California Republicans representing some of the nation’s most Obamacare-dependent areas in America took a giant political risk on Thursday by voting to repeal the landmark health care law, as they believed their political danger was eased as they got something to brag about back home.
They said they were convinced for much the same reason as so many other undecided Republicans who helped give GOP leaders the health care win they had so desperately sought: The addition of $8 billion to the bill to help with insurance costs for people with pre-existing conditions.
The congressmen dismissed estimates that the money isn’t nearly enough: an analysis by the liberal Center for American Progress said it would subsidize care for only 76,000 people out of millions.
Rep. Jeff Denham, R-Turlock, said he also received a commitment for a look at what he called problems with access to doctors in California’s Central Valley. He said there’s a shortage of doctors and need for greater reimbursement for those who agree to serve low-income Medicaid patients.
He refused to say who gave the commitment but said he brought the issue up in a meeting with President Donald Trump.
“We’ve asked him to take a look at California and some of the neediest in our community that still have an access issue,” he said.
The House, with the support of all of California’s 14 Republican members, voted 217 to 213 to repeal and replace Obamacare. The California Republicans were crucial to that success. They were a large bloc, and a switch of two votes would have doomed the bill. Most California Republicans refused to commit to supporting the bill until the last minute.
The consumer group Health Access California estimates that the GOP bill will result “in at least four million Californians losing coverage, and many more will pay higher health care costs.” The liberal Center for American Progess estimated that 60,000-plus fewer people would have coverage in Rep. David Valadao’s Central Valley California district alone by 2026.
The California Republicans agreed to vote for the bill under intense pressure from the White House and Republican leadership, including House Majority Leader Kevin McCarthy, R-Bakersfield.
The vote was an especially big risk for Denham and Valadao, R-Hanford. Democrat Hillary Clinton topped Trump in the presidential election by 15 percentage points in Valadao’s district and 3 percentage points in Denham’s.
Democrats are already on the attack, and health care will be a major issue for 30-year-old Turlock native and venture capitalist Josh Harder, who announced his candidacy for Denham’s seat this week.
Democrats were quick to use the vote against their rivals.
Katie Porter, a Democrat running in Orange County against Republican Rep. Mimi Walters, immediately attacked Walters for her support of the Obamacare repeal and replace bill. Clinton beat Trump in Walters’ congressional district by 5 percentage points.
“Time and again throughout this process, congresswoman Walters showed she simply didn't care about how her plan would hurt her constituents,” Porter said. “Families in this district deserve leaders who will stand up to Trump and fight for our interests.”
Walters countered that congressional Republicans kept a promise made seven years ago to repeal Obamacare.
“The Affordable Care Act has clearly failed the American people through unaffordable premiums and deductibles, massive tax burdens on small businesses, and collapsing healthcare exchanges,” she said.
The House Republican bill also prevents the use of federal tax credits to purchase plans that cover abortion. That is a huge issue in California, where abortion is considered a basic health service under state law and plans are required to cover it. A legal battle between the state and the federal government is certain if the provision is also passed by the Senate.
“California can adjust their abortion policy,” said Rep. Doug LaMalfa, R-Richvale.
California’s 38 House Democrats all voted against the bill and predicted their Republican colleagues will pay in next year’s midterm election for supporting the legislation.
“The people who voted for this will have this tattooed to their foreheads going forward,” said House Minority Leader Nancy Pelosi, D-San Francisco.
California’s Democratic senators, Dianne Feinstein and Kamala Harris, plan to oppose the bill in the Senate.
“The Republican health care bill is a statement that they believe health care is a privilege for the few, not a right for all,” Harris said.
Sean Cockerham: 202-383-6016, @seancockerham
Michael Doyle: 202-383-6153, @MichaelDoyle10