Every member of the House who voted for Zombie ‘Trumpcare’ must be held accountable.

In a pyrrhic victory for the House GOP leadership, the Zombie “Trumpcare” bill passed on a party-line vote with 20 GOP defections, on a bare-minimum vote of 217-213.

Arizona Congressional delegation: Voting yes: Franks, Gosar, McSally, Schweikert; Voting No: Biggs, Gallego, Grijalva, O’Halleran, Sinema. Don’t give Biggs any credit, he wanted a straight up repeal of “Obamacare.”

“This legislation is illogical, immoral and wrong for the country,” said Rep. John Delaney (D-Md.). “The American Health Care Act is a reckless, ideologically-motivated bill that will increase pain and suffering across the country so that political actors can claim a ‘win. ’ ” Dems tear into ‘shameful’ ObamaCare repeal vote.

House Minority Leader Nancy Pelosi warned Tea-Publicans before  the vote Thursday afternoon that “You have every provision of this bill tattooed on your forehead.” “You will glow in the dark on this one. You will glow in the dark.” Nancy Pelosi tells Republicans that Trumpcare is ‘tattooed on your forehead’.

After the vote, Republican lawmakers loaded into Capitol Police buses to drive to the White House for a celebration with President Trump. As they got on board, a group of protestors gathered nearby, chanting “shame!” at them. House passes ObamaCare repeal.

This vote was a cynical act of craven political cowardice. Tea-Publicans are terrified of their GOP crazy base and the conservative media entertainment complex that feeds their insanity. They voted for political cover against a primary challenger who is crazier than they are (if that is possible) funded by these right-wing organizations. Protecting their incumbency in a GOP primary was their only motivation. They made the cynical calculation that this was more important to them than Americans losing their health insurance and potentially losing their life as a result. Dante has a new ring in the Inferno just for them.

The Zombie “Trumpcare” bill will now move over to the Senate where it will die. The House bill will never become law. GOP senators: We’re doing our own healthcare bill:

Several Republican senators sent a warning shot to the House after its passage of an ObamaCare repeal-and-replace bill Thursday, indicating it won’t be easy to get the measure through the upper chamber.

Sen. Dean Heller (R-Nev.), one of the most vulnerable GOP senators up for reelection in 2018, said he wouldn’t support the House’s bill in its current form.

“We cannot pull the rug out from under states like Nevada that expanded Medicaid and we need assurances that people with pre-existing conditions will be protected,” he said in a statement.

Sen. Rob Portman (R-Ohio) made clear his concerns over how the House bill treats Medicaid. While ObamaCare expanded the healthcare program to more low-income Americans, the House bill would eliminate that expansion in 2020.

“I’ve already made clear that I don’t support the House bill as currently constructed,” Portman said in a statement, “because I continue to have concerns that this bill does not do enough to protect Ohio’s Medicaid expansion population, especially those who are receiving treatment for heroin and prescription drug abuse.”

Republicans have little margin for error in the Senate. With a 52-48 majority, they can only afford to lose two votes — assuming Vice President Pence swoops in to break a tie — under the fast-track budget maneuver Republicans are using to repeal ObamaCare.

Sen. Lamar Alexander (R-Tenn.) pointed to the difficulties to come. He highlighted his three priorities for the bill, which include rescuing Americans in areas where their health marketplaces may not have any insurers offering plans in 2018.

“The Senate will now finish work on our bill, but will take the time to get it right,” Alexander, chairman of the Senate Health, Education, Labor and Pensions Committee, said in a statement.

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Senate leadership has acknowledged the legislation will need to change in the chamber in order to get enough of its members on board.

“We can’t be for half a dozen different proposals; we have to be for a proposal for us to get 51 votes in the Senate,” Senate Majority Whip John Cornyn (R-Texas) told The Hill an hour before the House vote.

“We’ll start with the House bill, but we’ll need to work with every member of the Senate conference to see what they need to get to yes.”

Likely changes could focus on Medicaid and adding increased financial assistance, in the form of tax credits, to help low-income Americans afford health insurance.

It’s possible the Senate could run into the same problem the House toiled over for almost two months. Move the bill to right, and moderates will defect. Move the bill to the center, and the measure will lose conservative votes.

Sen. Lindsey Graham (R-S.C.) tweeted that “A bill — finalized yesterday, has not been scored, amendments not allowed, and 3 hours final debate — should be viewed with caution.”

Greg Sargent of the Washington Post explains The GOP’s strange, ugly strategy of rushing today’s vote will backfire. Here’s how.

House GOP leaders are confidently forging ahead with the repeal-and-replace vote today, and they are laughing off questions as to why they would go forward despite their willfully premature and dim understanding of how the measure might impact millions of Americans and one-sixth of the U.S. economy. They are doing this without seeing a nonpartisan analysis of their new bill from the Congressional Budget Office — which will, conveniently, allow them to conceal the full truth of what they are voting for from their constituents.

But this is likely to backfire. Here’s why: The Congressional Budget Office score of the bill is coming, anyway — as soon as next week. And it will land after an untold number of House Republicans have committed themselves to the bill.

A Democratic leadership aide tells me that the CBO has confirmed to Democratic leaders that the CBO score will be completed and delivered next week or the week after. This means moderate and vulnerable House Republicans who are already worried about explaining to their constituents why they voted for the bill — which guts protections for the sick and rolls back coverage for millions of poor and working-class people while delivering a huge tax cut to the rich — will have to justify it again, in light of a nonpartisan analysis spelling out the grisly details of what they really voted for.

it’s perfectly plausible that the new CBO score could show that the new version is substantially worse than the last one. The old CBO score found that the last bill could leave 24 million people without coverage — 14 million of them due to the phaseout of the Medicaid expansion — while driving up premiums in the near term for older people. The new bill won over conservatives by allowing states to waive the requirement that insurers cover essential health benefits and refrain from jacking up premiums on people with preexisting conditions.

Many analysts have pointed out that the latter provision could lead to soaring costs for the sick, potentially pushing them off coverage. To deal with this, GOP leaders agreed to a last-minute change to the bill that would provide a paltry additional $8 billion to help those people. This may have succeeded in giving moderates the fig leaf they need to vote for it.

But the new CBO score could illustrate with new vividness the true impact of the new bill’s relaxation on protections for preexisting conditions — and show that this last-minute change is not going to mitigate the damage it could do to them in any meaningful sense. As it is, most analysts already agree that it won’t, but the CBO could enshrine this in a great deal more detail. Nicholas Bagley, a health policy expert and law professor at the University of Michigan, emails me:

A CBO score would give us some sense of how relaxing the ban on discriminating against people with preexisting conditions would affect coverage. It would also show moderate Republicans just how little difference an infusion of $8 billion will make to the overall coverage figures. Congressional Republicans are shooting in the dark here. They may not like what they find when CBO turns on the lights.

Harold Pollack, a public policy professor at the University of Chicago, adds that the new CBO score could demonstrate that premiums are going to rise for the sick in spite of the latest GOP efforts to throw a few pennies (relatively speaking) at that problem:

The new CBO score could easily show even higher premiums for people with costly conditions, not withstanding efforts to paper over these difficulties. It could also show even greater numbers of people losing coverage relative to current law. There are also substantial risks that CBO would simply find embarrassing errors due to the rushed and slipshod process through which AHCA was produced and repeatedly modified. The new CBO score could easily show fewer people covered, more difficulties with insurance markets, and higher premiums for people in greatest need of help.

If this happens, it will put moderate and vulnerable Republicans who supported the bill in an odd spot. They will be at home on recess, hearing from their constituents, and they will have to justify their vote for something that threatens to inflict all the harm that the new CBO score has now projected it will inflict.

What’s more, they will also have to explain in retrospect why they rushed the vote in advance of a CBO score detailing its impact, even though it was only a few days away — and is designed to help them make a more informed choice about what it is they were truly voting for. At that point, though, it will be too late. They will already be on the hook for it.

Greg Sargent’s coworker Paul Waldman gets it exactly right: Every Republican who voted for this abomination must be held accountable:

I won’t mince words. The health-care bill that the House of Representatives passed this afternoon, in an incredibly narrow 217-to-213 vote, is not just wrong, or misguided, or problematic or foolish. It is an abomination. If there has been a piece of legislation in our lifetimes that boiled over with as much malice and indifference to human suffering, I can’t recall what it might have been. And every member of the House who voted for it must be held accountable.

There’s certainly a process critique one can make about this bill. We might focus on the fact that Republicans are rushing to pass it without having held a single hearing on it, without a score from the Congressional Budget Office that would tell us exactly what the effects would be, and before nearly anyone has had a chance to even look at the bill’s actual text — all this despite the fact that they are remaking one-sixth of the American economy and affecting all of our lives (and despite their long and ridiculous claims that the Affordable Care Act was “rammed through” Congress, when in fact it was debated for an entire year and was the subject of dozens of hearings and endless public discussion). We might talk about how every major stakeholder group — the American Medical Association, the American Hospital Association, the AARP, the American Cancer Society Cancer Action Network, the American Heart Association, and on and on— all oppose the bill.

All that matters. But the real problem is what’s in the bill itself. Here are some of the things it does:

• Takes health insurance away from at least 24 million Americans; that was the number the CBO estimated for a previous version of the bill, and the number for this one is probably higher.
• Revokes the Affordable Care Act’s expansion of Medicaid, which provided no-cost health coverage to millions of low-income Americans.
• Turns Medicaid into a block grant, enabling states to kick otherwise-eligible people off their coverage and cut benefits if they so choose.
• Slashes Medicaid overall by $880 billion over 10 years.
• Removes the subsidies that the ACA provided to help middle-income people afford health insurance, replacing them with far more meager tax credits pegged not to people’s income but to their age. Poorer people would get less than they do now, while richer people would get more; even Bill Gates would get a tax credit.
• Allows insurers to charge dramatically higher premiums to older patients.
• Allows insurers to impose yearly and lifetime caps on coverage, which were outlawed by the ACA. This also, it was revealed today, may threaten the coverage of the majority of non-elderly Americans who get insurance through their employers.
• Allows states to seek waivers from the ACA’s requirement that insurance plans include essential benefits for things such as emergency services, hospitalization, mental health care, preventive care, maternity care, and substance abuse treatment.
• Provides hundreds of billions of dollars in tax cuts for families making over $250,000 a year.
• Produces higher deductibles for patients.
• Allows states to try to waive the ACA’s requirement that insurers must charge people the same rates regardless of their medical history. This effectively eviscerates the ban on denials for preexisting conditions, since insurers could charge you exorbitant premiums if you have a preexisting condition, effectively denying you coverage.
• Shunts those with preexisting conditions into high-risk pools, which are absolutely the worst way to cover those patients; experience with them on the state level proves that they wind up underfunded, charge enormous premiums, provide inadequate benefits and can’t cover the population they’re meant for. Multiple analyses have shown that the money the bill provides for high-risk pools is laughably inadequate, which will inevitably leave huge numbers of the most vulnerable Americans without the ability to get insurance.
• Brings back medical underwriting, meaning that just like in the bad old days, when you apply for insurance you’ll have to document every condition or ailment you’ve ever had.

It is no exaggeration to say that if it were to become law, this bill would kill significant numbers of Americans. People who lose their Medicaid, don’t go to the doctor, and wind up finding out too late that they’re sick. People whose serious conditions put them up against lifetime limits or render them unable to afford what’s on offer in the high-risk pools, and are suddenly unable to get treatment.

Those deaths are not abstractions, and those who vote to bring them about must be held to account. This can and should be a career-defining vote for every member of the House. No one who votes for something this vicious should be allowed to forget it — ever. They should be challenged about it at every town hall meeting, at every campaign debate, in every election and every day as the letters and phone calls from angry and betrayed constituents make clear the intensity of their revulsion at what their representatives have done.

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The Republican health-care bill is an act of monstrous cruelty. It should stain those who supported it to the end of their days.

UPDATE: Good catch by Jim Nintzel at the Tucson Weekly. AP: McSally Urges Colleagues To Vote for This ‘Fucking Thing,’ aka Zombie Trumpcare:

After declining to inform the public of where she stands on the Zombie Trumpcare bill, it appears that Congreswoman Martha McSally (R-AZ02) is fully behind it, according to AP reporter Erica Werner, who reports that McSally told her GOP colleagues it was time to get this “fucking thing” done.

Indivisible Southern Arizona is planning a “death march” on McSally midtown offices at 4400 E. Broadway at 5 p.m. today.