Eyeing a victory, a jubilant Trump tweeted during the vote that, if successful, Republicans would gather for "big press conference at the lovely Rose Garden of the White House" immediately afterwards.
"This is a scar that they will carry", Pelosi said of House Republicans who voted for the plan.
The GOP bill now heads to the Senate, where it stands to face an even larger hurdle as Republicans hold a narrower majority in that chamber. GOP leadership will need to soften the American Health Care Act for those senators too. In the finally tally, 20 Republicans voted against the measure.
The House is scheduled to vote on the GOP-backed, Obamacare replacement bill Thursday, almost two months after an aborted first vote on the proposal. As of the end of 2016, approximately 6.4 million Americans have signed up for healthcare through Obamacare's government exchanges, many of whom have benefitted from the Medicaid expansion that was a crucial part of the law. In the minutes after the vote, the BI North America Hospitals Index fell as much as 1.6 percent before reversing to close up 0.2 percent.
Assuming that all Democrats voted against the bill - which they did - the Republicans needed to avoid having 22 of its own House members defect to the "no" camp.
One of the central issues in the House debate was the treatment of people with "pre-existing" conditions. It will create chaos in our health care system and decimate access to health care.
An amendment added to the bill after it failed to garner enough Republican support in March would allow states to opt out of two key Obamacare provisions. Except for this time, they are gutting critical consumer protections like the ban on dropping coverage because of pre-existing conditions. The bill also suggests increases in premium plan prices, and how programs such as individual health plans and Medicaid would be funded.
Obamacare expanded Medicaid, provided income-based tax credits to help the poor buy insurance on individual insurance markets set up by the law, and required everyone to buy insurance or pay a penalty. As a result, young, healthy people could find more affordable coverage options.
House Minority Leader, Democratic Nancy Pelosi, said on Thursday at a press conference: "This disastrous bill has been condemned by nearly everyone". The Congressional Budget Office estimated that an earlier version of the bill would leave about 14 million fewer people covered by Medicaid by 2026.
"You vote for this bill, you have walked the plank, from moderate to radical", she said. ". This is a repeal and replace of Obamacare, make no mistake about it. Make no mistake".
The bill will also provide extra 8 billion dollars over five years for high-risk pools aimed at helping states and insurers deal with high-cost patients.