The Republican plan to replace the Affordable Care Act passed the House of Representatives by a vote of 217 to 213, only one vote above the 216 needed for passage.
The bill now moves to the Senate, where the chances of passage are expected to be even slimmer.
Here are some of the highlights of the health care bill:
Here are the key measures in the House bill:
- Mandates: It guts the IRS requirement that people face a fine for not purchasing health insurance.
- Tax credits: Income-based subsidies enabling people to purchase insurance in the individual market will be replaced with refundable tax credits based on age.
- Medicaid: The Medicaid expansion is frozen immediately. In two years, the states have the choice of adopting a block grant for the program or coming up with a new formula based on population instead of need. Work requirements have been added for most able-bodied recipients who aren't pregnant or caring for a child under 6.
- High-risk pools: The bill provides $130 billion to states over 10 years for high risk insurance pools to cover the most expensive to insure. An additional $8 billion will assist people with pre-existing conditions.
- State waivers: States can obtain waivers so insurers don't have to offer benefits packages that include maternity care and mental health coverage. Waivers can also be obtained to charge sicker people and people with pre-existing conditions more. Those people would most likely then go into the high-risk insurance pools.
- Taxes: It repeals every tax in the Affordable Care Act, including the .9 percent tax on couples making more than $250,000 and a 3.8 percent tax on investment income.
- Health Savings Accounts: The measure increases the allowable contribution limits of health savings accounts.
- Other: It continues to permit people under the age of 26 to stay on their parents' insurance.