In March, House Speaker Paul Ryan (R-Wisconsin) suffered a pretty humiliating defeat. Even with support from President Donald Trump, Ryan failed to garner enough support to bring his replacement of the Affordable Care Act, called the American Health Care Act, to the House floor for a vote.

At a press conference held shortly after taking the AHCA off the table, Ryan said "Obamacare [ACA] is the law of the land” and will remain so “for the foreseeable future.” But during the last couple weeks, Republicans have been scrambling again, rewriting the AHCA in order to secure the votes necessary to clear the House.

On May 4, the House voted 217-213 to pass the AHCA, even though the nonpartisan Congressional Budget Office has yet to score the bill, so it’s unknown how much it will cost, exactly how many people will lose insurance, and who most benefits.

The recent changes to AHCA aren’t starkly different from the first bill, and analysts estimate that, like the first AHCA, 24 million Americans could lose health insurance by 2026. The changes also mean costs will likely increase for people with pre-existing conditions, like asthma, cancer and even pregnancy. And by drastically lowering the amount of money allocated to patients with pre-existing conditions, only 5 percent of patients with pre-existing conditions will receive subsidies to defray some of their medical costs.

The vote was rushed through so fast that some lawmakers admitted they didn't fully read the bill. The bill basically allows states to opt out of many protections mandated by the ACA.

Here is how U.S. representatives from Southwestern Pennsylvania voted on AHCA. (Note: If Southwestern Pennsylvania's three Republican representatives had voted against AHCA, instead of in favor of the bill, it would have failed.)

Mike Kelly (R-Butler) - YES

Kelly released a statement shortly after the vote that read: “I have joined the People’s House in fulfilling a promise more than seven years in the making by voting to advance the American Health Care Act to the U.S. Senate. Repealing and replacing Obamacare has been our unmistakable mandate since it was first passed. … The American Health Care Act represents the beginning of a better health-care system that is patient-centered, choice-filled, and cost-lowering.” Kelly’s statement also says that AHCA “modernizes and strengthens Medicaid, the federal health-care program for low-income individuals."

But, data-journalism website FiveThirtyEight points out, AHCA makes drastic cuts to Medicaid, which could have a big impact on Kelly’s district. According to census figures, there are about 38,000 people on Medicaid in Kelly’s district, which is the second-most of a Republican-held district in the state.


Keith Rothfus (R-Sewickley) - YES

Rothfus released this statement after the vote: “Obamacare is making insurance unaffordable for those in the individual and small-group market, both with and without pre-existing conditions, and the Democrats have no solutions to the problem. The American Health Care Act is a solution that addresses both coverage for those with pre-existing conditions and affordability for everyone, with states having an opportunity to move away from Washington mandates and towards flexibility and choice.” Rothfus also spoke on the House floor before the vote, delivering an emphatic speech that is uncommon for the representative.

But, since AHCA will increase premiums on older Americans, no matter their income level, there could be an outsize effect on Rothfus’ constituents if AHCA becomes law. Rothfus' district is the oldest in the Commonwealth with a median age of more than 45 years old, according to census figures.

Tim Murphy (R-Upper St. Clair) - YES

Murphy released this statement shortly after the vote: “This marks the beginning of a desperately needed restructuring process of America's health-care system. We have a lot more work to do. I remain committed to protecting the most seriously ill, including those who suffer from mental illness and addiction disorders.”

However, City Paper detailed in March how Murphy's support for the initial AHCA was in conflict with his longstanding push to improve the nation’s mental-health coverage. Murphy, a licensed psychologist, actually voted against the concerns of the country’s largest organization of psychologists, the American Psychological Association. The APA was opposed to the initial AHCA and the association came out against the new bill saying that it will reduce medical coverage for mental-health and addiction.

Murphy's district also has suffered drug-related overdose deaths well above the state average. Greene, Washington and Westmoreland counties, which sit in Murphy's district, all experienced more than 35 overdose deaths per 100,000 residents in 2015, according the Pennsylvania Coroners Association.

Mike Doyle (D-Forest Hills) - NO

#Trumpcare could strip healthcare tax credits from 7 million veterans, leaving them in the lurch. Disgraceful.https://t.co/9bX1vJ6lgX

— Mike Doyle (@USRepMikeDoyle) May 4, 2017

Doyle has been an outspoken opponent of the Republicans' push to repeal and replace the ACA for some time now. He spent the run-up to the vote tweeting about AHCA, which he calls “Trumpcare,” and how some of its provisions might hurt people with pre-existing conditions and veterans, citing an article from the right-leaning Washington Examiner.