It also is expected to lead to bigger increases in the premium prices of individual plans over the next two years than would be seen if Obamacare remained in effect. And it would give wealthy Americans a tax break.

Republicans rushed to vote on the bill without first having it analyzed by the nonpartisan Congressional Budget Office, which would have provided estimates of coverage losses, premium effects, and costs to the federal budget. A CBO score on the bill could come next week — and provide opponents of the bill more ammunition against it.

An earlier effort to vote on the bill was aborted in late March when GOP leaders saw that it would fail to win enough support to pass it. Before that failed effort, the CBO projected the bill would lead to 24 million more Americans without health insurance over a decade, and insurance plan premium rates up to 20 percent higher than Obamacare rates would be in 2018 before dropping.

Since then, the legislation has undergone a series of changes designed to attract support from both the conservative and moderate wings of the Republican caucus.

Hours before the House vote, Democratic House leader Nancy Pelosi blasted the bill and the GOP.

“Republicans are again maliciously trying to destroy health care,” Pelosi said.

“They have this vote tattooed on them. This is a scar that they will carry,” she said.

Indeed, it was fear of repercussions at the ballot box that spooked many Republicans as their leaders urged them to vote for the bill. Polling in March on the original version of the legislation showed that just 17 percent of Americans supported the bill.

That dismal level of support reminded Republicans how Democrats lost control of the House in the 2010 midterm elections after passing the Affordable Care Act that year.

Republicans ever since have vowed to repeal Obamacare. But before November’s election of Trump as president, they had been stymied in that effort by President Barack Obama, who could veto any bill that would undo his signature health-care reform law.

Trump on Thursday praised the bill less than an hour before the voting began.


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