The House finally gave President Trump the health care vote he wanted this afternoon, passing its bill to repeal and replace the Affordable Care Act by the thinnest of margins. It now goes to the Senate, which is likely to rewrite it heavily and go through its own balancing act between moderates and conservatives — if it can pass the bill at all.

The key numbers:

  • Yes votes: 217
  • No votes: 213
  • Number of votes Republicans could lose: 22
  • Number they did lose: 20

What stays the same: The Senate will be under as much pressure as the House to finish the job of replacing the ACA, especially now that the House has passed a bill.

The differences: Senators are more independent than House members — and more likely to resist White House pressure. Plus, they might wait for a Congressional Budget Office estimate.

The "fly on the wall" moment: The applause from the Republican side of the chamber when they reached 216 votes — followed by the Democrats singing, "Na na na na, hey hey, goodbye."

The debate in two quotes:

  • " A lot of us have been waiting seven years to cast this vote. A lot of us are here because we pledged to cast this very vote." — Ryan
  • " You will have this bill tattooed on your forehead." — House Minority Leader Nancy Pelosi

What to watch: If the CBO says the House bill increases the deficit — which is possible after the latest changes — it might lose the budget "reconciliation" protections that would allow the Senate to pass it with 51 votes, according to conservative health care analyst Chris Jacobs. And if it needs 60 votes, it will fail because Democrats will never vote for it.

What's next: President Trump has promised a "big press conference at the beautiful Rose Garden of the White House."

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