7 Things To Know About Thursday's House Health Care Vote

Republicans negotiated late into the night Wednesday and into the morning as the House leadership prepared for a vote Thursday on the American Health Care Act, the Obamacare alternative. But as of Thursday, it's not clear which version of the bill will be voted on and whether it can get enough votes to pass.

If the bill passes, it will have cleared its first significant hurdle to becoming law. If it doesn't pass, Republicans may have to start again from square one, or perhaps even give up on their efforts to completely overhaul Obamacare. (For more information on this and other political stories, subscribe to the White House Patch for daily newsletters and breaking news alerts.)

Here's what you need to know about the bill as it heads for a vote:

1. If the ACHA passes today, it has a harder path forward in the Senate.

After a bill is approved in the House, it moves on to the Senate. For the AHCA, that's much more hostile terrain (and the House hasn't been particularly friendly, either).

Why? Well, for starters, Republicans face a slimmer margin in the Senate than in the House. Though they hold a majority in the Senate, they can only afford to lose two Republican votes and still pass a bill along party lines. If three Republican Senators defect, and no one from the Democratic caucus votes for the bill, the AHCA will have no hope of becoming law.

Senate rules are also much stricter. Because the GOP is using reconciliation procedures to avoid a filibuster, only "budgetary" provisions can be included in the bill. Whether or not the version of the AHCA passes that passes the House will be kosher under the Senate rules is an open question.

2. Changes are still being made.

Amazingly, House Republicans were still debating changes to the AHCA before noon on Thursday, even though the vote is scheduled for later in the day. This means that lawmakers may vote on something that they don't understand very well, hasn't gone through the usual House committees in its final form and hasn't had a complete evaluation by the Congressional Budget Office.

3. Essential health benefits may go.

Republicans are rumored to be mulling an amendment to the bill that would repeal Obamacare's "Essential Health Benefits." This provision of the law requires insurers to cover a defined list of health care services, including emergency care, maternity care, prescription drugs and mental health care.

Critics of this provision argue that it makes health care plans more expensive overall, which is true. But proponents argue that without a defined and comprehensive requirement to cover certain types of care, insurers could end up tricking customers and selling them flimsy plans that don't provide coverage when patients really need it.

4. Failing to pass would be a huge blow to President Trump.

If the bill does not pass today (or later fails to pass the Senate), it will be seen as a huge failure for the president. Trump has thrown the full weight of his office and administration behind the bill, calling it "wonderful" and personally lobbying Republican lawmakers to vote for it.

The White House has also indicated that it doesn't have a backup plan for repealing Obamacare.

"There is no Plan B. There's Plan A and Plan A," Press Secretary Sean Spicer said of the bill at Wednesday's briefing.

This kind of stance may make for a stronger hand in negotiations, but if these negotiations fail, it will leave the White House looking weak and mismanaged.

On the other hand, passage today could help display the president's persuasive powers, given the current doubts surrounding the bill's passage. But it wouldn't be long before he faces a second test in the Senate.

5. Campaign funding is on the line.

House Republicans have face some threats that the party leadership may not support them in their future campaigns if they vote no on the AHCA.

But potential dissenters from the party line have a backup option. The famous Republican donor network, funded by the Koch brothers, has promised to provide extra financial support for representatives who vote against the legislation, according to CNN. This strengthens the opposition's hand, providing a financial cushion in the event that the party pull back support.

6. Major groups oppose the bill.

As the Koch brothers' promise helps demonstrate, many typical Republican constituencies, supporters and think tanks oppose the AHCA. Activist groups, including the Heritage Fund, the Cato Institute, FreedomWorks and Tea Party Patriots are all urging lawmakers to vote "no."

In addition, the AARP (an incredibly important voice representing many older Americans), the American Medical Association and the American Hospital Association have voiced their objections to the AHCA.

The U.S. Chamber of Commerce, a mainstay of conservative lobbying in Washington, D.C., has come out in favor of the bill, as have groups including the Association of Mature American Citizens and the American Action Network. But for those placing their hopes on the bill, the support is far from overwhelming.

7. The bill is moving very fast.

Regardless of the bill's merits, it is moving very fast through the House. It's striking, for example, that Republicans are still debating changes on the day of the scheduled vote.

And as stated above, any changes that Republicans make will not be reviewed by the relevant committees or by the Congressional Budget Office. The party leadership, most notably Speaker Paul Ryan, has decided that doing this thing fast is the best way to do it. But if they wanted to, Republicans could take their time and allow more time for debate and consideration.

BONUS: A new poll out Thursday found that only 17 percent of voters support the American Health Care Act, while 56 percent oppose the bill.

Like the White House Patch Facebook Page.

Follow us on Twitter.

Sign up to comment on the site.

Photo by Chip Somodevilla/Getty Images News/Getty Images