The Note: Republicans deliver on their health care dream, but could face a nightmare

House GOP passed their ambitious plan to repeal and replace Obamacare yesterday.

ByABC News
May 5, 2017, 8:25 AM


--ANALYSIS - ABC’s RICK KLEIN: They stood together, at least long enough to enjoy a crisp spring afternoon in the Rose Garden. President Trump and House Speaker Paul Ryan put together the team that delivered on a longstanding Republican dream, in a vote that solidifies Ryan’s hold on power and establishes a template for all that winning the president promised. But everyone is awake now. First comes the challenge of getting back to that same spot on the White House grounds for a ceremony that involves a bill becoming an actual law. Then comes the fallout: fiscal, political and personal. If anywhere near 24 million people lose their health insurance, or if out-of-pocket costs for people with pre-existing conditions spike, which Republicans would want to face voters with this as their signature achievement? Do they even have confidence that Trump would defend his own bill, especially given his newfound affinity for Australia’s publicly funded universal health care? Trump-Ryan could be the perfect GOP partnership, so long as it lasts – a mix of legislative brawn and brains that delivers. Or it could all end horribly for the Republican Party, with a mix of policy and politics that provokes a backlash that might seem familiar to those who’ve watched health care debates play out before. Republicans were celebrating the day. But it’s worth noting that they weren’t even the ones gloating the loudest on the House floor.

--TRUMP SAYS OBAMACARE 'DEAD' AFTER GOP HEALTH BILL PASSES HOUSE: House Republicans passed their ambitious plan to repeal and replace Obamacare, sending the measure to the Senate, where it is expected to be significantly revised. The bill passed the House in a narrow 217-213 vote. All Democrats opposed the bill. Following the House vote, House Republicans celebrated with a press conference at the White House Rose Garden with President Donald Trump who touted the bill as a "great plan" even though they got "no support from the other party." ABC's BENJAMIN SIEGEL and VERONICA STRACQUALURSI.

--NEXT STEPS FOR GOP HEALTH PLAN: SENATE PLANS TO WRITE ITS OWN BILL: While House Republicans celebrated the passage of their Obamacare replacement bill by busing over to the White House’s Rose Garden for a celebratory press conference, their Senate counterparts were already working to manage expectations, declaring they are going to write an entirely separate bill, report ABC's ALI ROGIN and MARYALICE PARKS. “At the end of the day, I think it'll be a Senate bill and then those two bills at some point will have to come together and we'll get started on that Senate bill immediately,” Sen. Roy Blunt, R-Mo.

--THIS WEEK ON "THIS WEEK": After the House passes the GOP’s health care bill, White House budget director Mick Mulvaney comes to “This Week” Sunday.

--WHY TRUMP CHOSE SAUDI ARABIA FOR FIRST FOREIGN TRIP: President Donald Trump is expected to visit Israel, the Vatican and Saudi Arabia later this month on his first foreign trip as president, two senior administration officials confirmed for ABC News. Trump is also planning to attend the NATO meeting in Brussels and the G-7 summit in Sicily. A senior administration official said that Saudi Arabia will be the first country visited and that the symbolism is intentional, ABC's JONATHAN KARL, CECILIA VEGA and JOHN SANTUCCI write.


ANALYSIS: TRUMPCARE CARRIES UNCERTAIN PRICE TAGS, FOR INDIVIDUALS AND THE GOP. After fits and starts and apparent dead ends, House Republicans feared inaction more than they feared action. They took a stand in a way that will have profound implications for politics in the Trump era – and for the health care of millions of Americans. On one level, the belated approval of a health care bill by the House should be unsurprising. This is delivering on a promise that’s united the GOP, including with the new president who has shattered so many Republican traditions, writes ABC's RICK KLEIN.

THE 20 REPUBLICANS WHO VOTED AGAINST THE HEALTH CARE BILL. Twenty House Republicans broke with their party to vote against the American Health Care Act's passage Thursday, an effort that failed to produce enough opposition to block the bill, which was approved by a 217-213 margin. Of the several Republicans who were publicly undecided in advance of the vote, at least three -- Reps. Will Hurd, Dave Joyce, and Mike Turner -- voted against the measure. ABC's JOHN PARKINSON and BENJAMIN SIEGEL have more:

HOW EVERYONE IS REACTING TO THE HOUSE PASSING THE GOP HEALTH CARE BILL. The passage of the Trump administration's health care law by the House provoked strong reactions on both sides of the political divide, note ABC's RYAN STRUYK and RILEY BEGGIN. Even as the House GOP leadership celebrated the measure's passing on Thursday, Senate Republicans, who will be next to consider the bill and ultimately decide its fate, didn't appear to be rallying behind the president's health care overhaul just yet.

HOW THE NEW TRUMPCARE BILL COULD AFFECT HEALTH CARE CONSUMERS. After weeks of wrangling, protests and pressure from the White House, a new health care bill was passed by the House of Representatives Thursday. The new bill has changed multiple times since Republicans originally introduced it in March. ABC's GILLIAN MOHNEY has some key takeaways about the newest version of the American Health Care Act (AHCA), also referred to as Trumpcare.

TRUMP PRAISES AUSTRALIAN UNIVERSAL HEALTH CARE SYSTEM AT MEETING WITH PM. President Donald Trump had kind words for the Australian health care system at a meeting with that country's prime minister Thursday, just hours after Republican members of Congress succeeded in passing their efforts to roll back the Affordable Care Act. “We have a failing health care -- I shouldn't say this to our great gentleman and my friend from Australia because you have better health care than we do," said Trump. ABC's ADAM KELSEY has more:

STATE DEPT'S INTERNAL SURVEY PROBES FOR CUTS. The State Department is probing its employees to find redundancies, waste and inefficiencies.ABC News has obtained the internal survey sent to the department’s 75,000 employees here in Washington and at missions around the world. It reads like many corporate questionnaires, but imbued with a looming sense of massive cuts, with several questions about how employees spend their time, what work could be outsourced to other departments and what programs are not meeting the department’s mission. “What should the department stop doing?” it asks bluntly at one point. ABC’s CONOR FINNEGAN has more:

TRUMP ADMIN. TAKES A STEP TOWARD 'EXTREME VETTING' WITH RULE TARGETING SOCIAL MEDIA ACCOUNTS. The U.S. State Department is proposing tougher questions for some visa applicants that would include requiring thousands to give the government access to their social media accounts from the past five years. The proposal would be a significant step toward the "extreme vetting" of immigrants that President Trump promised to implement, explains ABC's CONOR FINNEGAN.

SENATE PASSES GOVERNMENT FUNDING BILL. The Senate has passed a $1 trillion omnibus spending bill that would keep the government running until September, with a vote of 79-18. The spending bill will now head to President Trump’s desk, ABC’s VERONICA STRACQUALURSI notes.

LGBT ACTIVISTS REACT TO TRUMP'S LATEST EXEC ORDER: 'WE HAVE TO REMAIN EXTREMELY VIGILANT.' Flanked by religious leaders from various denominations, President Donald Trump signed an executive order Thursday pledging to "vigorously promote religious liberty" and allow faith-based organizations greater participation in politics without risking their tax-exempt status. While groups are split on whether this order will have any noticeable effect, some in the LGBT community feel it could threaten their rights, notes ABC's KAELYN FORDE.

POLLING AUTOPSY SHOWS LITTLE EVIDENCE OF SHY TRUMP VOTERS. A task force of research experts says there's "little backing" in 2016 election polling data for the shy Trump hypothesis - the theory that Donald Trump supporters were unwilling to tell pollsters they favored him because they thought it was socially unacceptable to do so. A 104-page report from a special American Association for Public Opinion Research panel charged with evaluating political polling after the 2016 presidential election found that national polls were "generally correct," writes ABC's RYAN STRUYK.


@AshleyRParker: In which @maggieNYT and @GlennThrush paint a most unflattering picture of "stalking butler" Reince Priebus:

@mollyhooper: .@Reince exiting gop cloakroom tells me: "The president stepped up and helped punt the ball into the end zone."

@allinwithchris: Trump says Australia's (single payer) health care system is better. @BernieSanders: "Thank you Mr. President"

@PRyan: This is a victory for conservatism. We are continuing to uphold our promises to the American people by fixing our broken health care system.

@HillaryClinton: A shameful failure of policy & morality by GOP today. Fight back on behalf of the millions of families that will be hurt by their actions:

@mj_lee: Wolf: Did you read the health care bill? Chris Collins: "I will fully admit, Wolf, I did not." @CNN

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