WASHINGTON — The House of Representatives today narrowly approved a bill to dismantle the Affordable Care Act.

Legislators voted 217-213 to overturn many of the law’s popular consumer protections, eliminate the individual mandate, and recast the insurance market.

“This bill delivers on the promises that we have made to the American people,” said House Speaker Paul Ryan, (R., Wis.). “A lot of us have been waiting seven years to cast this vote … to rescue people from this collapsing law.”

The vote, on President Donald Trump’s 105th day in office, reinvigorates the Republican vow to reverse the signature legislative achievement of former President Barack Obama. But the House bill faces an uphill battle in the Senate, where its sharp spending cuts will almost certainly be softened. And any legislation the Senate passes will have to be reconciled with the House version.

Ryan and other Republicans said the GOP plan would boost competition, cut costs and return power to states and individuals. Keeping Obamacare, Ryan said, would mean “even higher premiums, even fewer choices, even more insurance companies pulling out.”

Democrats, none of whom voted with the majority, said the bill would deprive the poor and middle class of health insurance.

“Trumpcare eviscerates essential health benefits,” such as maternity care and prescription drug coverage, said House Minority Leader Nancy Pelosi, (D., Calif.),  “and guts protections for people with pre-existing conditions.”

The bill’s passage marked a dramatic rebound a month and a half after House leaders failed to garner sufficient votes to approve an earlier version of their bill, called the American Health Care Act.

The vote came after last-minute arm twisting, with moderates appeased by an $8 billion amendment for a high risk pool to help patients with pre-existing conditions pay for higher premiums and out-of-pocket costs.
Republicans went ahead with the vote without a full analysis of the legislation from the Congressional Budget Office. The CBO estimated the bill’s earlier version would cause an estimated 24 million people to forgo or lose insurance by 2026.

“There’s been a lot of drama, a little bit of trauma along the way,” said Rep. Tom Cole, (R., Okla.), a member of the House GOP leadership, according to USA Today. Cole and fellow party members dismissed concerns about having enough time to scrutinize the bill, debate it, and gauge its effect.

“We can’t wait a moment longer than necessary to provide relief,” said Rep. Diane Black, (R., Tenn.), USA Today reported. “Americans are suffering from rising costs. Under Obamacare, the situation is getting worse every day.”

B. Douglas Hoey, chief executive officer of the National Community Pharmacists Association, said, “House Republicans considered and passed this legislation under a process that greatly limited what provisions and policies could be considered germane, excluding virtually any of interest to community pharmacies.

Lawmakers intend to develop subsequent health care legislation to fill in the gaps. NCPA and its members will continue to engage lawmakers to champion priorities for community pharmacies during this process.

Hoey urged pharmacists to contact their representatives and senators to reiterate the importance of pro-patient, pro-pharmacist policies. “These include maintaining prescription drug coverage and ensuring adequate pharmacy reimbursement for patient care as well as sufficient access to community pharmacies and bipartisan transparency provisions related to PBMs in federal exchange programs.”

John Arensmeyer, founder and CEO of the Small Business Majority, expressed frustration and disappointment with the vote.

“This is an irresponsible and costly move that will do little more than create instability in the insurance market and greatly reduce the ability of small business owners, their employees and self-employed Americans to obtain health coverage,” he commented. “What’s more, we know small businesses strongly support the current health care law and oppose the replacement.”

Arensmeyer’s organization’s opinion polling found small businesses favor the Affordable Care Act over the American Health Care Act by two-to-one. The survey also found that small business owners oppose key components of the AHCA, and that nearly six in 10 support the ACA.