By Ed O’keefe, Paige Winfield Cunningham and Amy Goldstein, The Washington Post

WASHINGTON – House Republicans narrowly passed a controversial bill to revise Affordable Care Act, fulfilling a major Trump campaign promise but sending the measure on to an uncertain fate in the closely divided Senate. House Minority Leader Nancy Pelosi calls the measure "a monstrosity," and said "Republicans have made Trumpcare even more dangerous and destructive than the last time they brought it to the floor." Among many other concerns, GOP senators from states that have expanded Medicaid under the ACA have voiced concerns about rollbacks to that program included in the House bill. States could apply for waivers that allow insurance companies in their states to do three things: 1) Charge older people more than five times what they charge young people for the same policy; 2) Eliminate required coverage, called essential health benefits including maternity care, mental health and prescription drugs, required under the Affordable Care Act; and 3) Charge more or deny coverage to people who have pre-existing health conditions, such as cancer, diabetes or arthritis. “Because more people will have their premiums lowered, more people will have lower out-of-pocket costs, more people will have access to these high-risk pools and the states that take advantage of it, they will actually do better than the states that don’t.”

The bill would repeal Affordable Care Act’s individual mandate, instead replacing it with an option for insurers to hit people who do not keep continuous coverage with a 30 percent surcharge on their premiums.
The Republican-controlled United States House of Representatives votes in favor of the repeal of the 2010 Patient Protection and Affordable Care Act and passage of the House's 2017 American Health Care Act, by a narrow, 217–213 vote. Twenty Republicans and all Democrats opposed the bill, which now heads to the United States Senate for its legislative action.