But they also recognized the potential of a political gift, readying attack ads against GOP lawmakers who voted to strip health benefits from their constituents in service of an unpopular president. Republicans won no cover from leading health-care industry groups, who opposed the bill en masse. A widely-cited Quinnipiac University poll in March found that just 17 percent of respondents backed its passage, and that was before Republicans amended the measure to allow states to weaken popular consumer protections. And by holding a vote after limited public hearings, back-room deals, and without fully understanding the impact of the bill, the GOP opened itself up to the same criticisms it leveled (falsely, in some cases) against Democrats in 2010.
“They have this vote tattooed on them. This is a scar they will carry,” warned House Minority Leader Nancy Pelosi, who as speaker in 2010 shepherded the Affordable Care Act to passage. “Whatever happens down the road, the members of the House Republican caucus will be forever identified with the worst aspects of the bill they have passed.” As the vote ended on Thursday, Democrats waved to Republicans and chanted, “Nah nah nah nah, hey hey, goodbye.” It was a taunt Republicans tossed at Democrats back in 1993 when they voted for a tax increase until President Bill Clinton and saw their House majority disappear the next year.
Under intense pressure from the White House, Republicans cast their effort as a rescue effort to save Americans from a “collapsing” health-care law. They cited state after state in which insurers had pulled out of the individual market, leaving few choices and higher premiums for consumers. “This is a crisis, and it is happening,” Ryan said in an impassioned closing floor speech that drew cheers from Republicans. He called for lawmakers to “end this failed experiment” in health policy. “A lot of us have been waiting seven years to cast this vote.” As he wrapped up, Republicans chanted “Vote! Vote!” while Democrats shouted, “Where’s the score?” in reference to the missing budget projection. Meanwhile, Trump watched the vote from the White House, tweeting criticism at Democrats and preparing to welcome Republicans lawmakers for a celebratory press conference in the Rose Garden “if victorious.”
For House Republicans, the dozens of votes to repeal or roll back Obamacare they took over the years had been relatively easy, free of political or substantive consequences because the bills had no chance of becoming law. But this year was different. With control of Congress and Trump in the White House, they were, as more than one member acknowledged over the last several weeks, “shooting with live bullets.” (Their critics put it another way: They were “the dog that caught the car.”)
And yet, what pushed some reluctant members to vote yes in the final days was the growing realization that this bill, too, would not become law. Not as it is currently written. As many hurdles as the American Health Care Act has overcome among Republicans in the House, it faces even more among the considerably narrower GOP majority in the Senate, where party leaders must win over 50 out of the chambers 52 Republicans. Numerous senators have criticized aspects of the legislation, and shortly before the House vote on Thursday, Senator Lindsey Graham of South Carolina warned that the bill should be “viewed with caution.” Afterwards, top senators said they would work on drafting their own legislation, suggesting that the House bill might not even see a vote in the upper chamber.