Everyone get ready to be screwed! The House of Representatives passed the Republican plan to replace Obamacare Thursday afternoon, now it will face the Senate and hopefully it will die there. Republicans passed the bill by a vote of 217 to 213, just on vote over the 216 needed. It was only two months ago that the Affordable Care Act failed with just 21 votes to spare.

The bill passed with some marginal measures such as an additional $8 billion for people with pre-existing conditions in the current bill. This helped to get some moderates on board. These moderates should be worried about the re-elections in 2018 when people go vote against those that voted to take away coverage from people with pre-existing conditions. Sen. Bob Corker, R-Tenn, said that the House bill has “zero” chance of passing the Senate.

The Senate will not need any Democrats to pass it because they are using a procedural mechanism that allows the bill to pass the Senate to pass with 51 votes instead of the usual 60-vote threshold. There are 52 Republicans in the Senate. Those that helped pass the bill still do not know how much the bill will cost or its impact. In the last assessment, done before the bill was amended, 24 million people would lose insurance, it would save $300 million and premiums would go down ten percent after ten years.

Rep. Raul Labrador, R-Idaho, one of the most conservative members of Congress, said he will vote for the bill. But when asked if he can guarantee that no one would lose coverage under the GOP plan, he could not.

Here is a list of some of the measures in the House Bill (NBC News):

  • Mandates: It guts the IRS requirement in Obamacare that people with purchase health insurance or face a fine.
  • Tax credits: The bill replaces subsidies for people to purchase insurance in the individual market in the Affordable Care Act based on income with refundable tax credits based on age. The impact is that it will provide more people with assistance but with fewer dollars, especially for the older Americans.
  • Medicaid: The Medicaid expansion is frozen immediately and in two years the states can start to adopt either a block grant for the program or a new formula based on population instead of need. In an attempt to make the bill more conservative, work requirements have been added for most able-bodied recipients who aren’t pregnant or caring for a child under 6.
  • High risk pools: The bill provides $130 billion to states over ten years for high risk insurance pools to cover the most expensive to insure. A new amendment by Rep. Fred Upton of Michigan adds an additional $8 billion to assist people with pre-existing conditions.
  • State waivers: States can obtain waivers so insurers don’t have to offer robust benefits packages that include maternity care and mental health coverage. Waivers can also be obtained to charge sicker people and people with pre-existing conditions more. Those people would most likely then go into the high risk insurance pools.
  • Taxes: It repeals every Obamacare tax including the .9 percent tax on couples making more than $250,000 and a 3.8 percent tax on investment income.
  • Health Savings Accounts: The measure increases the allowable contribution limits of Health Savings Accounts
  • Other: It keeps the Obamacare provision that people under the age of 26 can stay on their parents’ insurance.