The House of Representatives is expected to vote on the American Health Care Act (AHCA) sometime Friday. As of this morning, it is not clear that the bill will pass the House: Media whip counts suggest 31 or more Republicans will vote no when the GOP can only afford 22 or 23 defections. And any Republican who does vote for the AHCA is likely to pay a political cost, since the bill is opposed by liberals, conservatives, consumers, and health industry groups and is currently polling at 17 percent approve, 56 percent disapprove.
For House Republicans, there is enormous career risk in voting for this bill, but if it fails, the credibility of House Republicans and President Trump will be jeopardized. Either way, this vote is likely to influence Republican fortunes in the 2018 election, and qualifies as “must-see TV” whenever it happens.
Here are five things to look for while watching the vote:
When does the actual debate and vote occur? The later it happens, the more we might infer that the House GOP was negotiating for votes until minutes before the bill came to the House floor. If the voting occurs after 5 pm, the stock market cannot react in real time, and the vote will be covered by cable news but not networks. If the vote is pushed until after midnight, the majority is really trying to hide its work.
Floor amendments can help cement a coalition by making the bill acceptable to moderates or allowing conservatives to clarify their positions. Are Democrats or rank-and-file Republicans allowed to offer any amendments? Right now it appears there will be zero amendments, with all the changes occurring automatically (without a separate vote) when the House votes to begin debate on the AHCA. Democrats will get one chance to send the bill back to committee, however, so it is interesting to see what one change (if any) they propose in a bill that they oppose completely.
3) The pace of voting on final passage
Many Republicans would probably prefer to vote against this bill, and will only vote for it only if their support is necessary for its passage. These members will be slow to vote while they wait to see if their support makes the difference between passage and failure. On the other hand, strong opponents of the bill and loyal supporters have no reason to delay their vote, especially Democrats, who will likely oppose the AHCA unanimously.
As the final passage vote unfolds, the more Republicans who are waiting on the sidelines, the more anxiety they feel about the bill.
4) How long does the vote last?
According to House rules, a roll call vote lasts 15 minutes — or just five minutes if there are multiple votes in a sequence. This rule is enforced by the speaker of the House ... which is to say, it is not enforced when the speaker chooses to ignore it while the majority party twists arms to win a few more votes. The most infamous example of extending a vote was the November 2003 House vote on the Medicare prescription drug program, when the Republican leadership kept the vote open for more than three hours while horse-trading for the last few votes in the dark hours before dawn.
5) What is the vote margin?
I will not venture a guess about the outcome when no one really knows. But I will mention a very good article by David King and Richard Zeckhauser about the margin on politically risky votes like the AHCA. In “Congressional Vote Options,” they find that bills like the AHCA tend to win by a little or lose by a lot. So if the AHCA passed the House, it will likely be with 215 to 220 votes, but if Republicans sense the bill will fail, there may be a mass exodus from the sinking ship, so the bill could fail with 150 to 180 Republican votes.