’s law, one of his crowning domestic achievements, for expanding coverage to 20 million Americans and forcing insurers to offer more generous benefits. They said the GOP measure would toss millions off coverage while delivering tax cuts to the wealthy.
“How can you do this to the American people, how can you do this to the people you represent?” asked Rep. Jim McGovern, D-Mass.
The first attempt to pass a health care bill ended in failure six weeks ago, when Republican leadership pulled the legislation before a vote was even held. Disgruntled conservatives said the measure was too meek while GOP moderates said its cuts were too deep.
The nonpartisan Congressional Budget Office estimated in March that the GOP bill would end coverage for 24 million people over a decade. That office also said the bill’s subsidies would be less generous for many, especially lower-earning and older people not yet 65 and qualifying for Medicare.
A CBO estimate for the cost of latest version of their bill will not be ready before the House conducts its vote.
The Associated Press contributed to this report.