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Ryan Sets "Do-Or-Die" House Vote On Obamacare

Update: The schedule for the vote has been revealed...

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It's a big day for Paul Ryan and Republicans in the House.  With the stage set for another Obamacare repeal and replace vote later today, all eyes will be anxiously watching to see whether the day will end in another miserable, embarrassing defeat or whether a new healthcare bill will finally be sent to the Senate.

Republicans have become increasingly confident throughout he week that they have the votes after several moderate Republicans switched from 'no' to 'yes' after changes were made to allow for more funding to cover patients with pre-existing conditions.  According to Bloomberg, the Trump administration projected confidence about the outcome at a White House dinner last night after an aide joined the dinner late, saying the count had reached 218, two more than needed to guarantee passage. The aide added that he thought the final tally would top 220 votes, according to two people who attended.

Of course, no Democrats are expected to back the bill so Republicans can only lose 22 votes from their own party if everyone in the House casts a vote.

Meanwhile, Kevin McCarthy seemed somewhat confident as well after leaving Paul Ryan's office last night.

“Would you have confidence? We’re going to pass it."

 

"We will be voting on the health care votes tomorrow. Because we have enough votes. It'll pass. It's a good bill."

 

That said, and to our great 'shock', House Minority Leader, Nancy Pelosi, continued to trash the new healthcare legislation, per CNN...

House Minority Leader Nancy Pelosi blasted the bill and decision to vote Thursday.

 

"Forcing a vote without a CBO score shows that Republicans are terrified of the public learning the full consequences of their plan to push Americans with pre-existing conditions into the cold," Pelosi said in a statement. "But tomorrow, House Republicans are going to tattoo this moral monstrosity to their foreheads, and the American people will hold them accountable."

... even though, as we pointed out yesterday, Obamacare exchanges around the country continue fail in epic fashion with the latest casualty coming in Iowa where the last large insurer, Medica, just announced they'll abandon the Iowa exchange in 2018 leaving pretty much the entire state without a single option for purchasing health insurance.  Per the Des Moines Register:

Medica, a Minnesota based health insurer, released a statement suggesting it was close to following two larger carriers in deciding not to sell such policies in Iowa for 2018, due to instability in the market.

 

“Without swift action by the state or Congress to provide stability to Iowa’s individual insurance market, Medica will not be able to serve the citizens of Iowa in the manner and breadth that we do today. We are examining the potential of limited offerings, but our ability to stay in the Iowa insurance market in any capacity is in question at this point,” the company’s statement said.

Of course, all of this should come as little surprise to our readers as we've been writing for years that the entire Obamacare system was on the "verge of collapse" as premiums were soaring, risk pools were deteriorating and insurers were pulling out of exchanges all around the country leaving many Americans with just a single 'option' for health insurance (see "Obamacare On "Verge Of Collapse" As Premiums Set To Soar Again In 2017").  In fact, the following charts provide a stunning illustration of that collapse (charts per Bloomberg):

 

So, if the bill manages to pass the House, the real question becomes what happens in the Senate?

Assuming Republicans can pass the bill via the reconciliation process they'll only need a simple majority and they control 52 seats.  That said, at least eight Senate Republicans are strongly opposed to different elements of the bill which means modifications will be required to flip at least 7 Republican votes.

But, even if they're able to flip the votes required, Schumer has already threatened to throw up a procedural roadblock known as the "Byrd Rule."  The rule governs legislation passed under the special budget rules Republicans are using to pass the healthcare legislation. To pass muster, legislation must be primarily focused on addressing the deficit, which is why only provisions that have a budgetary impact can be included.  That said, Senate Democrats will argue that changes like an amendment that allows states to opt out of certain elements of the bill would violate the Byrd Rule. Per The Hill:

"To my moderate Republican colleagues in the House, I ask, 'Why would you risk a yes vote for a bill that is devastating to your constituents and has virtually a minuscule chance, virtually no chance of becoming law?' " Schumer asked on Wednesday.

 

He added that "the reality is TrumpCare cannot pass the Senate."

 

"The amendment to allow states to drop pre-existing condition requirements, for instance, very possibly violates the Byrd rule. If the moderate group in the House gets an additional amendment to the deal with the very same issue, that may violate the Byrd rule as well," Schumer said.

So what say you?  Does the Trump administration score it's first major legislative victory today or will Republicans deliver themselves another embarrassing defeat?