Arizona House Republicans – except one – on board with health bill

Arizona conservatives were largely on board Thursday with the House's passage of the American Health Care Act, a move that revived Republican hopes of repealing central parts of President Barack Obama's signature health-care law.

Freshman Rep. Andy Biggs, who represents a conservative congressional district east of Phoenix, was the only Arizona Republican to vote against the legislation, joining Democratic Reps. Ruben Gallego, Raul Grijalva, Tom O'Halleran and Kyrsten Sinema in opposing the bill.

Republican Reps. Trent Franks, Paul Gosar and David Schweikert, along with Rep. Martha McSally, went along with House Speaker Paul Ryan, R-Wis., on the legislation, which is a top priority of House GOP leaders and President Donald Trump.

Why Biggs voted no

Biggs was one of 20 Republicans who voted "no" along with 193 Democrats. The House voted 217-213 to pass the bill.

In a statement explaining his vote, Biggs criticized the measure for leaving "the basic framework of Obamacare in place," and "even worse, I have seen no compelling evidence that the AHCA will offer substantive relief to Arizona families who have been crushed by devastatingly high health insurance premiums."

McSally, whose swing district's complexion ensures constant re-election pressures, was credited with a companion bill to eliminate the American Health Care Act's exemption for members of Congress and their staff.

"This is not a perfect bill, but it is better than a failed system," McSally said, referring to Obama's Affordable Care Act.

McSally drew attention Thursday, after an Associated Press congressional correspondent, via Twitter, quoted her as using profanity to rally her fellow Republicans. McSally was said to have urged her colleagues to get this "(expletive) thing" done, per the AP reporter's tweet.

While he supported the bill, Gosar was measured in his praise of it.

"As a dentist impersonating a politician, I am going to tell Arizonans the truth about the updated version of the AHCA: This bill is NOT a full repeal, I repeat NOT a full repeal of Obamacare," Gosar said in a written statement. "However, after working alongside my colleagues in the House Freedom Caucus, we have been able to secure Conservative, time-tested changes to the original version of the AHCA. These changes will immediately eliminate Obamacare taxes, lower health insurance premiums, offer more choices for Arizonans and begins the process of rebuilding a patient-centered market."

Schweikert was instrumental in an earlier amendment that would create a $15 billion federal risk-sharing program to help pay for coverage for people with pre-existing conditions and high-risk patients.

"Two Arizona Republicans played pivotal roles here," Biggs said of Schweikert and McSally's contributions.

Uncertain future in Senate

Ryan and Trump suffered a political setback in March, when an anticipated House vote on an earlier version of the bill was canceled because of a lack of support from House conservatives.

The House-passed bill now faces an uncertain future in the GOP-controlled Senate.

"Let's face it, the Senate is often where great ideas go to get screwed-up," Schweikert said Thursday in an interview on Phoenix radio station KFYI-AM (550).

Ryan and the Republicans touted the bill's new refundable tax credits to help people who don't get insurance via their employers; its changes to Medicaid that they say will make the program "flexible and responsive to those it was created to serve"; it boosts tax-free "Health Savings Accounts" to help people whose insurance plans carry high deductibles; and its defunding of Planned Parenthood, which provides women's health services including abortions.

House Democrats savaged the revised legislation as cruel and even deadly, saying, among other criticisms, that, unlike Obama's Affordable Care Act, it inadequately protects the tens of millions of Americans with pre-existing conditions.

Republicans added another $8 billion for patients who already have diseases such as cancer to the $130 billion already in the package. The gesture won over some Republicans who were on the fence.

Ahead of the vote, Schweikert pushed back on claims that pre-existing conditions are not covered.

"If you're like me, if you're asthmatic or something else you have, you get coverage," Schweikert, a member of the influential House Ways and Means Committee, said on KFYI. "So if you hear someone using the term 'pre-existing condition, you're not going to get coverage,' they're lying to you."

Pre-existing conditions provision at issue

Despite the addition of the extra money for such conditions, House Minority Leader Nancy Pelosi, D-Calif., and other critics on Thursday continued to blast the bill's provisions concerning pre-existing conditions as grossly insufficient.

In a written statement after the vote, Gallego said, "Millions of Americans will lose their health insurance, and those who keep it will incur higher out-of-pocket costs and face longer waiting periods for coverage. The GOP plan kills protections for people with pre-existing conditions, eviscerates Medicaid, and will leave veterans with fewer choices about where to seek care. Republicans should be prepared to be held accountable for their ‘yes' votes on this disastrous bill when the American people head to the ballot box in 2018."

O'Halleran, a freshman representative from northern Arizona, objected to the bill because he said it would put thousands of Arizonans at risk of losing coverage.

The precursor version would have increased the number of uninsured people by 24 million in 2026, according to an analysis by the Congressional Budget Office. But House Republicans proceeded with the updated bill without getting an updated CBO analysis, which Pelosi said shows they are afraid of the facts.

"While the ACA is far from perfect, this replacement legislation does little to fix the problems our families are facing," O'Halleran said in a written statement. "Arizonans with pre-existing conditions such as cancer or Alzheimer's could lose coverage, and nothing has been done to stem the skyrocketing premiums our seniors will face or protect veteran care."

Speaking Wednesday on radio station KTAR-FM (92.3), Sinema said, "Obamacare is not working in Arizona," where costs have soared, but that "the (Republicans') bill isn't good enough the way that it's written."

She said some parts of the Affordable Care Act are important to the state. "For instance, the expansion of Medicaid, which helps low-income working families get access to health care," Sinema said in the radio interview. "If that gets cut, which this current bill proposes, it'll cost Arizona $5.6 billion over the next six years. Now that's huge."

After the vote, Sinema said she voted against the bill because it "jeopardizes the economic security of hardworking Arizona families."

Franks, the senior Republican in the state's House delegation, described the bill as landmark.

"Passing the American Health Care Act is the start of our promise to 'repeal and replace' Obamacare," Franks said in his post-vote statement. "The AHCA moves us closer to a patient-centered system that meets the needs of more Americans better than under Obamacare. People with pre-existing conditions will be protected while allowing states greater flexibility to lower premiums and stabilize the insurance market."

McSally said she had worked to make the legislation better.

"I have voiced concerns, identified constructive improvements, prevented destructive additions, and ultimately secured victories for the vulnerable in our communities totaling $165 billion," she said in a statement after the vote.

Before the vote, Biggs reiterated that he opposed the American Health Care Act because "it is not a clean repeal of Obamacare" and that he is still committed to doing that.

Biggs submitted two amendments that were not included in the GOP package. He sought to change the bill to let people buy health insurance across state lines. He also wanted to let states opt out of any Affordable Care Act or American Health Care Act provisions without getting a waiver from the Department of Health and Human Services.

In an interview with The Arizona Republic, Biggs suggested he would have liked more time to work on the bill, which despite his opposition he called a dramatic improvement over the previous incarnation.

"I think there's a narrative out there that nothing's been happening, and so people get antsy, and they want to see something fast," Biggs said. "And legislating takes a while, especially legislating on something that is one-sixth of the entire economy."