“I'm a strong supporter of the Affordable Care Act,” Rep. John Carney (D-Del.), the chief sponsor of the bill, said during the floor debate. “But no law is perfect.”
But critics of the proposal warned that it would have unintended consequences. In particular, they cited a concern that the law could allow plans sold to legal immigrants living in the U.S. to avoid the ACA's coverage requirements. In addition, they argued that the bill lacks any protections to make sure that health plans sold to expatriates provide adequate levels of coverage.
“I think we can fix both of those issues,” said Rep. Henry Waxman (D-Calif.), the ranking minority member of the House Energy and Commerce Committee. “We should have fixed both of those issues before it was brought up on the House floor.”
But Rep. Charlie Dent (R-Pa.) insisted that Democrats were exaggerating the bill's ramifications, and that it would affect fewer than 300,000 individuals. “This bill represents a very narrow change to the law that saves jobs,” Dent said. “This bill simply mends the law, not ends the law.”
The vote was almost identical to when the bill previously came to the House floor April 7. But in that instance, because it was taken up under “suspension of the rules,” it required two-thirds support for passage and fell short.
Carney argued that changes had been made to the bill since then to address concerns. Most notably, expatriates must spend at least six months abroad during a year to qualify for an ACA-exempt plan, rather than the previous three-month requirement.
The legislation was backed by the American Benefits Council, the National Association of Health Underwriters and the U.S. Chamber of Commerce. But there was widespread opposition from unions and immigration groups, including the AFL-CIO and the National Immigration Law Center.
Unlike many healthcare measures, the vote didn't split neatly along partisan lines. Sixty Democrats voted in favor of the bill, while 17 Republicans opposed it.
Follow Paul Demko on Twitter: @MHpdemko
