At New York Magazine, Ed Kilgore has a succinct description of how the Republicans got their Obamacare replacement/Trumpcare bill passed in the House “by an eyelash.” As Kilgore writes, “House Republicans managed to pass a revised version of the American Health Care Act today by the narrowest of margins: 217–213, with two members absent (and three vacancies). Twenty Republicans voted against the bill. All Democrats did so as well.” Kilgore explains how the GOP got their skeptical members to cave: “The drive to enact this bill — an earlier version was pulled from a scheduled floor vote in March with defeat certain — looked to have stalled earlier this week. But then one announced “no” voter, Representative Fred Upton, Republican of Michigan, came up with an amendment adding a small but symbolic sum of $8 billion to the funds available to states to deal with people that have preexisting health conditions. When the president and congressional GOP leaders avidly agreed, Upton (accompanied by another prior “no” voter, Bill Long) quickly flipped to “yes.” The momentum crucially shifted based on the claim that the House GOP had “addressed” the preexisting conditions issue.” The token sum gave the remaining Republicans just enough cover to cave to Trump, Ryan and the ‘Freedom Caucus.’

But the Republican bill severely weakens pre-existing conditions protection for health care consumers, particularly with respect to pregnancy and child birth. As Danielle Paquette notes at Wonkblog, “Under the GOP’s proposal, states are given the option of dumping an Obamacare rule that requires insurers to provide maternity coverage to all women and safeguards them from fee increases in the event of a pregnancy. In other words, maternity coverage, as dictated by the federal government, would no longer have to be an “essential benefit…Under the GOP plan, a person who loses their employer-provided insurance could face a premium spike if they try to regain coverage in the state or private markets…The Center for American Progress, a left-leaning think tank, estimated that a woman seeking maternity care under the GOP’s current plan could face surcharges up to $17,000.”

Disappointing as the House vote was, at least we can credit House Minority Leader Nancy Pelosi and other Dems with impressive leadership in rallying every House Democrat to vote against the Trumpcare bill. James Hohman touches on her efforts at The Daily  202: “Pelosi has relentlessly stuck to four talking points that polling and focus groups show are most effective: The GOP plan would raise out-of-pocket costs, hurt people between the ages of 40 and 65, mess up Medicare and strip away coverage from some of the 24 million who got it under the ACA…“When you tell people, ‘This is what you’re going to get,’ that’s harder than saying, ‘This is what you’re going to lose.’”

Irwin Redlener, M.D., president and founder of Children’s Health Fund and professor of pediatrics and Health Policy and Management at the Mailman School of Public Health, Columbia University, turns the spotlight at The Daily Beast on what Trumpcare would do to children: “If it passes the Senate and is signed into law by the president, it will be an unprecedented setback, fundamentally threatening the stability of guaranteed access to quality health care of some 35 million children who benefit from the current array of safety net programs that poor—and working poor—families depend upon…The most concerning element of this bill is the provision to transform Medicaid into either a “block grant” or “per-capita cap” system. Either approach would result in drastic cuts to Medicaid and diminished health benefits for nearly half of all American children. Some estimate that Medicaid will sustain as much as $800 billion in cuts over 10 years if this bill is enacted. Given that children make up the largest proportion of Medicaid enrollees, it’s a virtual certainty that they will bear the brunt of these cuts…The GOP’s bill may already be more unpopular than Obamacare ever was.”

So what are the political consequences for House members who voted for Trumpcare? Aaron Blake offers this assessment at The Fix: “…there are clearly some Republicans who may have jeopardized themselves Thursday. According to Stephen Wolf of Daily Kos Elections, 24 House Republicans who voted for the bill come from districts where President Trump didn’t get a majority of the vote, and 14 come from districts that went for Democrat Hillary Clinton. Those are two-dozen districts where this vote can quickly be thrown in the GOP members’ faces. And, again, Democrats need 25 seats.” No doubt many House Republicans. who voted for the bill are secretly hoping it doesn’t pass. “Republicans opened themselves up to all these lines of attack on Thursday,” writes Blake, “and you can bet Democrats will use them. But it’s likely that the backlash won’t be quite as big if the GOP ultimately fails to turn this bill into law…”

“Want to take immediate revenge on House Republicans who voted to destroy health care? Here’s how,” writes David Nor at Daily Kos. Nir provides a list of 24 Republican House members made even more vulnerable by their votes for Trumpcare, and explains a really cool project of ActBlue, which merits the support of every progressive: “The fantastic folks at ActBlue have created something called “nominee funds” that you can donate to immediately. These funds are organized on a district-by-district basis: You contribute now, and all money is held in escrow until after each state’s primary. At that point, the cash is transferred in one fell swoop to the Democratic nominee, who can then start using the money for his or her general election campaign pronto…A big surge in donations now would have huge salutary effects right away: It would both terrify Republicans and boost Democratic efforts to recruit good candidates. Of course, it would also help us defeat these Republicans next year. And as it happens, 24 is exactly the number of seats we need to take back the House….So make them pay: Donate $1 right now to each of the Democratic nominee funds targeting vulnerable House Republicans who voted to destroy access to health care.“

Defeat of the Trumpcare replacement bill in the U.S. Senate comes down to whether or not three Republicans needed to defeat the measure will vote against it. Early speculation is focusing on Sens. Rob Portman (OH), Lisa Murkowski (AK), Susan Collins, report AP’s Alan Fram and Richard Lardner, with more conservatives Sens. Lindsay Graham (SC), Ted Cruz (TX) and Ramd Paul (KY) also expressing significant concerns.

In his Monkey Cage post, “Want to change Congress? Change who votes in ‘safe’ Republican or Democratic primaries,” Seth J. Hill, assistant professor of political science at the University of California, San Diego, discusses the possibilities for strategic crossover voting. Hill notes, “The idea here is to provide a rough estimate of how feasible it would be for citizens who don’t normally vote in Republican primaries to participate in those primaries to create incentives for GOP candidates to take more centrist positions.” Hill cites the 2014 open primary for Republican  Sen. Thad Cochran’s seat in Mississippi. “Cochran did not win the most votes in the first primary election,” notes Hill. “But in a runoff, his campaign was able to bring out new voters, including from Democratic portions of the state. The number of votes cast increased by nearly 20 percent, and Cochran won. This suggests that at least in some cases, entrepreneurial candidates can mobilize new voters in primary elections, altering the dynamics of the contest.”

At The Atlantic, Ron Brownstein addresses a question of crityical importance for Dems, “Can the Democrats Convince Millennials to Vote in 2018?,” and notes, “The challenge is especially urgent for Democrats because Trump divides younger and older Americans so sharply. Though Trump showed strength among blue-collar white Millennials, he carried just 36 percent of young people overall last November. Polls show he’s lost ground since. Both the CNN/ORC and NBC/Wall Street Journal surveys released last week found his approval rating among adults ages 18 to 34—almost exactly the Millennial generation’s boundaries—falling below 30 percent. That’s much lower than his ratings among older adults, especially those 50 or older…Polls have also found that over three-fourths of Millennials oppose both Trump’s Mexico border wall and his push to repeal Obama’s climate-change agenda. Eliminating funding for Planned Parenthood, cutting taxes for top earners, barring Syrian refugees—each Trump priorities—all face preponderant Millennial opposition in surveys…Millennials said they preferred Democrats for Congress by crushing margins of nearly 30 percentage points in both the NBC/Wall Street Journal and CNN/ORC surveys. That’s more than double the party’s advantage among younger voters in NBC/Wall Street Journal polls from 2010 and 2014.”