The American Health Care Act (AHCA) made headlines on Thursday as it passed a narrow vote in the House of Representatives. Following their victorious vote, Republicans celebrated the progress they had made — but, if critics have their way, the celebration will be short-lived. The GOP health care plan is far from finalized, and there are several actions that could still block the AHCA from becoming law.
To put it simply, the AHCA would repeal and replace major parts of the Obama administration's Affordable Care Act (ACA), making good on a promise that many Republican candidates, including President Trump, used in the most recent election cycle. In truth, Thursday's vote was a success for Republicans. Back in March, House Republicans had to abandon their health care proposal because they didn't have the votes they needed in order for it to pass. The failure drummed up some bad press for Republican leaders like House Speaker Paul Ryan, who has dedicated much of his congressional career to health care reform. Not to mention, Trump couldn't list health care reform as one of his achievements within the first 100 days of his presidency. Thursday's successful vote earned them a certain level of redemption.
For total redemption, though, the GOP will have to get its bill through the Senate and to the president's desk. With a Republican majority in the Senate, that may not sound difficult. Then again, even a Republican majority in the House couldn't help Ryan on his earlier attempt at health care success.
Here's exactly how the health care plan could be stopped from being signed into law:
1. The Congressional Budget Office Score
The "fiscally responsible" House Republicans just passed the ACHA without even waiting for the Congressional Budget Office's cost estimate.— jordan 🌹 (@JordanUhl) May 4, 2017
The Congressional Budget Office (CBO) is required by law to evaluate and prepare a report — also known as a "CBO score" — on most bills that are approved by a House or Senate committee. In this case, House Republicans voted on the AHCA before a CBO score could be obtained. As a result, lawmakers voted without a full audit of the plan's cost and impact. The CBO score could impact what happens in the impending Senate vote.
2. Phone Banking
Regardless of where in the United States you live, your representative has already voted — or missed voting — in Thursday's House session. For that reason, it's important to focus advocacy efforts on the Senate. Calling, emailing, or otherwise contacting your senator could help to sway the vote away from AHCA.
3. The Senate Vote
It's not clear when the Senate vote will actually take place. Given the divided, often negative response from the public to Thursday's House vote, there could be a lengthy debate over the bill in the Senate. If a majority of senators do not vote for the bill when the time comes, the GOP's health care dreams could be dashed once again.
4. A Veto From President Trump
Let's say the AHCA does pass with a majority of votes in the Senate. Based on your elementary-school civics education, you know that the next step is for the president to sign the bill into law. If Trump's supportive tweets on Thursday were any indication, then it seems reasonable to believe that he would sign the AHCA, should it arrive on his desk. If, for whatever reason, he chose to veto, though, it would head back to the House, where it would need a two-thirds vote to pass. Thursday's close results did not come near to meeting that threshold, suggesting that overriding a presidential veto could be unlikely.
5. The Courts
Even if the AHCA becomes law, it likely faces another battle before it has any real impact on individual Americans. Once on the books, the AHCA is susceptible to lawsuits, throwing the decision over enforcement to the courts. This is exactly what happened with the ACA during Obama's first term. The ACA was signed into law in March 2010. By January 2011, more than half of U.S. states had filed lawsuits to challenge it.
After Thursday's vote, it's fair to say that the AHCA is closer to becoming law than ever before. For Republicans who support the bill, that's something to celebrate. For others, it's a call to action that should inspire activism ahead of the Senate's impending vote.