Government-wide spending bill headed for a House vote

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House Republicans say they will vote on a long-awaited vote to repeal and replace Obamacare on Thursday, after a pivotal 24 hours in which the White House and GOP leaders agreed to changes that won over two prominent holdouts and paved the way for action before lawmakers take a weeklong vacation. It was a perilous journey, and its Senate pathway will be at least as bumpy with little doubt the measure will change, assuming it survives.

The House has passed a $1.1 trillion bill to fund the government through the end of September, the first significant piece of bipartisan legislation of Donald Trump's presidency.

And that was in a chamber Republicans control 238-193. A total of 216 yes votes were needed to pass the bill, meaning Republicans could only afford 22 defectors. "It's been a very hotly contested budget because, as you know, we have to go through a long and rigorous process".

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"The bill passed by the House today will result in millions of Americans losing access to quality, affordable health insurance and those with pre-existing health conditions face the possibility of going back to the time when insurers could charge them premiums that made access to coverage out of the question", Dr. Gurman said.

But he said the way the employer plan provision is structured might make it hard for states to do anything about, even if the legislature and governor want to preserve a ban on coverage limits and other benefits.

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. "The bill also rolls back Medicaid expansion that provides coverage to more than 420,000 Louisianans - almost [one] out of every 10 people in our state".

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Even if the GOP secures a win in the House, the Senate is expected to change the bill. Instead, what is going to happen is that the Senate is going to try to pass their own bill with no timeline for passage, and then the House and Senate will need to reconcile their bills into one final bill, which may or may not be able to pass the House and Senate depending on how far to the middle the final bill moves. Senators represent entire states, and many tend to reflect more pragmatic views than their House colleagues. After 2020, states that expanded Medicaid would no longer receive enhanced federal funding to cover low-income adults, and those that hadn't expanded would be immediately barred from doing so. Numerous 31 states that accepted Obama's expansion of that program are led by GOP governors, and senators have no interest in cutting their states' funds and taking coverage away from voters. The bill not only re-introduces preexisting conditions as a means to deny healthcare, but also adds new conditions to be considered; the most surprising of which are sexual assault victims, and those who have birthed through C-sections.

"I've supported the practice of not allowing pre-existing conditions to be discriminated against from the very get-go", Rep. Fred Upton (R-Mich.), a former chairman of the House committee that handles most health issues, told a MI radio station Tuesday in explaining his decision not to support the bill. In a letter to McConnell, they wrote that the measure "does not provide stability and certainty for individuals and families" who use the program.

Still, the House vote may provide some momentum behind Senate Republicans, although their version may look starkly different than what came out of the House. We've broken down how its provisions would change health coverage for nine key groups of people. The Senate has been less optimistic about the bill, according to The Hill.

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States that did not expand Medicaid under Obama's law are looking for additional funding for their programs. Sen. Lindsey Graham, R-S.C., told CNN in an interview on Tuesday, adding, "This was not winning from the Republican point of view". The leaders - Democrat, Republican, House and Senate - work well together. But polls have shown a public distaste for the repeal effort and a gain in popularity for Obama's statute, and Democrats - solidly opposing the bill - said Republicans would pay a price in next year's congressional elections.

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