US House votes to repeal, replace Obamacare, Senate battle looms

The US Capitol is seen in Washington, DC, on May 4, 2017 after the House of Representatives narrowly passed a Republican effort to repeal and replace Obamacare, delivering a welcome victory to President Donald Trump after early legislative stumbles. (NICHOLAS KAMM / AFP)

WASHINGTON - The U.S. House of Representatives on Thursday narrowly approved a bill to repeal and replace Obamacare, handing Republican President Donald Trump a victory that could prove short-lived as the healthcare legislation heads for a likely battle in the Senate.

The vote to undo major parts of former President Barack Obama's signature domestic achievement, which enabled 20 million more Americans to get health insurance, was Trump's biggest legislative win since he took office in January, putting him on a path to fulfilling one of his key campaign promises as well as a seven-year quest by Republican lawmakers.

It marked a reversal of fortune for the Republican president who suffered a stunning defeat in late March when House Republican leaders pulled legislation to scrap Obamacare after they and the White House could not resolve the clashing interests of Republican moderates and the party's most conservative lawmakers.

With Thursday's 217-213 vote, Republicans obtained just enough support to push the legislation through the House, sending it to the Senate for consideration.

Trump has called Obamacare a "disaster" and congressional Republicans have long targeted the 2010 law, formally known as the Affordable Care Act, calling it government overreach.

But despite holding the White House and controlling both houses of Congress, Republicans have found overturning Obamacare politically perilous, partly because of voter fears, loudly expressed at constituents' town-hall meetings, that many people would lose their health insurance as a result.

With Thursday's 217-213 vote, Republicans obtained just enough support to push the legislation through the House, sending it to the Senate for consideration. No Democratic House members voted for the bill. Democrats say it would make insurance unaffordable for those who need it most and leave millions more uninsured. They accuse Republicans of seeking taxcuts for the rich, partly paid for by cutting health benefits.

The legislation, called the American Health Care Act, is by no means a sure thing in the Senate, where the Republicans hold a slender 52-48 majority in the 100-seat chamber and where only a few Republican defections could sink it.

Obamacare expanded Medicaid, the government insurance program for the poor, provided income-based tax credits to help the poor buy insurance on individual insurance markets set up by the law, and required everyone to buy insurance or pay apenalty.

The Republican bill would repeal most Obamacare taxes, which paid for the law, roll back the Medicaid expansion and slash the program’s funding, repeal the penalty for not purchasing insurance and replace the law’s tax credits with flat age-based credits.