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The Republican-sponsored American Health Care Act (AHCA) passed the House 217-213 Thursday, with one vote to spare, although it will face an uncertain path in the Senate.

No Democrats voted for the bill, and 20 Republicans voted against it. The bill largely repeals and replaces Obamacare.

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The health care bill passed by House Republicans covers pre-existing conditions, but not the way Obamacare does. Instead, the bill would allow st...

Speaking to reporters after the vote, House Majority Whip Steve Scalise, R-Louisiana, said he knew they had the votes on Wednesday and he said if they hadn't passed it, it would have impeded "the rest of our agenda."

"We proved that we could accomplish something this big," he said. "I can't thank the president enough. President Trump and Vice President Pence have been directly engaged," adding that Pence called him twice on Thursday to check in about individual members.

House Republicans left the Capitol after the vote, headed to the White House on buses. Scalise said they were invited to the Oval Office or the Rose Garden.

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CBS News chief Washington correspondent John Dickerson weighs in on the political impact of the House passing an Obamacare replacement bill.

As soon as Republicans cleared the threshold to pass the bill, House Democrats began singing in unison, "Nah, nah, nah, nah, nah, nah, nah, nah, hey, hey, goodbye" toward the Republicans.

Rep. Chris Collins, R-New York, said he's not worried about Republicans' prospects for the 2018 midterm elections.

"If we weren't able to repeal and replace Obamacare, it would have been a bad midterm for us. I think we will hold our own, if not pick up seats," he told reporters.

House GOP leaders expressed confidence earlier that the bill would indeed pass.

"This will pass," House Majority Leader Kevin McCarthy, R-California, told reporters as he left a closed-door meeting with the House Republican Conference. House Majority Whip Steve Scalise, R-Louisiana, also seemed confident that the bill would pass.

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The House has passed a bill intended to replace Obamacare. CBS News chief congressional correspondent Nancy Cordes joined CBSN with the reaction ...

The upbeat mood ahead of the key vote comes after weeks of trying to revive their original version of the bill, whichfailed to win enough support in Marchand had to be pulled from the floor. Republicans, however, have since made several revisions to the measure -- with the latest one made on Tuesday after skeptical members met with President Trump at the White House. Rep. Fred Upton, R-Michigan, proposed an amendment to the bill that would add $8 billion over five years to cover insurance for people with pre-existing conditions. The addition appeared to sway members who previously opposed the bill, as well as those who were undecided.

"I like the Upton amendment," Rep. Lou Barletta, R-Pennsylvania, told reporters after huddling with his colleagues Thursday. "Actually, it puts more money in the high-risk pools for those with pre-existing conditions, and the fact of the matter is those with pre-existing conditions would have no insurance because the Affordable Care Act is going to totally fail."

Other GOP lawmakers said that their plan was a much more sustainable alternative to Obamacare.

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The House has passed the GOP bill to replace Obamacare. CBS News political director Steve Chaggaris joins CBSN to discuss what the next steps are...

"This is about delivering much more affordable healthcare in contrast to a collapsing Obamacare," said Rep. Kevin Brady, R-Texas, chairman of the powerful tax-writing House Ways and Means Committee. He added that it "creates momentum for tax reform" and takes $1 trillion of tax hikes out of the economy that he said have been hurting patients and small businesses.

For weeks, Speaker Paul Ryan, R-Wisconsin, insisted that the bill would only come to the floor when Republicans had the votes to pass it. They can only afford 21 defections, assuming all Democrats vote against it. Rep. Dan Newhouse, R-Washington, will miss the AHCA vote, his office confirmed to CBS News. He's out of town due to a family emergency. This means that Republicans can afford 21 defections.

After huddling Wednesday night, House GOP leaders decided to move forward and schedule the vote for Thursday afternoon, despite the lack of a score from the nonpartisan Congressional Budget Office (CBO), which estimates how it would affect the federal deficit and Americans with health insurance. The CBO's score of the original bill estimated that 24 million people would lose their insurance over the course of a decade.

Asked about the concern that the final bill hasn't been scored, Collins said, "We have the score on the base bill that saves billions and billions of dollars."

Collins, the first House member to endorse Mr. Trump during the 2016 campaign, said that while the original CBO score showed it would reduce premiums and save money, he doubted its prediction about 24 million people losing their coverage.

"I don't think there was any accuracy in that," he said. "This isn't a tough vote. This is a vote we promised America. This is living up to our promise to repeal and replace Obamacare which is failing minute by minute and day by day."

But some, like South Carolina Republican Sen. Lindsey Graham, still expressed concern.

The bill would, among other things, repeal the individual and employer mandates put in place by Obamacare that has required people to carry insurance or face a tax penalty, it would provide refundable tax credits to help people afford coverage, expand health savings accounts and phase out an expansion of Medicaid.

Health and medical advocacy groups have slammed the legislation through all of its forms. The president of the American Medical Association, Andrew W. Gurman, warned Wednesday "millions of Americans will lose their health insurance as a direct result of this proposal."

Meanwhile, the chairman of the Freedom Caucus, Rep. Mark Meadows, R-North Carolina, said he's looking forward to what the Senate will produce.

"It'll come back even better, and that we'll get it passed and finally lower premiums for the American people," he said. "I've talked to over 14 different senators on this subject and I'm very optimistic that we'll find some common ground."

CBS News' Walt Cronkite, Major Garrett, Katherine Watson contributed to this report.

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House Republicans narrowly pass GOP health care bill - CBS News

The Republican Congress returns to Capitol Hill this week increasingly uncertain that a major legislative victory is achievable in the three weeks before lawmakers leave town for their month-long summer recess.

Most immediately, GOP leaders and President Trump are under enormous pressure to approve health-care legislation but that is only the beginning. Virtually every piece of their ambitious legislative agenda is stalled, according to multiple Republicans inside and outside of Congress.

They have made no serious progress on a budget despite looming fall deadlines to extend spending authorization and raise the debt ceiling. Promises to launch an ambitious infrastructure-building program have faded away. And the single issue with the most potential to unite Republicans tax reform has yet to progress beyond speeches and broad-strokes outlines.

The fallout, according to these Republicans, could be devastating in next years midterm elections. A demoralized GOP electorate could fail to turn out in support of lawmakers they perceive as having failed to fulfill their promises, allowing Democrats to sweep back into the House majority propelled by their own energized base.

Rep. Mark Meadows (R-N.C.), chairman of the conservative House Freedom Caucus, said if Republicans cannot deliver on their promises in the coming weeks, voters are going to start saying, What difference does it make whos in power?

There is a real anxiety among the people that I serve on why were not putting more things on the presidents desk, he said. Theyre tired of excuses.

All told, Republicans are in danger of squandering their grasp on the White House, the Senate and the House after a decade of divided government and years of stoking a conservative base to expect major policy wins. Unable so far to secure progress on his top priorities, Trump is also bumping up against history: Every president of the modern era has been able to claim at least one signature legislative achievement before the first August recess.

Sen. Roy Blunt (R-Mo.), a member of the Senate GOP leadership, said he worried that his party is not seizing the early months when a new president is historically best positioned to enact the boldest parts of his agenda.

I think thered be no reason for voters to look at this yet and think, Oh my gosh, a lot of the most valuable time of an administration is already gone. But if youve watched this for years, when an administration really makes great successes, its usually in that first year and, more importantly, in that first seven months of that first year, he said.

The immediate obstacle has been the health-care legislation, which Republicans have campaigned on relentlessly since the Affordable Care Act passed in 2010 but is now mired in widespread unpopularity and GOP infighting.

[Senate GOP and White House plan final, urgent blitz to pass health-care law]

Blunt said that after weeks of stalled progress, Republicans soon must decide whether the bill is viable: This does not get better over time, and were losing valuable time to get other things that we need to do as well.

A growing number of GOP leaders and K Street advocates think the party must move quickly beyond health care, win or lose, and proceed with a less internally divisive tax bill. Leaders had already abandoned, back in the spring, their earlier goal of passing tax reform over the summer. But with health care consuming the Senate, they have shown few signs of progress.

Republicans recognize theyre not out of the woods, said Thomas M. Davis, a former Virginia congressman who directs Deloittes federal lobbying practice. Davis said he thinks the Republican victory in a special congressional election in Georgia last month granted the party a reprieve but it wont last long without a legislative achievement.

Theyve got a high wave coming at them in the midterms, he said. I think they realize theyve got to buckle down and do things. Theyve got to produce, and tax reform would be the number one thing.

Key Republican leaders have started looking beyond health care. Senate Majority Leader Mitch McConnell (R-Ky.) has acknowledged the possibility of a bipartisan repair to ailing health insurance markets should GOP senators fail to come to terms on a more ambitious ACA replacement. And House Speaker Paul D. Ryan (R-Wis.) has turned his attention squarely to tax reform as the health-care legislation that barely passed his own chamber sits in the Senate.

Our job and our goal is to get tax reform done in 2017, so that when we roll into the new year in 2018 we roll into having a new tax code, Ryan said at a Thursday event in his home district, according to remarks released by his office.

Even staunch conservative advocates of repealing the health-care law are preparing for a quick pivot to tax legislation.

Tim Phillips, president of the Koch network group Americans for Prosperity, said Friday that his group has been disappointed by Congresss failure to act quickly to dismantle the ACA and now considers its repeal a long-term effort.

The priority is definitely tax reform, he said. If you think about the long-term direction of the nation, genuinely dramatic tax reform would do the most good for the largest number of Americans.

Watching on the sidelines are Democrats, emboldened after spending weeks generating public opposition to the GOP health-care plan and whose cooperation will be needed to pass a series of complex items in the coming months.

Sen. Elizabeth Warren (D-Mass.) said shes amazed that Republicans are willing to burn time off the congressional calendar pursuing this terrible plan when deadlines are bearing down on us, like raising the debt ceiling.

Theyre in the majority in the House and the Senate, they own the White House and thats the direction they want to drive the country? A place where most of America doesnt want to go? I dont get it, she added.

Mark Zandi, the chief economist at Moodys Analytics, said the dysfunction in Congress stands to roil confidence in the U.S. economy, particularly if lawmakers flirt with defaulting on the debt limit.

Companies are already growing pessimistic about prospects for aggressive tax cuts, he said, and even the suggestion that Congress might fail to increase the debt limit could have serious market consequences. The overall picture is also causing major uncertainty for businesses that are trying to plan for the months and years ahead.

Businesses are delaying investment decisions because they dont know what tax rate theyre going to have in the future, Zandi said.

Ryan has called for an ambitious restructuring of corporate taxation, eliminating loopholes and taxing imports to bring rates down from the current 35percent rate to as low as 15percent. But the plan to tax corporate imports, known as border adjustment, has encountered fierce head winds,even among some Republicans. Many GOP senators have rejected the idea, and lobbyists have lined up to preserve favorable treatment for various industries.

The Trump administration has yet to reach consensus with House and Senate Republicans on the parameters of a tax bill, though aides say talks are progressing.

No matter what happens on health care and tax reform, Republicans and Democrats also must agree on spending by the time the new fiscal year begins Oct.1 but no serious discussions about a plan have begun, according to multiple congressional aides.

Equally concerning for GOP lawmakers is that they must pass a budget ahead of tax reform to enact the special instructions that would allow them to approve a tax bill on a simple majority vote rather than the 60-vote supermajority required of most legislation in the Senate.

Also in the fall, Treasury Department officials expect to hit the nations borrowing limit. Treasury Secretary Steven Mnuchin has called for Congress to increase the debt limit by the end of July without attaching additional policy measures. But conservatives are pushing to include spending cuts, and GOP leaders have not yet taken concrete steps on the issue.

The key disputes of the moment are not between Republicans and Democrats but within the GOP. But on fiscal matters, both parties see bipartisan negotiations as inevitable.

House Republicans have floated a 2018 budget that boosts defense spending beyond the caps set in a 2011 bipartisan accord, and breaking them will require negotiations with Democrats who have long insisted on a corresponding rise in nondefense spending.

Rep. Joseph Crowley (D-N.Y.), the chairman of the House Democratic Caucus, said Democrats are also prepared to block spending bills that fund a U.S.-Mexico border wall or contain conservative policy riders they oppose.

That is an opportunity for us to have the leverage we need to take care of the folks we care about, he said.

Other legislative deadlines also loom: The Federal Aviation Administration, the National Flood Insurance Program and the Childrens Health Insurance Program are set to expire in October, and a Department of Veterans Affairs program that gives veterans more flexibility in where they seek health care a program launched in response to years of scandal at the department is set to run out of funding next month.

This week, McConnell is devoting most of the Senate floor time to confirming Trump nominees to mid-level Cabinet positions and the federal courts. Christopher A. Wray, Trumps choice to be the new FBI director, is set to appear before the Senate Judiciary Committee for his confirmation hearing on Wednesday.

And Russia looms over the Capitol: Lawmakers are negotiating the final details of a bill to stiffen sanctions against the country while multiple committees are advancing their probes into Russias meddling in U.S. elections.

Behind closed doors, McConnell will remain focused on his attempt to persuade 50 of the 52 GOP senators to back a single health-care bill.

Leaders and their staff continued to work throughout the holiday week on ways to tweak the draft legislation they released last month, according to several senior GOP aides. A major part of the work has involved near-constant talks with scorekeepers at the Congressional Budget Office, the nonpartisan agency that provides economic analysis to Congress.

It could take at least another week before the CBO analysis is complete, the aides said, meaning that the earliest chance for a health-care vote would be the week of July 17.

Kelsey Snell and Karoun Demirjian contributed to this report.

Read more at PowerPost

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Republicans increasingly uncertain of a legislative victory before August - Washington Post

Kansas City Star (blog)

Dave Helling: Mainstream Republicans may have had enough of GOP extremists Kansas City Star (blog) Moderate Republicans and Democrats joined together to override Gov. Sam Brownback and rescue the state from his tax cut experiment. That same coalition almost expanded Medicaid in the state, an extraordinary rebuke to the conservative governor. and more »

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Dave Helling: Mainstream Republicans may have had enough of GOP extremists - Kansas City Star (blog)

Republicans relished criticizing congressional Democrats when they fumbled or flat-out didnt try to approve a budget.

They took particular joy in upbraiding former Senate Majority Leader Harry Reid, D-Nevada, when he didnt shepherd a budget through the Senate, piously preaching the virtues of congressional budgeting.

Certainly the struggle to OK a budget doesnt look good for Republicans, who now control the House and Senate.

There was a plan a few weeks ago to advance a budget through the House Budget Committee. But that effort crumbled when Republicans fought over defense spending. Republicans fractured again when they fought over slashing some $50 billion in entitlement spending.

The law says the House is supposed to adopt a budget in April.

But the Houses collapse when it comes to budgeting threatens to imperil the most holy of Republican agenda items: diminishing federal spending and tax reform.

Lets go subterranean for a moment.

Congress doesnt approve money annually for costly federal entitlement programs such as Medicare, Medicaid and Social Security.

Those dollars just fly out the door automatically. Its known as mandatory spending.

Now, Congress doesnt have to spend it. Lawmakers voted decades ago against deciding each year how much money to allocate to those programs. The federal Treasury directs about 70 percent of all federal spending to that trio of entitlements. An increasingly large chunk of mandatory spending is interest on the debt.

The rest of the money -- about 30 percent -- constitutes discretionary spending.

Congress wields discretion over spending everything else. How much goes to the National Park Service. How much to run the Federal Reserve. How much to operate the State Department. How much it allocates to itself.

By the way, the chunk of change devoted to the legislative branch is on the rise after the shooting at the Republican congressional baseball practice. A few million more dollars are in the pipeline for security improvements and to hire additional U.S. Capitol Police officers.

So, if you truly wanted to harness federal spending and the nations $21 trillion debt, from which side of the ledger would you cut? From mandatory spending or discretionary spending?

You cannot address long-term debt without looking at the mandatory side of the budget, said White House budget Director Mick Mulvaney. You would be hard pressed to be able to balance the budget without looking at mandatory spending.

But thats where the problem lies for House Budget Committee Chairwoman Diane Black, R-Tenn.

True budget savings would come from slashing entitlement spending.

Black and other GOPers would like to reduce $200 billion in entitlement (mandatory) spending. But a coalition of 20 moderate Republicans pushed back. They argue that Blacks plan isnt practical and that they are reticent to vote for such a deep cut. Losing those 20 Republicans doesnt quite kill the vote count for the budget. But its close.

President Trump wants to spend more on defense in this budget. Defense hawks demanded somewhere north of $640 billion for the Pentagon. Of late, the defense target has fallen between $617 and $623 billion.

Technically, defense spending isnt supposed to exceed $549 billion. Thats the ceiling imposed by sequestration, the mandatory set of spending cuts created by the 2011 Budget Control Act, which raised the debt limit.

One senior Republican close to the discussions suggested they should have started with a defense number around $603 billion and negotiated up to lure defense-minded Republicans.

Keep in mind that Republicans would first have to engineer a budget that wouldnt collapse in committee to say nothing of getting nuked by GOPers on the floor.

So, theres a stalemate.

Failing to adopt a budget would certainly be a blow to Republicans -- especially former House Budget Committee Chairman and now House Speaker Paul Ryan, R-Wis.

The House didnt advance a budget last year on Ryans watch, either. No budget means theres no way to mine the federal coffers for major cuts essential to contracting the deficit.

But a bigger problem lurks for Republicans.

No budget could imperil the GOP plan to approve tax reform.

Ryan insists Republicans will approve tax reform.

Tax reform is happening, not next year or next Congress, he said recently. It is happening now, in 2017.

Heres the issue: Republicans would face a filibuster in the Senate from Democrats and probably some Republicans on tax reform.

The GOP leadership in both bodies wants to use a special process called budget reconciliation for tax reform to avoid a filibuster. This is the same parliamentary scheme Republicans are now using to deal with ObamaCare.

Otherwise, the sides must round up 60 votes just to break the filibuster to start debate on the tax bill and 60 votes a second time to wrap things up.

However, theres a reason the process is called budget reconciliation. The House must first adopt a budget to give the Senate something with which to work.

No budget, and any effort at tax reform could be in trouble.

Certainly the House could approve a skeleton budget, designed expressly as a shell for the Senate to use when handling tax reform.

In other words, its a budget in name only. Only the framework. The House essentially followed that path in January to set up the legislative vehicle to repeal and replace ObamaCare.

Meantime, look at the raw dollars. The biggest standoff among congressional Republicans in settling the budget impasse is waged between defense advocates and Republicans who want to fund everything else -- yet cut spending.

This is where things get interesting.

The House Appropriations Committee wrote a defense spending bill totaling $658.1 billion. Thats $68.1 billion more than last year and $18.4 billion more than Trump requested. When the House Armed Services Committee wrote this years defense authorization bill -- which is different from the appropriations legislation -- Republican lawmakers found themselves all over the map.

Washington Rep. Adam Smith, the top Democrat on the Armed Services panel, took note.

We do not have $600, $700, $800, $900 billion to spend on defense unless we pretty much completely eliminate all non-defense discretionary spending, which there isnt support for doing, he said. Twenty trillion dollars in debt, a $706 billion deficit, trying to find $50 billion in mandatory savings, and the majority cant even do that, all right?

Smiths remark crystalizes the entire debate about the GOP attempting to complete a budget.

As a result, Kentucky Rep. John Yarmuth, the leading Democrat on the House Budget Committee, says that the GOP shell budget is looking more and more likely.

And theres a reason behind that. The faux budget would not be so much to actually alter the nations spending trajectory. But if the House approves a budget, it will serve as a contrivance to help tax reform navigate the U.S. Senate.

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House Republicans stymied in their efforts to adopt a budget - Fox News

Local Democratic officials on Thursday panned the Republican state Senate leaders threat to halt the Long Island Rail Roads third track project.

The Metropolitan Transportation Authority resubmitted an amendment to its Capital Program that would fund the $2 billion plan to a state review board last Friday, reportedly because state Senate Majority Leader John Flanagan (R-East Northport) threatened to have it blocked.

Nassau County Democratic Chairman Jay Jacobs, state Sen. John Brooks (D-Seaford) and county Legislator Laura Curran (D-Baldwin) said Flanagans move will only exacerbate commuters transportation woes.

Senate Republicans are stopping a necessary modernization and they should be ashamed of throwing away almost $2 billion for major improvements to the LIRR, Jacobs said in a statement. Our commuters and our economy cannot continue to suffer while they play politics.

The joint statement from Jacobs, Brooks and Curran who is running for Nassau County executive infuses politics into the debate more than before as funding it hinges on political considerations.

The LIRR wants to add a third track to a key 9.8-mile stretch of its Main Line between Floral Park and Hicksville. Project officials say it would take three to four years to build and would improve service by increasing capacity and giving trains a route around delays.

The project would also modernize LIRR signals along the stretch, remove seven street-level railroad crossings and build noise-deflecting walls, among other improvements.

State Sen. Martin Golden (R-Brooklyn), who reportedly takes direction from Flanagan, is one of four members of the Capital Program Review Board, which must approve any amendments to the MTAs 2015-2019 Capital Program. The MTA Board of Directors approved the amendment that would provide $1.95 billion for the third track in May.

The withdrawal and resubmission of the funding plan gave the MTA 30 more days to address lingering questions about the project before another possible veto.

Jacobs, Brooks and Curran argued the project is more desperately needed now, as the MTA is under a state of emergency and LIRR commuters deal with for two months of disruptions due to repairs at Penn Station in Manhattan.

We desperately need to increase our transportation options and modernize the LIRR but unfortunately, once again, Albany politicians are fighting for themselves rather than for whats best for Long Islanders, Curran said in the statement.

But Republican state Sen. Elaine Phillips of Flower Hill said resetting the clock gives MTA officials more time and flexibility to develop a comprehensive solution to the LIRRs systemic service problems.

The decision by the Governor and the MTA to resubmit the amendment and provide more time for the process is the right one, Phillips said in a statement Friday.

Since Democratic Gov. Andrew Cuomo introduced it in January 2016, local officials, residents and interest groups have argued about the projects possible benefits and the potential damage it could do to affected communities, including Floral Park, New Hyde Park and Mineola.

Phillips and Republican Sen. Kemp Hannon of Garden City have been two of the projects most vocal critics.

Flanagan, Phillips and Hannon have been pushing Cuomo to grant other requests in exchange for approving the funding, such as more money for hospitals and involvement in a dispute between Nassau and New York City over Queens water wells, Newsdays The Point newsletter reported Friday.

While many in New Hyde Park and Floral Park still strongly oppose the project, the villages mayors signed memoranda of understanding with the LIRR last week that they say will give their communities extra benefits and protection during the construction period.

Those agreements should remain in place regardless of whether the Capital Program amendment proceeds in its current form, Phillips said Friday.

New Hyde Park Mayor Lawrence Montreuil said he thinks it could be good for officials to consider whether the money is better spent on more immediate infrastructure needs.

If there is that question in peoples minds I think maybe a 30-day delay is not the end of the world, Monetruil said.

Nassau County Comptroller George Maragos, another Democrat running for county executive, agreed that the third track is critical, but said Democrats and Republicans should work together to get the needed funding to fix the LIRRs problems.

E. OBrien Murray, a spokesman for Jack Martins, Phillips state Senate predecessor and the Republican county executive, praised Cuomo the MTA for resubmitting the amendment. But he condemned the Nassau Democrats for making empty political statements.

Instead of being truthful about the Third Track project, which does nothing to solve the immediate commuter crisis but is a long term capital project, Jacobs, Curran and Brooks are dishonestly attempting to confuse these two important issues, Murray said in a statement.

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Local Dems slam state Republicans on 3rd track funding - The Island Now