The US House of Representatives has approved a Bill erasing much of former president Barack Obama´s healthcare law.
Relieved Republicans have muscled their healthcare bill through the US House of Representatives, taking their biggest step towards dismantling the Obama healthcare overhaul since Donald Trump took office.
They won passage only after overcoming their own divisions that nearly sank the measure six weeks ago.
Beaten but unbowed, Democrats insisted Republicans will pay at election time for repealing major provisions of the law. They sang the pop song Na Hey Kiss Him Goodbye to Republican politicians as the end of the voting neared.
The measure skirted through the House by a thin 217-213 vote, as all voting Democrats and a group of mostly moderate Republican holdouts voted no.
A defeat would have been politically devastating for President Trump and Speaker Paul Ryan.
Passage was a product of heavy lobbying by the White House and Republican leaders, plus late revisions that nailed down the final supporters needed.
The bill now faces an uncertain fate in the Senate, where even Republican politicians say major changes are likely.
“Many of us are here because we pledged to cast this very vote, ” Mr Ryan said.
He added: “Are we going to keep the promises that we made, or are we going to falter?”
Leaders rallied rank-and-file politicians at a closed-door meeting early on Thursday by playing Eye Of The Tiger, the rousing 1980s song from the Rocky III film.
In a statement, Senate Majority Leader Mitch McConnell called the House vote “an important step” to repealing Mr Obama’s law and said: “Congress will continue to act on legislation to provide more choices and freedom in healthcare decisions.”
Polls have shown a public distaste for the repeal effort and a gain in popularity for Mr Obama’s statute, and Democrats – solidly opposing the bill – said Republicans would pay a price in next year’s congressional elections.
Mr Ryan cancelled a March vote on the healthcare bill because disgruntled conservatives said the measure was too meek while Republican moderates said its cuts were too deep.
Over the past few weeks, the measure was revamped to attract most hard-line conservatives and some Republican centrists.
In a final tweak, leaders added a modest pool of money to help people with pre-existing medical conditions afford coverage.
The bill would eliminate tax penalties in Mr Obama’s law which has clamped down on people who do not buy coverage and it erases tax increases in the Affordable Care Act on higher-earning people and the health industry.
It cuts the Medicaid programme for low-income people and lets states impose work requirements on Medicaid recipients.
It transforms Mr Obama’s subsidies for millions buying insurance – largely based on people’s incomes and premium costs – into tax credits that rise with consumers’ ages.
It would retain Mr Obama’s requirement that family policies cover grown children until age 26.
But states could get federal waivers freeing insurers from other Obama coverage requirements. With waivers, insurers could charge people with pre-existing illnesses far higher rates than healthy customers, boost prices for older consumers to whatever they wish and ignore the mandate that they cover specified services such as pregnancy care.
The bill would block federal payments to Planned Parenthood for a year, considered a triumph by many anti-abortion Republicans.
