this is cnn breaking news. hello. i'm jake tapper live in washington, d.c. >> i'm wolf blitzer. we want to welcome our viewer here in the united states and around the world. we're following breaking news. the political cliff-hanger hanging over health care reform that's playing out right now. the house of representatives begins voting this hour on the latest effort to repeal and replace obamacare. will they or won't they have enough votes to pass it? republican leaders say they

will. >> how are you feeling? >> i feel great. >> do you have votes? >> yes. >> absolutely? >> yes. >> here's a look at some of the biggest changes. high risk pools return to cover people with pre-existing conditions. the bill repeals obamacare subsidies and replaces them with refundable tax credits based on age and income. it drops the individual and employer mandates, overall medicare funding, and eliminates obamacare taxes on wealthy americans, insurers and others. our chief political correspondent dana bash is up on president fill hli -- >> the latest is that republican leaders are quite a bit confident that they have the votes. what a difference from the last time we were here talking about what was happening, talking about the fact that they had --

excuse me for one second. i'm going to talk back to you. we have some audio issues. i'm going to talk back you to. >> dana, stand by for a moment. this is a technical moment. we'll get her microphone fixed. this is a critically important vote that's coming up presumably within the next hour. >> two major things going on. the politics of it and the policy of it. in terms of the politics of it, there is a big concern that republicans are able to go back home during the next recess and have something to talk about to conservatives that they did. the first step in repealing and replacing obamacare in their view is something that they'll be able to do, especially after the government spending bill in which democrats got a lot of what they wanted and republicans got relatively very little. then there's the policy of this. the truth of the matter is there are a lot of senate republicans right now who are very concerned about the process that this has gone. very limited debate. no amendments. not a lot of time to understand

what exactly is in the bill. but the house republicans sense that they will be able to have a victory. they will be able to pass this bill. senate republicans are very concerned. they don't know what's in it and they don't know that they're going to be able to support it. >> one of the most sensitive issues right now is normally before a big vote like this the congressional budget office, nonpartisan, they layout what it's going to cost the american public, how many people are going to be affected. they did that six weeks ago. there was no vote before the first vote that was supposed to take place and it caused a lot of anguish. >> you don't have to go back far and find all sorts of quotes, including now vice president mike pence krit sidesicriticizi democrats for rushing the vote

to the floor. at the same time there's absolutely no comparison when it comes to how much time was spent on the legislation. it's true that a lot of democrats probably did not know everything that was in that bill. but by the same token, that took ions compared to the time this is going to hit the house. >> dana, update us on when we anticipate the actual roll call. >> we got our audio worked out here. the answer is probably within the next 15 minutes or so is when the roll call is going to begin. we're going to see just how much this confidence that we're hearing from the republican leadership is going to bear out. but one of the key questions in addition to a lot of issues with regard to this major, major vote is going to be taken here is what's going to happen when they walk down the steps and get in their cars and go home and whether or not republicans are going to get applauded as they

think they are going to do when they promised they were going to repeal obamacare or whether they are going to face a buzz saw that will get them back in the place that a lot of democrats were in after the obamacare vote, which is losing their seats. i want to bring in somebody who's in a bit of a swing district, a democrat, congressm congressman you were not here during the obamacare vote, but are in a purple district fair to say in new jersey. do you feel that your c constituents are going to see this and say i really wish that you voted to repeal obamacare because there's so many problems with it. how are you going to go home and face your constituents? >> it's been very consistent for the last month and the phones are ringing off the hook. people don't want this. they don't like the way it's done. it's really going to hurt my district. the numbers have come out. $4,000 new tax for families in

new jersey. peoples are worried they're going to throw them out unfortunate nursing home. the incoming i'm getting when i talked to folks last weekend was pretty clear. please stop this. fix obamacare. which i really want to do. but do it in a bipartisan way. don't just let them jam something down us that's going to hurt us in new jersey. >> to be real here, there's no bipartisan way. could you see yourself working with republicans to make some major changes to obamacare for real? because from my understanding, is that the democratic base would go ballistic if you tried to do that. >> i talked throughout my campaign there are areas like the cadillac tax, the medical device, i'm not talking about throwing it out but make it better. you can't just show up and say here it is, now vote on t. you have to be part of the process. >> so knowing that is not going to happen, it's not -- >> maybe not on this issue.

>> the republicans are arguing over and over again that this whole obamacare idea isn't working. that you have states even in the last 24 hours like iowa where every insurance provider has pulled out of the state that is related to obamacare. that's a fair criticism. there are people out there who are insured but can't afford it. >> i'm focusing on my state because obviously that's where i represent in northern new jersey. when i hear is pretty consistent from the hospitals. i just talked to the ceo from the largest employer hospital. everyone fears the same thing in new jersey. this is very bad for us. the medicaid dollars are going to shift a lot of costs over to the state and that means our tax dollars are going to go up. that's how they're looking at it from how it affects us. i can't talk about the other states. >> you know, you obviously came in knowing that the potential to dry to dismantle obamacare was going to be on the table. did you have any inclination at all given where you're from and

given the fact that it's not exactly the most liberal place in the world, even though you're a democrat, to be more aggressive? did you try to work with republicans to fix it? >> i did. i co chair some of the problem solverers caucus. we sit down with things like tax reform and infrastructure. on this issue from the beginning we were never really brought into the circle. i said to my colleagues on the other side please, there are a bunch of us who actually want to fix this if you do it the right way. i'm hoping in the months ahead that there's a chance to make this better. you're right that is's probably not very realistic but that doesn't mean we shouldn't keep trying. >> back you to, wolf and jake. >> dana, thanks very much. we'll stand by for the roll call which is about to begin on the floor of the house. while we don't know how much this revised plan will cost, let's talk about what we do know about what's inside the bill. tammy is a cnn writer who covers

obamacare and health policy. do we know what types of pre-existing conditions would qualify someone for the pools. >> the pricey ones, cancers, heart disease, diabetes, but there are also conditions you might not think of. in maryland one state accepted a kid with acne. >> what would happen next for these people? >> well, that remains to be seen. it will depend on whether they live in a state opts to wave these protections. that waiver is actually going to be pretty easy to get. so it's really going to be up to the state because every state would run their own pool. those that opted for the paver. but presumably they would probably try to apply for insurance. they'd get denied. then they'd be able to apply for for this high risk pool. >> let's talk about the changes to essential benefits. insurers must cover certain conditions. there is a provision that allows

states to be -- >> well, states could opt out of covering the ten essential haelg health benefits, like substance abuse, mental health, maternity. these are very important benefits to a lot of people. they were benefits that were hard to get on the individual market before. but again, these raise premiums. that's why the freedom caucus and other conservatives pushed to allow states to waive out of them if they wanted to. >> what about if you get health insurance through your employer? could this provision affect those folks? >> it is possible that the employer policies will change. but remember that employers, particularly large employers, use benefits to a track and retain workers. so if they were to start offering skimpy plans, employees would start leaving and they may not want to do that. yes, it's possible that some employers, particularly smaller ones won't off a comprehensive set of benefits.

it's possible people will have to pay more out of pocket or will find some of their benefits limited. among larger employers are the ones who employ most americans, probably not too too much is going to change. >> tammy, thanks very much. republican leadership say they have the votes. until lawmakers cast their vote, no one really knows whether they can actually reach that magic number which in this congress is 216. here with us to discuss all of it is cnn chief national correspondent john king, nia-malika henderson and gloria borger. nia, let me start with you and some tweets we saw this morning from senator lindsey graham. he tweeted you appreciate the a patient progress. i will admit i'm concerned with the progress. a bill finalized yesterday has not been scored, amendments not allowed, and three hours final debate should be viewed with

caution. we should point out this isn't just lindsey graham shouting this from the sidelines. he is now going to be asked to vote on this. >> it is likely a bill dead on arrival on the senate. we heard that from different senators. bob corker said the way the bill stands now, what's happening with the medicaid expansion. there's some moderates, there's some conservatives there as well. but that is this sentiment about this rushed process is what i'm hearing from republican strategists as well. i was just texting with one. he said that he can't believe that they're rushing this. there's no scoring or anything and it's going to do real harm. the harm he is thinking about is what they're going to hear from democrats. these are basically congress people who are putting their careers on the line the ads

right themselves. if you say it's a work in progress it's going to change in the senate, you see what the ads are going to look like in their districts. >> john king, yesterday i was interviewing john portman and he's a senator from ohio. he's just reelected so he doesn't have to worry about this for years and he was on the show to talk about opioid abuse. i was asking him about the fact that in the ehbs, which are the essential health benefits, if state no longer requires insurance companies to have them, that means drug treatment will no longer necessary be provided. are you not concerned about the health care bill? he said forget that. i'm concerned about what they're going to do with medicaid because medicaid is one of the main ways that people with dependency issues get treatment in my state. so republicans in the september are very aware of this and i don't accepts a ground swell of

support, at least not right now. >> so. what happens now is let's assume the republican leadership check the votes and they send this bill to the senate. senate portman is a serious policy guy. senator corker was on another network saying we're going to take our time. the essential benefit is a huge concern to senator portman and the mor moderates. their conservatives, right of center, remember mitch mckon --n only lose two or three if the vice president is there in the toend break a tie. you have concerns about what i'll call the more generous benefits that have become popular. now you're saying they're going to take something away. hospitalization, maternity. there are a handful at least of republicans who say well, let's be careful about this. then you have on the flip side the mike lees and rand paul and ted cruz who say we promised the

american people a full repeal of obamacare. >> this is not that. >> this is not even close to a full repeal. so you're going to have the same dynamics at play in the senate where i think you have less of a political imperative to move fast. so the speaker of the house thought the president of the united states demanded they do this in the house now because he wanted a trophy. here's the question, is it a participation trophy or do they get the final trophy? >> that's obviously the big question. i would argue not to be too cynical about it that they're trying to push this through because once they get the budget score, once they get the cbo analysis which says how many millions of people will be unsher unshu uninsured under this, we saw the last was 24 million over a number of years, and we have to see whether this actually adds to the deficit or doesn't. because if it adds to the deficit, they have a problem bringing it up in the senate. because it's under a budget bill and it has to be deficit neutral. but one of the ways that health

care -- that people feel health care, as they look at it after it's passed and they're going to read all these story bs ies abo and say how does it affect me and my family and if i have a pre-existing condition, i have cancer, and the american cancer society has come out against this because my insurance is going to go down and i'm going to pay so much more out of pocket, this is how people are going to judge these things. do i need mental health care? my state for example decides to opt out. do i need coverage for my addiction that i'm trying to break and i'm covered under medicaid? that's a big issue that it's hard to kind of talk about now, sort of generally we say oh, well there's going to be a roll back of medicaid. just wait. and governor john kasich also of ohio said he would not support this because he took the medicaid money under obamacare. this is a real problem for

republicans. they have to get out there, explain, and then wait for people to feel this. >> we're watching this high drama being played out in the house of representatives right now. a long-awaited vote on health care. the white house says it's optimistic about the outcome. is the president go b about to the major legislative victory he's been speaking of? special coverage right after this. ready or not, here i come. ♪ anyone can dream. making it a reality is the hard part. northrop grumman command and control systems always let you see the complete picture. and we're looking for a few dreamers to join us.

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. looking at the live pictures of the house floor where they're getting ready to vote. they need 216 votes. republicans can only afford 21 nos from their own members. no democrats will vote in favor of this legislation. we'll bring the vote as soon as it happens. >> joining us from capitol hill is ohio republican congressman. thanks so much for joining us. my knowing is you are planning on voting for this legislation. the congressional budget office estimated that in the last bill 24 million americans would no longer have health insurance. some of them would opt out willingly. others not. there has not been a congressional budget office study or score of this latest

bill. why not wait until there is a score before there is an analysis and you have a better idea of what this bill might actually accomplish? >> well, look, this bill has been debated two years ago. now it's been changed by a number of amendments. the amendments are the only things we're talking about. the amendments actually make it a little better. in my mind they help those that are going to need the safety net which i think is important. so again, i think what we need to do is this is process, process, process. as i've said so many times, i'm a businessman. a businessman wants to see things move forward. we need to move this forward. we need to get it over to the senate. we'll have plenty of time. this is not the final bill. this is the best we have today. let's continue to work it and make it better. >> but as a businessman, don't you wait until you have a full analysis of what something will do? you say this bill has been debated before but this amendment is new. the upton amendment to that amendment is new. these are new provisions.

we don't know exactly what the analysis will be or the effect will be on potentially millions of americans. i don't know. help me understand, please. the rush to do this today. >> i know what the effect is if we do nothing. again, i always compare this to this airplane can't continue to fly. the affordable care act is a problem. i've got people back home that have coverage but can't afford it. they have coverage but can't afford deductibles. they are planing. we have to make a change. we have to fix the problem. this is the beginning of a starting point of making a difference and changing this. i've been here now for six years. we've talked about repeal, repair, repeal, replace. we're at a stage we need to do something. the american people can't keep waiting. >> one of the provisions they understand and, correct me if i'm wrong, but one of the provisions i understand you like is the one that allows states to opt out of different obamacare provisions. such as for example what's called ehbs or essential health

benefits that is a standard imposed by obamacare that all insurance companies have to provide ten different things including maternity care, drug treatment care, et cetera. you like that, right? you want ohio to be able to decide whether or not it wants to opt in or opt out of ehbs, essential health benefits. >> the one size fitz all mentality doesn't work. this is a waiver. when they ask for a waiver, they have to meet a whole bunch of requirements and they have to make sure there's a safety net or a pool available. again, do i like getting the government closer to the people? absolutely. i believe as close as you get to the people, the better the product is. that's why i believe it's griea to allow governors the ability to waiver. it doesn't mean they're going to take the waiver and they still have to go through a long process of getting the waiver and they have to meet certain requirements. do i like it? yes. i like anytime they get

flexibility for governors to make a difference for the people they serve. >> do you want ohio to seek a waiver so insurance companies in your state are no longer required to provide essential health benefits? >> what i want to do is make sure the government -- we can't continue under this basis either. i'm on the budget committee. the budget numbers don't look very bright for the future. the best way of doing this is get it back in the state's hands. >> and dow want ohio to opt out of the ehb requirement? >> i would meet with the insurance industry. make sure where we're at with this. i believe that as a governor i'm going to make sure that the safety net is taken care of. that we're going to make sure the pre-existing conditions are still taken care of. that doesn't mean when you opt out you eliminate some of this stuff. at the same time i want to bring costs down and work toward getting costs done. i'm in a pretty interesting position because i'm also running for governor. >> i know. that's why i'm surprised you

haven't said if ohio should opt out of ehb. it seems like you want this option. i think states should be able to do this. what will you do as governor? >> well, i think what i would do is i'm not governor today. i have to look at those options and positions. i want to make sure people are covered. i'm going to look and decide whether it's best to waiver. i'm concerned that the way to get a waiver is very difficult. i don't know if ohio will even be able to qualify to get it done. but i would look at it and again, more that i can take back in ohio and the more i can get away from the federal government, the more i'm going to do to do. the closer we can get government to the people the better off we're going to be. >> do you want ohio to opt out of the requirement that all individuals in ohio with pre-existing conditions have to be allowed to get insurance? that insurance companies cannot discriminate against them? or do you want them to be able to opt out of that? >> that's not the -- the waiver is not that. the waiver is an opportunity for states to look at costs and to

better take care of the citizens of their state. if a governor decides to do that, that does not mean people lose their pre-existing condition. what that means is the governor has to make sure the people have continuous coverage and at the same time design a program and make sure that the people are taken care skof and protected. we can continue to run down this path. the federal government cannot continue to spend the money they're spending. states will have to do this anyway. we need to take a look at the options. >> so you think that the option should be there but you're not willing to say one way or another even though you're running for governor that you want to pursue any of those options? >> as a governor i would want to take as much back to the state as i can so i'm telling you i would want to pursue the best interests of the people of the stay ohio. what i think i would do is try to get as much as i can back to the state. look at the options, making sure

we're taking care of people in ohio and they aren't losing coverage and pre-existing conditions are being met. if i can do that inside the waiver program and still make sure i have a better product, you bet i'm going to do it. >> all right, congressman. thank you so much. appreciate your time, sir. >> thank you. >> coming up, moment of truth. we're showing you live pictures of capital hill. just a matter of minutes the house will vote on a republican plan to repeal and replace obamacare. will it be a major shot in the arm for the president and his party? at whole foods market, we believe in food that's naturally beautiful and fresh. delicious and powerful, and full of nutrients. so there are no artificial colors... no artificial flavors... no artificial preservatives... and no artificial sweeteners... ...in any of the food we sell. we believe that the food we eat connects us to the natural world and to each other.

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house democratic leader nancy pelosi is speaking live on the floor of the house. let's listen in. >> tens of millions of work families across america. trumpcare very clearly spotlights the dfrifferences. it is step forward in the longstanding republican belief that medicare should wigt -- if you believe in the health and well-being of the american people, you must reject this bill before us now. it is what -- here se what it means to the american people. much has been said about policy here today and over time. much has been said about politics. what are the politics of this. what's really important is what this means to the american people. and they know. they are listening. they know what it means to them. and it means, trumpcare does, it

forces families to pay higher premiums and deductibles increasing out of pocket costs. higher costs. less coverage. trumpcare will take away health care from more than 24 million hard-working americans, a crushing age tax. trumpcare forces americans age 50 to 64 to pay premiums five times higher than what others pay for health coverage. no matter how healthy they are. steals from medicare. steals from medicare. trumpcare shortens the life of medicare trust fund and funds that seniors depend on to get long-term care they need. that's why it's consistent with weather wither on the vine fills on see. and if that were not bad enough and they couldn't pass their bill because it was that bad, they move further away from the american people.

by gutting key protections. trumpcare trumpcare eviscerates maternity care, prenatal care and guts protections for americans with pre-existing medical conditions. as bad as trumpcare was the first time around, it was dead, it died right here on the floor, now it's come back to lifelike a zombie even more scary than before. and it is even worse. if republicans have their way, americans with pre-existing conditions will be pushed off their insurance and segregated into high risk pools where they will face soaring costs, worse coverage and restricted care. trumpcare means huge, huge premium increases. it's frightening future for families who need affordable, dependable care the most. now on the floor the republicans

have recklessly and some would say fraudulently say that trumpcare covers americans with pre-existing conditions. it does not. it does not. as they said about the upton amendment, the $8 billion is a pittance. as the kizer family foundation said it would cover the cost of 1% of the individual market. others have given it to 5%. 1% to 5%. does that mean covering? no. forcing a vote without a cbo score shows that the republicans are afraid of the facts. they're afraid of learning the full consequences of their plans of forcing americans with pre-existing conditions into the cold or as my colleague in new

york said off the sidewalk. if republicans thought they were really protecting people, they wouldn't be afraid of the facts. but they're also afraid of the truth. and the truth that would come forth if we knew the facts. and they're afraid that the american people will find out that this is not a health care bill. this is a tax bill disguised as a health bill. this is a bill that is the biggest -- one of the biggest transfers of wealth from the middle class to the richest people and corporations in america. it's a tax bill, not a health care bill. that's why they have to do it now so they can get on with their tax bill. the suffers trumpcare will inflict on the sick is all too clear. that is why this disastrous bill has been condemned by the american medical association, the american cancer society, american diabetes society, american dieabetes american lun association, the cystic -- aarp,

the march of dimes, the list goes on and on. . on and on. the american cancer society. instead of reading all of these pages, i will submit them without objection for the record. thank you, mr. speaker. under trumpcare families senior, vulnerable children with disabilities, people struggling on overcome addiction and the sick will lose their health care. rural hospitals will close. nearly 2 million jobs will be destroyed across america. 7 million veterans will lose access to tax credits for health care and all of this to give a massive tax cut to the richest in america. trumpcare is a billionaire's tax cut again disguised as a health care bill. it's robin hood in reverse.

today we have the -- we honor of visions of our founders who risked everything. they've risked everything. their lives, their liberty, t r their sacred honor to advance their life to life, liberty and the pursuit of happiness. a healthier life, the freedom to pursue your happiness. the freedom from being job locked or policy locked because of what the republicans want to do today. today we fight to preserve affordable health care as the right of every american, again, not the privileged few. today we fight for children like zoe madison lin. zoe was born with a congenital heart tesdefect in may of 2010. she faced her first of three heart surgeries at 15 hours. by six months old zoe was halfway to her lifetime limit her insurer had placed on her. she faced a grim future not only using up her lifetime limit by

preschool, by preschool, but by carrying a pre-existing condition that will require attention and care for the rest of her life. under the affordable care act, zoe is protected but president trump care puts her future in danger. i wish that our members who vote for this bill have better -- i hope you make time to sit down with the parents of a newborn or with a heart condition or a young woman who just learned she