(CN) – Republicans in the House of Representatives on Thursday narrowly passed the latest version of the Affordable Care Act repeal bill, fulfilling a major Trump campaign promise six weeks after failing to pass an earlier repeal measure.
The vote was 217-213, with all 193 Democrats in the House voting no. They were joined by 20 Republicans who dissented. One Republican did not cast a vote.
President Donald Trump immediately announced he will hold a victory press conference in the Rose Garden before departing for an already scheduled trip to New York.
After the repeal debacle in March, the Republican leadership in the House recrafted the measure to appeal more to hard-line conservatives.
That drew the ire of moderate Republicans who threatened to vote against the bill if something wasn’t done to help people with pre-existing medical conditions.
If the bill is passed by the Senate in its current form, it would:
- End tax penalties for individuals who don’t buy insurance coverage and larger employers who don’t offer coverage. Instead, insurers would apply a 30 percent surcharge to customers who’ve let coverage lapse for more than 63 days in the past year.
- End tax increases on higher-income people and a range of industry groups, including insurers, drugmakers and medical-device manufacturers.
- Cut the Medicaid program for low-income people and let states impose work requirements on Medicaid recipients.
- Prohibit states that haven’t already expanded Medicaid from doing so.
- Overhaul insurance-subsidy system, from one based largely on incomes and premium costs to a system of tax credits. The credits would rise with customers’ ages and, like the subsidies, could be used toward premium costs.
- Let states get federal waivers, allowing insurers to charge older customers higher premiums than younger ones with no ceiling. The Patient Protection and Affordable Care Act mandated limits in the difference in premium charges based on a mathematical formula.
- Block federal payments to Planned Parenthood for a year.
- Allow parents to cover grown children under their family policies to age 26, a holdover from the existing law.
The Senate is expected to significantly moderate spending cuts rolled into the plan. The GOP and President Donald Trump have made repealing the Affordable Care Act a priority ever since its enactment in 2010.
During a closed-door meeting Thursday morning, House GOP leaders reportedly told their members “It’s time to live or die by this day.”
The Associated Press contributed to this report.