House passes health care reform - why is this a win?

As I understand it, in the US government, legislation needs the approval of both the
House and the Senate to pass.
Yesterday, the House passed new health care guidelines and the press claims this as a victory for Trump.
Isn’t this calling it too soon. Doesn’t the Senate have to pass it as well and the President sign it (a no brainer I know).
From what I have heard, the Senate is unlikely to pass this so isn’t it back to square one?

I think the expectation is the Senate will greatly change it, but not kill it. I’m nowhere fully informed on it but I would wager as long as any healthcare law is passed they can say it’s been delivered and start cutting taxes on the rich.

It’s a win because the previous attempt failed due to disagreements within the more radical wing of the Republican party. This new version of the bill was meant to placate some of their concerns, but it also had the effect of alienating moderate Republicans. Eventually the House leadership was able to whip enough moderates into place in order to pass the bill. That’s good press for the House leadership, the party, and Trump.

You’re right that the bill must pass both houses before it can become a law, and there’s no way in Hell the current version will pass the Senate. They are already working on their own version which, if passed, will need to be reconciled with the House version through conference committee. (Or the House could simply decide to pass the Senate version. But they won’t.)

Which headline is going to sell more newspapers:

  1. Big win form Trump on Healthcare!

  2. Healthcare Change Likely to Die in Senate.

I think the OP is asking why the Trump administration & House Republicans are acting like they won. The answer, IMO, is that it’s further than they got before, and they needed something to celebrate.

For what it’s worth, today’s headline on the New York times is “HEALTH CARE BILL, PASSED BY HOUSE, FACES SENATE TEST”

It’s a win for Paul Ryan and the Republican Establishment. They showed they could put a winning coalition together to pass a bill they’ve been promising for years. The win is purely symbolic and internal but pundits assume that it presages further bills.

At this point, political hype. Think of it as an extended Trump rally preaching to the faithful.

Reports from the Senate say the House bill is dead on arrival. The Senate Republicans have their own plan. Whether they (Senate) goes with their own plan, or modifies it to incorporate the House bill remains to be seen. GovTrack says there’s a 13 percent chance the House bill will become law.

This.

If factual, the headlines should be reading “Republican factions agree on something. For once.”

They’ve spent years convincing a huge swath of Americans that Obamacare is going to kill their grandparents and bankrupt the country.

They’re celebrating it as a win because they have to **sell **it as a win.

Agree. It’s a “win” by the narrowest, most PR-related measurement. It is a win for Trump and certain segments/factions of the GOP, but in reality means little since the senate won’t give the house bill much attention, I imagine.

I struggle to understand why it would be considered a win even on the assumption it would pass the Senate.

I thought that what Republican voters had been clamoring for, to the extent it had any actual policy content, was repeal of the ACA. In particular, they disliked the idea of the federal government requiring you to buy insurance, disliked the requirements imposed on insurance companies, and disliked the massive subsidies being paid to people to buy insurance without mechanisms to (further) limit medical inflation.

AHCA doesn’t really make a dent in any of that. Other than cutting billions from Medicaid (something Trump said he wouldn’t do, IIRC), it changes a single insurance regulation (making old people pay more), and allows states to opt into expensive, required high-risk pools if they don’t like covering pre-existing conditions (the most popular aspect of the ACA).

How is making old people pay more and attacking coverage for pre-existing conditions considered a win among conservative activists in policy terms? Is it just that they really hate Medicaid and so the rest doesn’t matter?

It’s more of a celebration like “Wow, our elephant managed to jump over the first ditch… this time. Unlike last time.” There’s still the whole rest of the steeplechase for the elephant in the room to complete. And the longer the details are out in the open, the more closely the fine print will be examined and exposed. That might change some congressmen’s minds.

The senate will vote their own version, and/or amendments to the house version. Then, there’s a conference where house and senate hash out a compromise (They hope). Then both house and senate vote on this compromised, unamendable bill. If it’s acceptable to a majority in both houses - if! - then it passes and goes to the president for a signature.

Until then, assorted factions can say “we are doing what we promised while sticking to our principles, and nobody will be worse off.” They can say that…

Well it is a win at least for the House Republicans. They’ve been calling and promising a repeal for 6 years. And voted for it many times when that vote was meaningless. Even if it fails to pass the Senate, they can at least claim that they did their part.

I wouldn’t be surprised if at least some Republican members secretly hope that it does fail in the Senate. That way they can hold on their conservative bona fides of having voted to repeal while not actually have to pay the political price of seeing their plan enacted.

I’m really not sure whether you’re being ironic or genuinely confused. :confused:

I am genuinely confused about why high-information Republicans seemingly consider this bill to be a repeal of the ACA.

I think they are starting with the premise “Obamacare increased our health care costs by requiring insurance policies to cover all this extra stuff.” Then they can argue that this bill is a partial repeal which would lower your health care cost (as long as you aren’t in the high risk pool).

I don’t have any problem seeing how you could frame this as partial repeal.

But it’s repealing the parts that are popular, for the most part, isn’t it? Medicaid is popular, which is why Trump promised not to touch it. Coverage for pre-existing conditions is popular, which is why GOP representatives had to claim that this bill doesn’t touch that coverage requirement. It’s the individual mandate that is unpopular.

This bill guts Medicaid, allows states to opt out of guaranteed issue requirements (and throw those people to the wolves, effectively), and doesn’t get rid of the federal government penalizing you for failing to maintain insurance. Isn’t that repealing the wrong parts of the ACA?

Yes; I saw a clip of one (Republican) congressman who stated that the healthy people would pay less, and only those with pre-existing conditions - “because they didn’t take proper care of their bodies” - would pay more.

I think Republicans in the House really did feel that they needed to live up to their promises of the last several years to repeal and replace the ACA. Now they have their token vote to say they’ve tried. We’ll see how it plays out, but they are going to get painted as the party who funded a large tax cut for the wealthy by gutting the parts of the ACA that people cared about (pre-existing conditions and Medicaid) and not fixing anything. Millions of people will lose health insurance. Even if this bill doesn’t get any further, every Republican in Congress just gave Democrats some lovely campaign material.

Yes, sanctimonious bastard. There’s a difference between the incentives the health insurance companies already offer for losing weight, stopping smoking and so on, and penalizing autistic children (as just one example).

Emphasis added. Doesn’t it get rid of the mandate, so there is no “tax” anymore if you forego insurance? That means the feds aren’t requiring you to buy insurance.