This. After making phone calls and i couldnt turn these members from no votes to yes votes, i brought them here to the oval office and i was able to come to where im zpang to say i am now a yes. So right now, the way it is set up, if there is a press conference, if there are questions, the white house says they wont be directed toward the president. Interesting that the one who suffered last time they served their party rather than their members. One term up in montgomery county, pennsylvania, and she voted because the president asked her to with bill clinton to vote form tax bill. Now all the people from that neighborhood who are now republicans, theyre all afraid of being the same sword of victim. It is astounding. I guess well have one by tonight. Charlie denton, allen town. The southern part of new jersey. Fitzpatrick from bucks county and of course doctor meehan. They remember when the republicans marked margolies on her way out. Now you see the leaders and the followers all mocking with that nana mockery of the republicans having done the same thing. There is a high school aspect to this, i think. It is like winning or losing the football championship. These people are enjoying the sport torsion put it lightly of winning and losing elections and careers. People are learning about preexisting conditions, like pregnancy. About 27 of americans have something that falls under the category of a preexisting condition. But listen to the state thats actually have a higher percentage of residents who have preexisting kth. Oklahoma, tennessee, kansas, kentucky, indiana, fascinating to take a look at that list. Fascinating to see that americans are going to be learning, in many ways, at the same time members of the house are learning exactly what the details are. The high emotion for so many millions of americans but also their families. As everyone who knows has had a Family Member with cancer, a life threatening illness. It has a tremendous tent cals to their workplace, their family, their friends. It is even over 27 . It will be interesting to watch the coverage locally on those local talk shows. People liked the program without knowing it was called obamacare. When we get politics out, people will be looking in the papers tomorrow morning examining the details and trying to figure out what theyve been counting on for themselves and wondering what the politics are about. You look at the obamacare experience in 2010 and everything that has happened in our politics since then. Go back to the 1990s. Weve been talking about. That hillary care when the clintons tried to do the overall in 1993, 1994. Whf these things take center stage, people get nervous that the care in many cases are generally satisfied with. They get very nervous that will be jeopardized. Very nervous about the state of the system. All the concerns for people with preexisting conditions, people who have benefited from obamacare over the last few years. It just seems one of the lessons, if we want to talk raw politics. One of the lessons of 93 and he 94, politically when these things are happening, the politically safe place to be is against them. So i look at a democrat like joe manchin, if he is opposed to this, that wont be hard to explain even in a trump state. It will be a potentially complicated issue for the republican senator. If she ends up voting for this, that will be something tough to explain even though it is a trump state. Weve got a couple people joining us. Jennifer palmieri, for the president ial campaign. Jennifer, this must be an amazingly cathartic moment to watch what it looks like the went an election. Heres party maybe committing suicide in many cases, because the members of congress are doing what the president wants them to do. Not necessarily what the people at home will be happy they did. I cant recall watching more destructive act in politics. I also worked for president clinton in 1993 and president obama during health care. And in both cases, while people took difficult votes, there was a plan to get both the 93 bill and health care through senate. I dont see a plan on the republican side to do that with trump care a. And at a minimum, we know that these house members have taken a very dangerous vote that will be destructive to peoples lives if it became law. The best case is that the senate spends many, many, many months talking about health care. When i worked for president obama, a big problem for him was people were frustrated that it was taking so much time. That he was so focused simply on health care. There was a big opportunity cost right there. And the notion they could get something done that could fast senate and make it through house is unlikely. I think that the republicans, the motivation, the political motivations here were all within the Republican Party. The president wanted a win. Paul ryan couldnt have another loss. The Freedom Caucus wanted to save themselves. Those three entities talked to each other. Didnt talk to democrats, didnt talk on anybody on the outside. I think they put their members in an extraordinarily precarious position. And youre right. This ridiculous white house event will come back to haunt them all. As jennifer said, if youre going to get people to stick their neck out and get a tough vote, that includes the people from the northeast, you want to give them a bill to go home with. A very good chance theyll have the vote but not the bill because it wont get through senate. I talked at length with majority leader mcconnell. I think he knows the strikes high. My feeling is that weve had three elections where obamacare was the number one issue for Republican Voters and they wouldnt have majority in either the house or the senate if wasnt for their pushing back on obamacare. I think it is important to remember that there is the results of these elections, and the American People, out of millions of americans had who have worse Health Insurance options, there was a pushback that they didnt have the choices they thought they needed to have. There is a pushback on the idea that the government should mandate you through taxes and fees to Purchase Health care. And as we know, many of the Younger Voters even didnt get Health Insurance policies even though there was a mandate. So there are huge issues with obamacare the republicans now with the majority have got to face. I agree the politics are tough because it is peoples lives. To stand back and not take political step after you ran against this in these three or four elections would have been political suicide. Thats the suicide here. The right thing is to do the right thing. Yes. It is republican votes but jennifer needs to remember, obamacare passed with democrat votes only. But once you get something through, youre playing defense. When you succeed and you accept responsibility for something, the voters blame you. I heard you today. You were very ambitious for this bill. You said in addition to what they did in the house, you were hoping they would do tour reform. That takes on a whole new enemy army. Are you ready to go to war with the trial lawyers . I was kind of challenging the democrats. Hey, we have to do something to Lower Health Care costs. Were only going on Lower Health Care costs. This will take 60 votes in the senate but we have to do something how Many Democrats will you get for tort reform . Zero thats how you dont get to 60. Looking at the rose garden here. Were looking at the rose garden here and it looks beautiful. And serve taking their seats. Some standing up, as you often do behind a bill thats getting passed. The press are off to the left. You will see in the payments tomorrow on, hardball, a whole bunch of republicans. The coat and tie. One guy is combing his hair. Everybody will get ready for this big photo op with the president. Do you think this is a good photograph for republicans in various districts to go home with in. I heard what you said about this. My view is you cant swerve around the idea that this is a victory for President Trump. That the republicans really make the case. Theyre all in this together. Even the ones that voted against the bill, this will be seen as republican effort to Reform Health care. I would probably do this picture after the senate were to act. But i do think what theyre trying to do is propel and get more momentum as it moves to the senate. I dont think this is a vectory lamb as it is, trying apply more pressure to get through senate. I see darrell issa, the guy who likes investigations. Now he is in a tough district. He is present close to the front row there. Impressive. Let me go back to chris jansing, right there with a good look at whats going on. A lot of hugs. We just saw kell yaenl conway, Jared Kushner just came in. This is exactly what the president decided he wanted to do today. He wanted this setting. The grandness of this setting. A small group of military musicians playing in the back ground and of course, the buses have brought them over. A chance for the president to say, we did it. We promised you we would do it. We did it. It is hard given the way theyre standing on get an actual count of how many decided to come over here. Im sure there will be a lot of discernment of who came and who didnt come. And we see his daughter and his adviser, ivanka trump sitting down next to her husband, Jared Kushner. Theres the door opening for the oval office. I can see into the oval office now. We expect the president to come out. Big question is, will he take any questions he . Will he have any answers for report betters the concerns raised widely by everybody from the ama to the aarp but also to the general American Public about how will my premiums be affected and will preexisting conditions be covered . I can tell you among the people who are here as the invited guests of the president , there is a celebratory attitude. A lot of hugs and a lot of smiles. Lets to go greta had van susteren. Youre getting ready for your program. Do you see this as a split decision . Maybe im delusional but i dont get this at all. What is the celebration . Kinlt pass in the senate. It hasnt even gone to the senate. Their taking selfies of each and high fiving. It is like claiming victory in a Football Game at the end of the First Quarter or the half or something. I dont know why they put themselves in a position where theyre clapping each a on the back for getting something halfway done. The American People want a product. Were not even they and it is not likely to be there. We have this picture, this bus ride, this big hoopla. They Want Health Care fixed, they want preexisting problems taken care of. I dont are get this. It is fun for us, exciting, we have a bus going down constitution avenue. For what . Nothing has changed. Nothing has changed. This he just passed it to the senate. It will go kerplunk there. Then what . Youre a lawyer. Let me and you this. It seems the me, the last time i saw a picture like this, it was when al gore led a cheering session for bill clinton when he was impeached. I agree the whole thing was a political exercise on both sides. They went zpoudown there and di this crazy cheer. It was grotesque. Just sheer Party Loyalty is all that was there. Now were seeing first of all, the imagery of getting on a bus and getting trooped down like youre working for the guy. It doesnt look line checks and balances to me. If it had gone over to the senate today and passed in the senate, have at it. Get all the buses in town. The thing is, nobody is there. Do you think, chris, this will pass in the senate . No. Well, if it is going the usual route, the filibuster and cloture, no. I think this will require a regular vote. I think it is a 60 vote, not a 50 vote. If both parties want to hold on to that 60vote rule. Baeft there may be some changes in the senate. But in any event, this is not over. Usually you celebrate when things are over. Instead we have members of Congress Taking selfies of each other in the rose garden. And theyre clapping. I think it is pre mature. If this were a done deal hang if there. Well all listen to the program now. This will be fascinating politics. [ applause ] speaker ryan, majority leader mccarthy, majority leader, chairman brady, chairman walden, chair woman black, congressman mcarthur, congressman meadows and all the principle members of Congress Standing with us today on, behalf of President Donald Trump and the first family, welcome to the white house. And thanks to the leadership of President Donald Trump, welcome to the beginning of the end of obamacare. It was march 2010, seven years ago, democrats passed the government takeover of health care. And at that time republicans in congress promised the American People that law would not stand. Today, thanks to the perseverence, the determination, and the leadership of President Donald Trump and all the support of those gathers here, weve seen a historic first step to repeal and replace obamacare, and finally give the American People the kind of health care they deal serve. So today, with heart felt gratitude for all he has done to keep his word to the American People, for all he will do to continue to make America Great again, it is my high honor and distinct privilege to introduce to you the president of the United States of america, President Donald Trump. Thank you. Thank you, mike. Thank you. Thank you very much. This really is the group. What a great group of people. And theyre not even doing it for the party. Theyre doing it for this country. Because we suffered with obamacare. I went through two years of campaigning, and im telling you, no matter where i went, people were suffering so badly with the ravages of obamacare, and i will say this. That as far as im concerned, your premiums, theyll start to come down. Well get this passed through the senate. I feel so confident. Your deductibles, when it comes to deductibles, they were so ridiculous that nobody got to use their current plan. This nonexistent plan that i heard so many things about. I dont think youll hear so much right now. The Insurance Companies are fleeing. It has been a catastrophe and this is a great plan. I think it will get even better and make no mistake, this is a repeal and replace of obamacare. Make to mistake about it. Make no mistake. And i think most importantly, yes, premiums will be coming down. Yes, deductibles can will be coming down. More importantly, it is a great plan and thats what it is all about. We knew that wasnt going to work. I predicted it a long time ago. I said it is failing and now it is obvious that it is failing. Essentially dead. If we dont pay lots of ransom money to the Insurance Companies, it will die immediately. What we have is something very, very well crafted. There is a lot of talent standing behind me. An unbelievable amount of talent. That i can tell you. And coming from a different world and only being a politician for a short period of time, how am i doing . Ill doing okay. Hey, im president. Can you believe it . I dont know. I thought you needed a little more time, they always told me. More time. But we didnt. We have an Amazing Group of people standing behind me. They worked so hard and they worked so long. When i said lets do this. Just short little shots for each one of us and say how good this plan is. We dont have to talk about this unbelievable victory. Wasnt under believable. It will be an unbelievable victory when we get it through senate and theres so much spirit there. But i said lets go out. We have a list of some of the people. After that list goes, if they dont talk too long, our first list, well let some of the folks come up and say whatever we want. We want to brag about this plan. This plan, really. Ohoh well we may. But were going to talk about the plan and how good it is. Some of the great features. I want to thank paul ryan. He has worked so hard. I was joking, i said, you know, paul, for the last week ive been hearing paul ryan doesnt have it. It is not working with paul ryan. He is going to get rid of paul ryan. Then today i heard paul ryan is a genius. Hes come a long the groups have all come together. We have the tuesday group. So many groups. We have the Freedom Caucus. Their all great people. They all came together i would say in the last three, four days. Especially in the last day. I see mark and kevin and so many people. Jim. We just have developed a bond. This has really brought the Republican Party together. As much as weve come up with a really Incredible Health care plan, this has brought the Republican Party together. Were going to get this finished and then were going, as you know, we put our tax plan in. A massive tax cut. The biggest tax cut in the history of our company. I used to say, the biggest since ronald reagan. Now it is bigger than that. Also, pure tax reform. So were going to get that done next. And this really helps it. A lot of people said how come you kept pushing health care knowing how tough it is . Obamacare took 17 months. Hillary clinton tried so hard, really valiantly, in all fairness, to get health care through. It didnt happen. Weve really been doing this for eight weeks, if you think about it. And this is a real plan. A great plan. And we had no support from the other party. So i just want to introduce somebody to say a few words who really has been, i think, treated very unfairly. But it no longer matters. Because we won and were going on finish it off and go into a lot of other things and we are going to have a tremendous four years and maybe even more importantly, were going to have a tremendous eight years. But were going to start off with just a great first year. And paul ryan, come up and say a few words. Congratulations on a job well done. Thank you. First, thank you, mr. President , thank you. Thank you for your leadership. There are too many people to name who played such an Important Role in helping us get to this part. But i want to thank a few people in particular. I want to thank chairman waldon, kevin brady, diane black, Pete Sessions and the members of their committees for all the hard work they put into this. I want to thank all the other members who contributed to making this the best bill possible. It was really a collaborative could not sense us driven effort. I want to thank the people at the white house. I want to thank nick mulvany and especially reince priebus. We could not have done this will without you gentlemen. You guys are the best. Of course, this would not have been possible if it werent for these two gentlemen behind me. This is the fourth presidency ive served with. I have never, ever seen any kind of engagement like this. I want to thank President Trump for their personal involvement working the members to get this done and getting us to where we are. Thank you, gentlemen. Today was a big day but it is just one step in this process. An important step. We still have a lot of work to do to get this signed into law. I know that our friends in the senate are eager to get to work. They are. We are going to see that work through. Do you know why were going to see it through . The issues are too important. The stakes are just too high. The problems facing American Families are real. And the problems facing American Families as a result of obamacare are just too dire and too urgent. Just this week, just this week we learned of another state, iowa, where the last remaining Health Care Plan is pulling out of 94 of their 99 counties, leaving most of their citizens with no plans on the obama market at all. What kind of protection is obamacare if there are no plans to choose from . And this is a trend that were seeing all across the country. The truth is this law has failed and collapsing. Premiums are skyrocketing. It is getting worse and out of control. We have to put in place a real margaret place with lower premiums for families. Thats what the American Health care act is all about. It makes health care more affordable. It takes care of our most vulnerable and it shifts power from washington back to the states and most importantly, back to you, the patient. Weve got a lot of work to do. One thing is now clear. Republicans are committed to keeping our promise the lift the burden of obamacare from the American People and put in place a better, more patient centered system. It is my pleasure at this time to thank and to welcome to the state, someone who helped make this all possible, our very talented majority leader, kevin mccarthy. I remember the very first time i came down here to see the new president , President Trump. We talked about health care. Do you know what the president said . He said lets not make this partisan. Dont do what you think is right for the Republican Party. Do whats right for the american country. And today thats exactly what we did. You see, if you simply read the payments from this week, you take politics out of it and you put people before politics, how do you look in the faces of 94 counties in iowa out of 99 . Or not that they wont have very many choices. Theyll have no choice. How do you care for preexisting conditions when theres no care at all . Or you read the paper yesterday and you look at aetna pulling out of virginia or ten ten next year with 16 counties with no care. Or what about those families that paid into those 23 coops that obamacare created. 18 have collapsed. The only answer that this American Government gives them is a penalty. Simply look at the facts. More people took the penalty or the exemption than actually signed up for obamacare. I did not run for this office to promote a party. I ran for this office to make this country better. It would be easy to say no. It would be easy to watch it collapse. But i cant look at those families. I dont think thats right. And thats the exact message i got from this administration. So mr. President , i want to thank you for your leadership. I want to thank the Vice President. You know, ive only been through a few president s but ive never seen someone so hands on. He walked into my office yesterday. They said the president is calling again. I picked up the phone. I happened to be the majority leader, the former whip. I know my members well. The president gives me a list of who he thinks i would be best to talk to on the list. And he was right. Mr. President , they all voted for the bill. Today is a start. Today is the start of a new beginning yet. Bits providing Better Health care. But i happen to have been a Small Business owner. I listened to my district. Do you know how many families no longer have a 40hour job and now have to take two parttime jobs . Or how many small bits told me that they couldnt expand anymore because they were afraid of what obamacare would do for them. Were going to unshackle, build an economy that people have greater choice in their health care and protect preexisting conditions. And i thank you for that work. I want to call up [ applause ] i was this job before being majority whip. I 97 had to go through a bill like this. And i will tell you being the whip isnt one person. The deputy whip should get a lot of credit as well. Patrick mchenry. Steve never gave up, answered every question when the team between them, i put beyond any team we ever had. I give you the majority whip. Today we took first step toward rescuing families of the failures of obamacare. Weve been seeing it play out across the country. Youve seen families struggling from every part of country. Sharing with me stories of double digit premium increases every year. When we had the 27 1 2 hour markup to pass this bill out of committee, we had a long and important discussion about Health Care Policy in america and how this isnt about achieving some kind of political goal. It is about families who are struggling under the weight of this law that doesnt work. I reached out to my constituents and i said tell me your stories on how this obamacare is affecting you personally. Unfortunately, i got a lot of horror stories. We talked a lot about protecting people with preexisting conditions and there are so many things, multiple, multilayers in our bill passed today that not only protect people with preexisting conditions but actually focus real targeted money on lowering premiums for families with preexisting conditions. So during the committee hearing, it might have been around 3 00 in the morning, i shared a story of one of those. Chris slidell talked about their family having preexisting conditions. They have a Family Member with preexisting conditions. Because of the problems of obamacare, theyre paying double digit increases. This is the real story for families with preexisting conditions that are truly being hurt by obamacare. One of the Untold Stories are the dramatic increases in deductibles. So there are a lot of families that over 10,000 deductibles. For most people that means they cant even use the obamacare. Not only when we go to the doctor do we have to pay so much for the premium but almost everything is out of pocket because we have such a large deductible. So im paying a lot of money for a Health Care Plan that doesnt work for me. Please provide relief for my family. We hear these stories over and over. And what has been so encouraging about this debate, from the very beginning, every member of congress that has been involved in trying to get this bill passed has been focus told on too many things. The first is lowering premiums for families who are struggling. The second is making sure sxashs doctors make their over health care decisions. Unelected had people shouldnt have anything to do with the decisions between the patient and the doctor and that ends with this bill. And so as we went through this process, and it took weeks. Some people wanted to it take a couple of days. We said well take the time to get it right because it affects every person in this country. And every change made this better. Almost every change made along the way was focused on lowering premiums. Of course, you had a lot of other things to do. We reformed the medicaid program. One of the most broken parts is medicaid. So we gave states flexibility to be innovative and do nangs much more targeted way, help lower income families in a way that medicaid is failing them today. Thats another important aspect of this bill. We wouldnt be here without the work and the help of the president and the Vice President of the United States directly getting involved. Every meeting we had with members that wanted to get additional components added to the bill. President trump said, bring they will to the white house. I want to meet with them. I want to talk about how we lower premiums. President trumps focus from the beginning was the same thing. He knows obamacare fails but it is failing because it is hurting families. And he said how can we give patients more control of health care . And all the meetings we had along the way were focused on those objectives. Thats why it is so important to get this first step done today. And theres a lot more to be done. And i look forward to that. But ultimately getting the bill to President Trumps desk that hell sign that rescue families from this incredibly failed law and put patients back in charge. And the man who led the charge in the committee was the chairman, greg waldon. I want to bring him up. Ladies and gentlemen, mr. President , mr. Vice president , it has been an honor to work with you hand in hand to get this bill to this point. And i want to tell what you a great team we have and you have in congress and on the Energy Commerce committee. And mike burgess, come on out here for a second. Hes done incredible work this as well. Youve heard a lot about the goal to make insurance available to every american where they have choices and lower costs and competition in that market. It is collapsing around us, state by state, county by county. Last year there were 225 counties in america where you have one choice on the obamacare exchange. This year it is 1022. Youve heard now there are some counties where youll have no choices. Thats not access, thats not patient care. That is what were trying ref m reform. We have a lot of people joining us from msnbc to analyze the very, i think, historic name of this vote by the republicans. As we said, the republicans carried the house, 217213 them didnt waste a single vote. They had just enough republicans to pass the bill within the vote. That was it. They kept 20 votes on the side protecting these moderate republicans from having to take the heat for what will be seen as a very controversial move by the house today. Steve kornacki, go through it if you could. You did a great analysis of those who became exposed politically and those who played it safe. Yeah. If youre the democrats is that youre looking to 2018 and youre looking at strategy. Theres a very particular type of incumbent youve been looking at all along. A republican incouple bent who represents a district that Hillary Clinton won. It is interesting, those 23 republicans, 14 of them. 14 voted yes on this. So in theory, youre looking at the top targets here for democrats when they look healed to 2018. So far they want to pin on republicans that theyre targeting. 14 of the republicans from clinton held districts said go ahead and pin that on me. Obviously, as you were saying, there was a lot of hesitation, a lot of concern here among republicans in districts like. This i dont necessarily the want to go on the record voting for this but republican leadership, it looks like in the end, they made just enough of them walk the plank so they could get it through. Nine republicans from clinton held districts were able to vote no. 14 voted yes. If you take it to the second, if you look at the near miss districts. Districts clinton lost but she was close, within 5 points. 11 of those, nine republicans voted yes. You look on payment. The top targets for democrats on payment when they look ahead to 2018. A lot of republicans actually votedio this which politically speaking, thats the vote democrats wanted to see them take. The president looks very happy. We had it a minute ago. Big picture politics, the president didnt lose. Thats the way we score it day to day. And then he will blame the senate if they change and it moderate this bill to such an extent that then it cant get past the house. But this is a victory. The timing is questionable in that they passed a bill they hadnt read, they hadnt scored. They dont know how much money it will cost. How much will it affect deficit . How many people will be impacted by it . They have the claim that it covers people with preexisting conditions, and theyve put up the waemd 8 billion to cover those people. But by most calculations, even down the middle budget experts, that 8 billion will not nearly could have all the people with preexisting conditions that will be kicked out of their existing coverage once the insurers get ahold of this and it gives states the right toment on out. That will be the big factor. I think the math isnt that hard though. To be fair. We know that the government deals in box office numbers. Huge numbers. 8 billion over five years is 1. 6 a 84 to cover all the people in this country who have preexisting conditions. All that insurance coverage. All that medical, all those pills, all of that hospitalization. All that is covered by 1. 5 billion . 80 of people between 50 and 64 have preexisting conditions. That says nothing about the heart breaking jimmy kimmel story about his child and others who are born with conditions, infants born which then have a lifetime of preexisting conditions. Their entire families will be affected the they dont have the wealth of mr. Kimmel. This will be toxic and well have to see how the politics play out. As Steve Kornacki was just pointing out. Those from districts who did vote for Hillary Clinton will be the prime targets. And you heard the channel and the derision on the house floor when the final passage was going through. And it was similar to what the democrats end durd when, endured it. Somebody we both know lost a former, the university of pennsylvania professor right now, marjorie. Who likes trump, who doesnt, and thats an interesting debate that will go on for the next four years. I can see a lot of working class, what we called reagan democrats voting for attitude. And then going home to their spouse and saying how does this affect us . What President Trump said, this is a victory for them. The fact is, we look at it like a sporting game. Who wins, who loses, who is likely to get killed in the next election. Any one of us can go home and get a phone call from an emergency room having a sick relative and then we see where the rubber hits the road. And we dont know how this will affect anybody. We dont know the cost, the impact of it. Were just watching this display hoping this is a step in the right direction. But it is impossible to tell. Were all just rolling the dice and there is to easy answer. I dont think this is easy for the republicans or the democrats. I find it a little unseemly, people cheering as though this is a win or a loss. The real question is, given the limited resources we have for the nation, the limited resources we have for health care, is this a good wise decision . And it really is too easy to tell. It is hard to claim victory. And we know that it will go through a stumbling impact at the senate. The senate will make changes to it. When the changes are made, will they lose the house votes . We dont know. Look. Health care is so personal. We can all have some of the interesting aspects of watching politically. Bottom line is any one of us could get this phone call the tonight when this becomes more than watching on it tv. Let me go to ali velshi on this. I think were so early in this. Someone said were at halftime. I dont think were after the first play. Will i think theyre going to have to break a filibuster, to get this back to the house for a second vote. Here they won it by one vote so they cant move it an inch. Everybody has been saying you cant change anything substantially because you have to go back to the house that barely voted for it today. Thats correct. It the wont emerge from the senate in the fashion that it is now. Again, were now temperature threshold. The 216 threshold. That will be a big problem. Im with greta on this. This is a bad idea, the victory picture. Were not foreign ministinished. Just like the republicans gave president obama a hard time with, if you like your doctor, you can keep your doctor. This preexisting conditions had is empirically not true. What a lot of people dont know is the essential Health Benefits, the ten benefits that obamacare mandated that every policy have, now not only dont have to be there. It is very easy under this bill for states to get that waiver. All they have to do is write a letter to tom price. If the letter is not responded to, the state is granted waiver automatically. In that case, even employer sponsored plans can remove the Ten Essential Health benefits mafl terneternity, emergency ca pre natal, prescription drugs. So what is happening here, what a lot of people dont know. It has happened as Steve Scalise said in the middle of the night, there have been people not following this debate. Because those essential Health Benefits didnt apply to them. Theyre like us. We work for a Major Corporation which has some of the best nshls probably on earth. Even some of those people will now their insurance affected by. This once word of this gets wider and there are greater debates, youll find 8 billion to cover the increased cost by liberal estimates, i mean by progressive groups, it may be 1 of what is needed. By conservative estimates, less than 50 of what will be needed to cover people who are as a result of this bill going to be without insurance. The philosophical thing, not a thing, the debate itself. Whether the government has a responsibility for Peoples Health care or whether it is every man and woman for itself. The fact the republicans came back with basically tax credits which are basically, theyre refundable in some cases where a family doesnt pay into income tax because theyre low income. It is basically cash. The democrats really won the argument. Now question is, is it being fulfilled by the people promising it. And it seems to me what they did in the last 48 hours, was to say, okay. We wanted to have states rights here. That has become a big thing. Well give states the right to option out when they want the Services Provided or not. They kept that. They kept the states rights approach. It allows the more conservative states to do the more liberal states would do. Then to cover for that they put this little, i would call it a band aid. An 8 billion band aid on top of preexisting conditions and say, here. Youre worried about that 30second ad running against you next year . Heres your solution. Youll be able to say you voted to cover preexisting conditions. Even though every analysis will say, there is no way in the world that that 8 billion covers it. So the mistake is voting on a bill that people didnt get to read or score. Theyll realize the math is pretty simple. Two little statistics. One is that there are 34 developed nations in the world. 33 of which have some form of universal health care. The United States is the only exception of the richest countr United States has the worst outcomes of all including the lowest Life Expectancy by about a year and a half or two years and finally the United States pays 9,500 per person, per capita in health care, all the costs, the average of developed nations is 3,700. Again, 3,700 per person, for better outcomes, and a longer life than this Health Care System we have in the United States. You know, theres something go ahead, greta. Theres something to be said, though, chris, for letting the states make more decisions because it gets sort of unmanageable, unweeieldy to hav giant decisions one size fits all. Theres something to be said for that but i think, you know, bottom line, i think if you asked most americans, i think they want to make sure their neighbors can have health care in some form and be accessible or fair. But i mean, the idea of letting states do experiments, i know, look at what Tommy Thompson did in the state of wisconsin with welfare reform, sometimes its smart to let states come up with solutionses to meet their own particular need. The thing thats so troubling to me here is it has such a profound sense to me when i see the democrats saying, you know, screaming on one side, and the republicans screaming on the other side, in this instance you get sort of unseemly aspect of politics, dont get the idea that theyre really trying to solve real problems to effect real americans and if the republicans are right here, if this works and makes it better, thats great, but we dont even know now. We dont know what this is is going to cost, we dont know the impact on any of us. We really should wait to see whether there should beknee sho cheering by anybody. Its politics as well, truin. Paul ryan is celebrating victory. Winner or lose, it does matter. Let me ask you about the way everybody, but greta, you can do this as well as i can, which is the fact that the republicans were able to scratch together 217 votes today on the house floor rather than any surplus, they didnt waste they corral the members, say all you guys stand over here, well let you go if we dont need you and let 20 go. Didnt let anybody else go. In other words, they used every vote they needed but not one extra vote more than they needed so there were a lot of republ republicans who did not want to vote for this but were encour e encouraged to do so by the leadership. Doesnt that tell you how tricky this bill is . Indeed, it does. Give trump credit, he managed to get enough republicans on board. Speaker boehner wuchonce said t being speaker of the house is having a wheelbarrow with 300, 400 frogs in it and had to push it from one end of the floor to the other without frogs jumping out of it preside. The Republican Party has become a Diverse Party with the heres the president , greta. Heres the president. Great health care for vimpb everybody in our nation. We have an unbelievable country. An unbelievable country, but i want to thank the men and women behind me. I want to thank at least some of the men and women in front of me. Of course, i even want to thank the media. Thank you, all, very much, everybody. Thank you. Thank you very much. Thank you. Well, that was characteristic, wasnt it, of course the president taking a little soft shot at the media. Of course, this is a big day. I do think, i want to go back to ali velshi, everybody else to finish up the neblgs cxt couple minutes. The choreography, visual is unusual. We have a constitution based on three branches of government. The judiciary which the president has taken on rather brutally, i might say, i think wed all agree on that. He had the executive which he runs then we have the legislative. And here he is with the legislative sort of appealing to be subordinate to him. Ill go back to greta on that. I think theres a picture here that you may not want to explain in your civics book. Yeah, and without a doubt, but they actually did need the president to get them all on board, you know, this was not going to happen without the president. The president was actually a little bit, chris, like, you know, almost like lbj, you know, pounding people on the back, bringing them to the white house. Well, its been one of the criticisms that president obama experienced over the years is he didnt do enough back slapping, didnt bring people up to the white house. That is true. The oval office is so powerful. Thats incredible real educatst. President trump effectively did it. Whether you agree or not, he was very e fejtiorget effective at that is a fact, havent been able to do it until President Trump not only console ejoeled to do it, said im going to introduce a guy whos been treated really unfairly, paul ryan, there are a lot of americans who think the person who treated paul ryan very unfairly was, in fact, President Trump. He used every tool in his arsenal to get, as you said, those 217 votes and closing it in the other day with the upton amendment was what it took to do it. Hes given everybody, as you described it, a little bandaid, a little cover. Some of these members there for that photograph have very little cover. Theyre going to see whether this photograph today ends up in the stuff thats been, you know, put up against them when theyre running again. But the point is, he managed to give everybody the piece of cover they need and bridge a much bigger ideological gap. A lot of people talk about how obamacare passed with only democratic votes. They didnt need the ideological cover that the republicans needed and somehow donald trump managed to do that, managed to give them the ideological cover. Again, once the score is out, once this goes to the senate, this is a whole other discussion, but for the moment, this is dronald trumps win mor than anybody elses. Ali velshi, thank you for joining us. Of course Greta Van Susteren who comes on at 6 00 tonight on msnbc. An interesting afternoon. Again, i say 217213, it explains the whole day. No democrats voted for this bill. None. 213 against it. Theyre all safe tonight. The 20 republicans who voted against it, theyre relatively safe. And the 217 who voted for it have to explain the vote today. This is a very, very important vote to cast for. Against was easy. For, thats going to be important. Thats been our coverage right now. Ill turn it over to Steve Kornacki. Thank you. [fbi agent] youre a brave man, mr. Stevens. Your testimony will save lives. Mr. Stevens . This is your new name. This is your new house. And a perfectly inconspicuous suv. You must become invisible. [hero] ill take my chances. Hey youve gotta see this. Cno. N. Alright, see you down there. Mmm, fine. Okay, what do we got . Okay, watch this. Do the thing we talked about. What do we say . Its going to be great. Watch. Remember what we were just saying . Go irish see that . Yes im gonna just go back to doing what i was doing. Find your awesome with the xfinity x1 voice remote. All right. Good afternoon, everybody, im Steve Kornacki here in new york. Coming to you on what has turned into a major afternoon in american politics. Topping our agenda right now at the white house, there was just a victory lap. We won and were going to finish it off and were going to go unon to a lot of other thing and were going to have a tremendous four years and maybe even more importantly, were going to have a tremendous eight years. A Health Care Bill just passing the house this afternoon by the thinnest of margins. 217 republican votes for it. You see the ceremony there at the white house after, but this bill, this Health Care Plan, far from the finish line right now. Many hurdles it still has to clear before it goes into law. Were going to take you through those. Also on our agenda, democrats say the politics of this favor them. Republicans have the majority. They won the vote, but the American People now have to judge them by how they have acted. Democrats make no mistake about it already see this vote today as a major weapon as they try to win back the house in 2018. Is this Health Care Bill that was voted on today political suicide for that republican majority . And also, what does this all mean in terms of the future of obamacare . What protection is obamacare if there is no Health Care Plan to purchase in your state . This is the direction obamacare is rapidly heading. Obamacare still despite todays vote remains the law of the land, but republicans say that it is collapsing before our eyes. Trump says its in a death spiral. Is it . We will get into that and much more. Again, a very busy and very significant moment in american politics right now. The headline here, the second time is the charm, apparently, for republicans when it comes to getting their Health Care Replacement bill through the house. Remember, it collapsed at the end of march. They made some changes and they got their plan passed today in the house. Then that ceremony there at the rose garden, a triumphant ceremony with President Trump atte attending. This the first major piece of legislation