The House voted Friday to delay the individual mandate to buy health insurance under ObamaCare for five years, an idea that found support from 12 Democrats after frantic leadership efforts to keep its members in the "no" column.
Members approved the bill in a 238-181 vote. The initial vote total was different and said one Republican voted against the bill, but that vote was corrected minutes later — all Republicans ended up voting for the bill.
Rep. Steve Stockman (R-Texas) was initially recorded as a "no," but that was changed. Democrats voting for the bill were Reps. Ron Barber (Ariz.), John Barrow (Ga.), Ami Bera (Calif.), Joe Garcia (Fla.), Jim Matheson (Utah), Mike McIntyre (N.C.), Patrick Murphy (Fla.), Scott Peters (Calif.), Collin Peterson (Minn.), Nick Rahall (W.Va.), Bradley Schneider (Ill.), and Kyrsten Sinema (Ariz.).
Democrats were under pressure to fall in line against the bill after a stinging loss in a Florida special election this week, which heightened fears that the healthcare law will sink the party in the midterm elections.
Still, in a shift from recent ObamaCare votes, House Democratic leaders whipped votes against the mandate bill, and nearly limited the defections to single digits.
Friday's vote provides more ammunition for Republicans as they seek to attack Democrats on the healthcare law.
It also helps them keep up the pressure for a legislative fix to ObamaCare, particularly in light of more decisions from the Obama administration to delay key parts of the law. In the past few weeks, the administration has said it would allow non-compliant health plans to be sold through 2016, a move that was seen as helping Democrats before the midterms.
The administration has also said it would exempt people from the individual mandate to buy insurance through 2016 if a new plan would be too expensive.
Republicans said these recent delays, and delayed enforcement of the mandate for some employers to provide insurance, mean Democrats should be fine with a delay to the individual mandate.
"This was never ready for prime time, we have said that from the start," said House Energy and Commerce Committee Chairman Fred Upton (R-Mich.). "If the administration has decided to delay all these things, almost two dozen, why not delay this too?"
Republicans have had some success over the last few weeks in gaining Democratic support to chip away at ObamaCare. Last week, the House passed a bill to delay the individual mandate penalty, which 27 Democrats supported.
Earlier this week, the House easily passed three other ObamaCare bills, including one creating a new ObamaCare exemption for people whose religious convictions are incompatible with buying a health plan under the law. That bill passed by voice vote, a sign of overwhelming support.
In today's vote, Democrats accused Republicans of using bait-and-switch tactics, as the five-year delay was attached to a bipartisan bill, H.R. 4015, to permanently end the threat of cuts to the Medicare physician reimbursement rate. Members of both parties supported this permanent "doc fix" bill, but Democrats said the individual mandate delay is a "poison pill" that completely erodes Democratic support.
"This is not a delay that we can agree to," Energy and Commerce ranking member Henry Waxman (D-Calif.) said. "It hurts the Affordable Care Act, and it's a betrayal of our working together on a bipartisan basis to resolve this [doc fix] problem."
Republicans said that in light of the administration's own delays to the individual mandate, Congress should also have a right to use a delay to help pay for the doc fix.
This week, the Congressional Budget Office (CBO) said a five-year delay of the individual mandate would save $170 billion, enough to pay for the $138 billion doc fix. In today's debate, Republicans said Democrats are rejecting the "pay for" but not offering anything else.
"I know my friends on the other side of the dais may disagree with having to pay for new spending, but this is an important reform that Republicans put in place when they reclaimed the majority after the 2010 elections," Rep. Michael Burgess (R-Texas) said during Thursday debate. "If you want to increase mandatory spending, you should reduce mandatory spending elsewhere."
Other Republicans said House passage of the bill would begin a House-Senate discussion about how to pay for the bill.
But Democrats said the CBO score also estimated that the mandate delay would lead to 13 million more uninsured people by 2018, and would increase insurance premiums. They said that estimate shows the mandate delay is language that seriously undermines the law.
"The Republicans are bringing up a totally partisan bill to thwart a bipartisan bill," said House Ways and Means ranking member Rep. Sandy Levin (D-Mich.). "They are tossing aside common ground for barren ground, another Affordable Care Act repeal vote."
Democrats also said tying the doc fix to a delay of the mandate, and the resulting Democratic opposition, means Congress will need to scramble in late March to find an acceptable doc fix.
"We shouldn't be wasting time on this foolishness and recklessness," Pelosi said. "The Republicans' fixation with destroying the health security of millions of Americans through their efforts to destroy the Affordable Care Act imperil the permanent doc fix, and that must stop."
After today, both the House and Senate are out until March 24 — without new legislation, Medicare physicians will see a 24 percent cut to their payments on April 1.
Senate Democrats have said they want to pay for the doc fix with savings from reduced war spending. However, some Republicans have previously questioned the validity of this "pay for," which means it's not clear whether this Democratic idea can pass.
— This story was last updated at 12:06 p.m.