The next step for House Republicans will be to revise the bill to prepare it for House and Senate votes.
Finally, while Republicans tend to agree on step three, the legislation that would implement their preferred policies for the nation's health care system, there is one big hurdle: It would need 60 votes to pass a filibuster in the Senate, and getting eight Democrats to join seems highly unlikely.
President Donald Trump, House Speaker Paul Ryan and other GOP leaders can remind Americans that they seek to replace Obamacare not because it is the signature achievement of a Democratic president but because it is imploding.
Here is a view to the future; if this legislation continues Republicans could lose majorities in both houses, making Trump's trip for four years a tough one. If Trumpcare survives the House, it looks like it could be heading for a certain death in the Senate. They have also pushed for the bill's proposed freeze on Obamacare'sMedicaid expansion to be accelerated from 2020 up to 2019 or 2018.
If spending rises too much, insurance premiums will follow, and moreAmericans will find private insurance unaffordable.
Trumpcare looks dead, as internal division is rendering Republicans unable to govern.
"One hundred percent of the nos are yeses" Trump said at a meeting with 13 members of the Republican Study Committee.
House Republicans' proposal to revise the Affordable Care Act in the United States would lower the number of Americans with health insurance by 24 million while reducing the federal deficit by US$337 billion by 2026, congressional budget analysts said.
While governors, obviously, won't get a vote on the AHCA, Republican senators from expansion states are subject to similar pressures. Republicans of all stripes are waiting to see what changes are made by the House Rules Committee before it hits the floor.
"And we think the courts are not going to stop him from doing that?"
Rep. Mark Meadows, R-N.C., said the only change leaders might be willing to make was imposing an optional work requirement on some recipients of Medicaid, which helps finance health coverage for the poor. Finally, the new bill would prevent "non-expansion states from expanding Medicaid during the expansion phaseout", according to Axios.
"Now, we could wait for six months or a year, and let it happen", Trump said.
Earlier in the day, Pence told House conservatives that the administration was open to changes.
Hundreds of conservative activists rallied outside the Capitol in sub-freezing weather to call on congressional leaders and Trump to abandon the GOP bill and fully repeal Obama's law. John Thune, R-S.D., a member of party leadership, want to change the bill to make refundable tax credits more generous for older, lower income Americans. "This is going to be fantastic", he said. "We have talked about repeal since 2010, I ran on it in 2010 and when people heard that, they heard 'repeal Obamacare'". In its current form, the Congressional Budget Office expects the AHCA to grow the ranks of the uninsured by 24 million.
Bottom line: When most people in MI and nationally say they want to "repeal and replace" the ACA, they do not necessarily want to lose coverage or return to the pre-ACA world.