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Giphy

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."

Go deeper

Caitlin Owens, author of Vitals
2 hours ago - Health

Biden taps ex-FDA chief to lead Operation Warp Speed amid rollout of COVID plan

Photo: Alex Wong/Getty Images

President-elect Joe Biden has picked former FDA chief David Kessler to lead Operation Warp Speed, a day after unveiling a nearly $2 trillion pandemic relief plan that includes $400 billion for directly combatting the virus.

Why it matters: Biden's transition team said Kessler has been advising the president-elect since the beginning of the pandemic, and hopes his involvement will help accelerate vaccination, the New York Times reports. Operation Warp Speed's current director, Moncef Slaoui, will stay on as a consultant.

The case of the missing relief money

Illustration: Sarah Grillo/Axios

A chunk of stimulus payments is missing in action, thanks to a mix up that put as many as 13 million checks into invalid bank accounts.

Why it matters: The IRS (by law) was supposed to get all payments out by Friday. Now the onus could shift to Americans to claim the money on their tax refund — further delaying relief to struggling, lower-income Americans.

The post-Trump GOP, gutted

McConnell (L), McCarthy (R) and Trump. Photo: Erin Schaff-Pool/Getty Images

Republicans will emerge from the Trump era gutted financially, institutionally and structurally.

The big picture: The losses are stark and substantial.