The 19-17 vote sends the American Health Care Act to the House Rules Committee, with GOP leaders hoping to take up the bill in the full House next week.
CBO: It estimates the bill would leave 14 million fewer people insured in the first year, 24 million fewer by 2026.
If people have health insurance, they will use more health services - visits to doctors' offices, more tests, procedures and drugs - and health spending will rise. The House cannnot have more than 21 defections if all Democrats decline to approve the plan. "We're trying to make sure that we address as many of these concerns as possible without destroying the bill. and without losing votes but adding votes". The government's red ink would be reduced by $337 billion in the same period, but that would come largely by cutting assistance to poorer people while offering a whopping tax cut for families making more than $250,000 a year.
CBO estimated in 2013 that 22 million people would be purchasing insurance through the exchanges in 2016. They aren't the final word on whether the current GOP plan would succeed or fail.
Pence met repeatedly with House Republicans but rebels still abounded. Will these - should these - estimates compel GOP leaders to change the bill?
At a late rally in Nashville Wednesday, Trump said: "We're going to arbitrate, we're all going to get together, we're going to get something done". The urgency here comes not from the tenets of the bill itself but from a much bigger problem: Obamacare is floundering and risks collapse.
The Republican Study Committee, once a collection of house upstart conservatives, has become more moderate in recent years as the more conservative members founded the "Freedom Caucus".
The vote was considered the toughest of the three committee votes held so far on the controversial package. That won't and shouldn't happen.
President Donald Trump said Friday he is fully behind the Republican health care plan introduced in the House last week, calling it a "great plan" that's "going to be fantastic" for Americans. Premiums are rocketing. Coverage plans are narrowing. There is no good news about Obamacare.
In a nutshell, that's the story of moving from Obamacare to what some call "Trumpcare".
So the next chapter begins: What might an improved bill include?
For now, however, it's unclear whether the GOP bill in its current form can pass. If they really believe that, they are in total denial about what the rest of the American people already know; Obamacare is doomed and only massive changes can prevent a total breakdown of the health insurance industry. It would lower premiums. Opponents say it will severely limit the number of people who will have access to Medicaid because once the money runs out, it's out. Yes, probably by adjusting the Medicaid provisions.
The agenda of President Trump and congressional Republicans hinges on reforming the Affordable Care Act in some way.
But remember that if Washington fiddles, Obamacare may burn.
"No palace intrigue", Ryan said. "This is the moment".