Congress Completes First Step to Repealing Health Law

Congress has completed the first — and by far the easiest — step toward gutting President Barack Obama's divisive health care law.

The House passed a budget resolution Friday afternoon in a 227-198 vote that adopts a House-Senate measure to make it easier for a subsequent "Obamacare" repeal bill to advance through the Senate without the threat of a Democratic filibuster.

"We are closer to giving Americans relief from the problems this law has caused. Too many families have seen costs soar, quality drop, and choices reduced to one—which just isn’t a choice at all," House Speaker Paul Ryan said in a statement.

The legislation doesn't need to be signed by the president and won't actually change a word of the hotly contested health care law. But its passage was crucial if Republicans controlling Congress are to keep their longstanding promise to scuttle the law, which has delivered health coverage to about 20 million people but is saddled with problems such as rapidly rising premiums and large co-payments.

The timetable for the upcoming repeal measure is uncertain, but Republicans want to pass it as quickly as possible. The legislation passed Friday allows a follow-up bill to pass without having to clear the 60-vote filibuster hurdle in the Senate, where Republicans control 52 seats and Democrats are gearing up for an epic battle.

After pressure from both President-elect Donald Trump and rank-and-file lawmakers, House GOP leaders are now promising to advance legislation to repeal the health law and replace it with something else in tandem.

"We have a responsibility to step in and provide relief from this failing law," Ryan told reporters on Thursday. "And we have to do it all at the same time so that everybody sees what we're trying to do."

Trump is promising the public that he will sign legislation to repeal and replace the law soon. Republican leaders are trying to deliver, but it seems as if Trump may be overpromising, given the enormity of the task and the political stakes involved.

"He's not a creature of this place so there's always a bit of a learning curve," said the No. 3 Senate GOP leader, John Thune of South Dakota.

Senate Majority Leader Mitch McConnell, R-Ky., isn't setting a timetable but said Thursday that the early repeal bill would "begin to make important progress" and that Republicans "plan to take on the replacement challenge in manageable pieces, with step-by-step reforms."

"Repealing and replacing Obamacare is a big challenge. It isn't going to be easy," McConnell added.

McConnell spoke after the Senate approved the preliminary repeal measure by a near party-line 51-48 vote, drawing a Twitter thumbs-up from Trump: "Congrats to the Senate for taking the first step to #RepealObamacare — now it's onto the House!"

The controversial law has provided health care subsidies and Medicaid coverage for millions who don't get insurance at work. It has required insurers to cover certain services like family planning and people who are already ill, and has curbed rates that the sick and elderly can be charged.

GOP leaders hope to use their first bill to void and rewrite as much of Obama's law as they can, but so far they've provided little detail.

Republicans want to end the fines that enforce the statute's requirements that many individuals buy coverage and that larger companies provide it to workers — mandates that experts say were needed to stabilize insurers' rates. They also want to erase the taxes the law imposed on higher-income people and the health care industry, eliminate its subsidies that help people buy policies and pare back its Medicaid expansion.

But they face internal disagreements over policy, such as how to pay for their new statute and how to protect consumers and insurers during what may be a two- or three-year phase-out of Obama's overhaul.

They also must heed Senate rules forbidding provisions that don't directly affect taxes and spending from being safeguarded from filibusters. That means repealing important parts of the law — like the requirement that insurers offer coverage to all customers including the most ill — would have to await later bills that would need Democratic support.