Democrats boosted by Trump’s healthcare victory

After seven years of trying to repeal Barack Obama's healthcare reforms, Republicans in the House of Representatives marked Thursday's passage of a bill to replace Obamacare with a White House celebration at which President Donald Trump hailed "an incredible victory".

Democrats celebrated too, singing, “Na na na na, na na na na, hey hey hey, goodbye!” at their rivals in the chamber.

Every House Democrat voted against the American Health Care Act – which would radically overhaul Mr Obama’s Affordable Care Act – because they think it would raise premiums and result in millions of people losing access to health insurance. But they cheered in the hope that it would also help them win back the House in 2018.

As Mr Trump stood flanked by his party's congressmen in the White House Rose Garden, Nancy Pelosi, the top Democrat in the House, was across town warning Republicans they would end up ruing their votes.

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“You have every provision of this bill tattooed on your forehead,” she said, adding that Republicans who hoped the Senate would alter the bill in a way that made it more palatable to critics would not escape the wrath of voters.

“You will glow in the dark.”

Rare win

Even as Mr Trump acknowledged that the bill still had to get through the Senate, the White House celebrated a rare win. Mr Trump had hit his 100-day mark last weekend without achieving any of his legislative priorities for the first three months.

“It’s going to be an unbelievable victory . . . when we get it through the Senate,” Mr Trump said after the vote. “This has really brought the Republican party together.”

The White House had argued that repealing Obamacare – eradicating taxes it used to pay for coverage – would free funds to pay for tax reform. But while the House vote resurrected that option, which appeared moribund after a failed effort in March, there were suggestions that it could actually delay tax reform.

In a note to clients, Goldman Sachs said the vote eased doubts that the party could cobble together a majority to pass complicated legislation. But it said the fact that the House had to wait until the Senate wrote its own version of the bill raised the odds that the Trump administration would be unable to push through tax reform this year.

While the 217-213 House vote helped to alter the narrative that the Republican party was not accomplishing anything despite controlling Congress and the White House, the healthcare bill faces obstacles in the Senate, where Republicans have made clear they will write their own version of the measure.

Rob Portman, an Ohio Republican senator, highlighted one serious concern when he opposed a provision that would cut funding for Medicaid – a federal programme to help poor people get medical care – and exacerbate the opioid crisis in Ohio and the rest of the country. Some party senators were also unhappy that the House voted before getting an evaluation of the bill's cost and coverage implications from the nonpartisan Congressional Budget Office.

‘Obamacare has failed’

John Barrasso, a Wyoming lawmaker who is a doctor and a member of the Senate Republican leadership, said his colleagues were "committed to continuing the good work that the House has done" but would pursue an "open process" to allow people to evaluate any bill. He added that the fact that health insurers were pulling out of some markets for cost reasons meant it was imperative to act.

“Obamacare has failed miserably, so we need to do something,” Mr Barrasso told the Financial Times.

Tim Greaney, a University of California professor, said the House bill faced obstacles in the Senate because many Republican senators were not up for re-election in 2018, potentially making them less willing to help Mr Trump unless they genuinely believed in a bill. He added many were worried about the impact on Medicaid, which would hit state budgets and raise the burden on some state hospitals.

Assuming that Republicans can pass a bill through Congress, Democrats hope the final measure will be watered down but still allow them to target House Republicans in the 2018 midterm congressional elections.

"A number of House Republicans from swing districts ended up voting for the bill after opposing the earlier draft, which is peculiar because the bill they voted for is more conservative than it was at the beginning," said William Galston of the Brookings Institution. "The Democrats will target vulnerable Republicans by pounding away on the bill's removal of protections for beneficiaries with pre-existing conditions."

John Weaver, a strategist who advised Ohio governor John Kasich in the 2016 election, said the Republican party was heading for a bad result next year.

Copyright The Financial Times Limited 2017