US Senate Passage of House Bill Unlikely

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Despite the euphoria of House Republicans who supported the narrow victory of their health bill yesterday, 217-213, there is little chance a bill like it will pass the United States Senate.  The Senate may pass its own bill but it is likely to be dramatically different from the House version.  Then, it would have to go to  a conference committee for compromises which would probably be unacceptable to conservative Freedom Caucus in the House.

The House bill would be a disaster, causing at least 24 million to lose health insurance because the bill reduce subsidies to those most in need.  That was the estimate of the Congressional Budget Office of the previous version of the bill before it was made worse by provisions allowing states to opt out of requirements that insurance had to not discriminate against those with pre-existing conditions.  In addition, the bill will end Medicaid as a federal entitlement program in 2020 and turn it into a block grant to the states, cutting $880 billion.  Taxes in the Affordable Care Act for higher income Medicare beneficiaries would also be cut in the House bill, causing the long term health of Medicare to be decreased, moving the date forward by over three years to 2024 when the Trust Fund for Medicare couldn’t pay full benefits.

All New York Democrats voted against the bill with only Republicans John Katko and Dan Donovan voting against it.  The other seven Republicans in the state voted for it.   The issue is likely to be the centerpiece of the battle for control of the House of Representatives in 2018 and Republicans chances of holding it may be more endangered now.  Historic averages of losses for the first midterm of a party that controls the White House and the House and Senate is 35 seats.  Republicans would lose control of the House if they lost 23 seats.