Screen shot from the live House feed toward end of voting on H.R. 986

Members of the U.S. House voted 230-183 Thursday to pass H.R. 986, a bill that could keep the administration of President Donald Trump from implementing new Affordable Care Act (ACA) state waiver program guidelines.

The Democrats who participated voted 226-0 to support the bill.

The Republicans who participated voted 4-183 against H.R. 986. About 2.1 percent of House Republicans crossed party lines to vote for the bill.

H.R. 986 appears to be the first stand-alone health insurance policy bill that has come up for a recorded vote on the House floor since Democrats took control over the House in January.

Republicans control the Senate, with 52 of the 100 Senate seats. In theory, if a bill reaches the Senate floor, the Republicans could lose a vote if three members, or 5.7% of their members, cross party lines to vote with the Democrats.

SREW Program

The Trump administration recently developed rules that could let a state bend Affordable Care Act health insurance benefits and underwriting rules if the proposed changes could help expand the number of people with health coverage.

Administration hope to create a new State Relief and Empowerment Waivers program, or SREW program, using Patient Protection and Affordable Care Act (PPACA) Section 1332.

PPACA is one of the two statutes in the ACA statutory package. PPACA Section 1332 gives states a chance to ask for federal permission to tweak ACA rules to suit local conditions. The administration of former President Barack Obama interpreted the provision to mean that a state could not ask for changes that would change ACA benefits and underwriting rules.

The Trump administration's SREW version of the program might let a state use products that do not meet ACA major medical insurance standards, such as short-term health insurance, to provide some coverage for who do not qualify for ACA coverage purchase subsidies, or who cannot afford to buy individual major medical coverage, even with the help of ACA premium tax credit subsidies.

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House votes to curb Trump administration ACA waiver program

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