The US House of Representatives voted 217-213 [roll call] Thursday to repeal portions of the Affordable Care Act (ACA) [text, PDF] and replace them using the proposed American Health Care Act (AHCA) [text]. The AHCA would no longer impose a tax penalty for those who don’t have insurance, but would allow insurance companies to charge a penalty when someone buys insurance after it has lapsed for a period. It would replace income-based health insurance tax credits with age-based credits. It would also restrict federal funding to states for Medicaid [official backgrounder] and cut taxes that had been used to pay for the funding. Finally, it would provide states with the ability to opt-out of many requirements of the ACA, including no longer requiring insurance companies to cover pre-existing conditions. US President Donald Trump said [statement] the bill would reduce insurance premiums and deductibles, but House Minority Leader Nancy Pelosi (D-CA) said [statement] it would leave 24 million more people without health insurance and lead to higher premiums for vulnerable groups. The bill would need to be approved by the Senate and President before becoming law.

Repealing the ACA has been a significant priority for Trump and Republican lawmakers. In March, an earlier version of the AHCA was withdrawn from consideration [JURIST report] after failing to get enough support to pass. Earlier that month, Republican lawmakers released two amendments [JURIST report] to the AHCA in an effort to appeal to both conservative and liberal critics. Senators proposed [JURIST report] the initial ACA replacement bill at the end of January. This came after President Donald Trump signed an executive order [JURIST report] aimed at repealing the ACA, shortly after being sworn in. The Senate had prepared for the repealing of the ACA earlier that month when it voted 51-48 [JURIST report] to prevent the process from being subject to a filibuster.