find your awesome with the xfinity x1 voice remote. the vote happening right now. that's going to do it for msnbc live. my partner katy tur picks this up now. >> nail biting moment now. we're at the white house where the senate is voting on the health care plan now. house speaker paul ryan addressed the chamber just moments ago. >> addressing this chamber he called on congress to act. and today we take the next step to repeal and replace obamacare. minority leader nancy pelosi speaking just moments ago as well. >> as bad as trumpcare was the

first time around, you know, it was dead, it died. it died right here on the floor. now it's come back to life like a zombie, even more scary than before. >> all of this action comes with lingering unanswered questions about the bill's cost and how it would affect your next doctor's visit. what we know, coming up. then there's the trump factor. this vote could set the stage for the president's first significant, if not controversial, legislative accomplishment since taking office. but let's start with the politics of t. we have our reporters in washington. let's go first to mike vacarra who is on capitol hill. you've been speak to go republicans. some haven't said whether or not they're going to vote on this bill. how sure is leadership that they have the votes necessary? >> katy, a lot of times what will happen is republican leaders, or democratic leaders,

for that matter, when there is a big moment on the floor like this, they'll put their best face forward. you do not see them just winging it, throwing a bill on the floor. under recent circumstances, it's happened twice in recent memory in the last 20 years, but they are very confident in public and they are confident behind the scenes in private. i talked to one man in leadership earlier today. he tells me that the tide started to turn the beginning of this week. now, recall that there were two high-profile defections. a complete surprise to many, they had significant pressure put on them. they marched down to the white house. they got that $8 billion concession added to the bill to help those who might have more expensive premiums because of preexisting conditions. that helped turn the tide significantly, so they do expect to move forward, to have some success here. we're told members of congress, republican members of congress,

there are buses lined up out front of the capitol right now. they're going to get on those buses. where are they going to go? down to the white house and appear with president trump for a big celebration. so they are going to play this to the hilt as far as the public relations and the pictures are concerned. it's been a long time coming for republicans, but the question really is, is this the end or just the beginning? because from here the tough part comes. they have to send it over to the senate and everything they've been struggling with and negotiating. vice president pence up here on a regular basis the last several days, the president hosting members, making calls. all of that likely to be viscerated in the senate. that's like toly to take place and when this goes through, katy. >> they're voting on the sally bill, which is a bill to make sure they can't maintain the benefits of obamacare. dick sherman standing by right next to mike vacarra patiently

waiting. jake, so far the republicans haven't really been so transparent in what exactly is in this bill. what is the rush? >> once you get the votes, you take it to the floor, as mike said. you don't go to the floor without the votes, you go the minute you have them. but a couple dynamics worth pointing out. they don't have the budgetary impact, what we call the score, so we don't know how many people this is going to cover, we don't know the cost of this bill. they did not let this wait out in the public for three days, so people might not have read this bill. this is not how republicans said they would do business in washingt washington. wh when they took the majority in 2010, they specifically promised they wouldn't do what they're doing now. members of congress go home for 11 days starting tonight, and they don't want these guys and girls and ladies and men going home without voting on this. they don't want people to hear from their constituents about their opinion on this. they want to take this to the floor, they want to get this done and begin the process in

the senate and eventually get to tax reform. they're in a rush now. the political wind is at their back and they want to do something with it. >> the caucus now subjecting to the platform, it sounds like. how much did the white house play to get this to the floor today, chris jansing? >> reporter: you'll hear from the president that he believes he hadded a big hand in this. there is certainly something to back it up. as you know, over the last 24 hours, 36 hours or so in particular, he was really working the phones. and we heard from republican members of congress who said, i talked to him for 20 minutes. these were not like, you know, one-off phone calls. he kept pressing me, pressing me. i kept saying no, no, no. so he called people over here in the west wing. he had them go in the oval office and he made the case very similar to what we heard him make in march when they didn't even get to a vote on health care, and that is this is what i ran on, this is what you ran on, this is what the american people are expecting from us.

and so a little bit earlier when he was in the rose garden, he said that it's going to be a wonderful vote. we fought very hard to be able to do that, but what they haven't been able to do, and just to follow up on what jake said, is to really explain the costs of it, the winners, the losers of it. they had an off-camera briefing with sara huckabee sanders, the deputy press secretary, and when she was asked about the cbo score, she said, and i'm quoting her here, katy, even if they were to score it, it's impossible to score a lot of things that would go into this. even if it was to be scored, i think it would be impossible to predict how that might actually affect the impact of provisions in the legislation. in other words, we don't have a number for you, and we don't have exact specifics on what it will mean to many of the millions of americans, 20 million of them, but the president has delayed his trip to bedminster which was scheduled for, i think, right

about now. they're planning to do that victory lap here for him. it is that legislative victory that so far in this presidency has alluded him if they do, indeed, win this vote, katy. >> yesterday we saw a couple congressmen go to the white house. they walked away with what is being referred to as the upton amendment. that's $8 billion that will go to help cover the costs in high risk pools for the states that take the waivers. other than that, mike, what else do we know about this bill? what is in this bill? >> what you see being voted on the floor right now, it was an inadvertent oversight where, if you can believe it, members of congress would have been exempt from some of the provisions in the bill. when the affordable care act passed, obamacare, members of congress were subject to the provisions within obamacare. so they're correcting that now, and that's why you see the rarest of rare votes. 410 people, not one nay vote, so nobody wants to be on the wrong

side of that. the provisions, obviously the preexisting condition provision was the preeminent stumbling block to try to get moderates on board here. that's why you saw the 8 billion at the last minute added in addition to some 130 billion that was already in there to help mitigate or help fray the costs on some of these high risk pools. but a lot of this does realize the longstanding kbiambitions o republicans. the poverty line now about $20,000 for a family of four. the federal poverty line. that's going to go away in two years, as of 2019. some of the taxes on wealthier americans that were instituted as part of obamacare that helped pay for some of those provisions, those are also going to go away to the tune of some -- you know, billions of dollars over the course of the next 10 years, chris. >> and mike and chris have just been talking about how the republic cabs aans are going to

white house to celebrate if they pass this. the president has done somewhat of a victory lap on, where else, twitter. if victorious, republicans will be having a big press conference at the beautiful rose garden at the white house. ali, there is a little known provision of this bill which will impact employer health care plans, not just those who are aren't under their employer plans, but those who might have health insurance from a big corporation. >> right, and that's most americans, by the way. most americans get their health care through their work. katy, about a month ago you and i had a conversation about something called essential health benefits. in one version of what the freedom caucus wanted, they wanted to take away the obamacare requirement that these basic benefits are met. we may have a screen of them. but they're maternity, pregnancy, prenatal care, opioid addiction, mental health care, prescription drugs, emergency care, things like that, right?

now, under the provisions of the american health care act, and you got to dig and you got to really weasel your way around to find this, but there are abilities, as you know, for states to get a waiver from the provisions of this. if they get that waiver, they can also push people into high risk groups, and they can allow insurers not to cover those essential health benefits. so there are many people sitting here saying, look, this preexisting condition thing doesn't apply to me because i am employed and my insurer provides it. your insurer may if it is based in a state that exercises one of those waivers may be able to buy coverage that doesn't cover one of those essential health benefits, and you may find you're not covered as a result of this. donald trump just tweet aed a f minutes ago that, i'm watching the democrats defend the you can keep your plan and your premiums will go down, the obamacare lie. this may end up being the thing we talk about for years, that

people with preexisting conditions, whether employed or not employed and getting insurance on their own, may both face increased premiums. this is not going to be a guarantee that if you have a preexisting condition that you will not see a massive, massive increase in your rates. the other thing is the bill did add $8 billion for the extra cost of insuring people with preexisting conditions through these high-risk pools. estimates by some conservative groups is that that is 15 to 20% of the actual amount that is needed. estimates by other groups is that it's 1 to 5%. at best the $8 billion is the extra cost of insuring people with preexisting conditions, katy. >> it seems that the house has finished voting on the sally amendment. they should be getting underway with health care vote at any moment. we'll be keeping an eye on it as it happens. we should also note, yeah, this is going to change if it goes to the senate. we had senator joe mansion in

west virginia say -- and more to the president, he told him this in a phone call, that people might not remember who gave them health care, but they're certainly going to remember who took it away. senator ben cardin, a democrat as well, calling this health care bill offensive. he also said it will political consequences. and a republican was aware of it as well. amendments not allowed and three hours final debate should be viewed with caution. even if the house does end up voting yes on this, it is unclear what will happen to this bill and what it will look like when it comes out of the session. jake sherman, ali velshi, chris jansing, my thanks actual of you. you can see 162 republicans say yes, five say no. we will keep an eye on it. that is the politics of it. now let's talk about how it is going to affect you. with us three health care

professionals, medical contributor natalie azar, dr. john torres and from cancer action network, dick woodriff. how do we know this is going to cover more people? do we know this? and how do we know it's going to be cheaper as republicans promised? >> every analyst so far has said the exact opposite. i think we get back to the semantics of access versus actually covering people. anybody has access to medical care in this country, but if you can't afford it, what's -- you know, what's sort of the bottom line there, what's the logic? i think we have to sort of shift our philosophy. the way i see it is you take away the individual mandates so healthy people aren't signing up. that means healthy people aren't getting definitive care. you're shifting the economic burden of health care costs to the sickest people, and as we

all know, prevention is much cheaper than treating chronic diseases. so in this discussion, i could echo what all the analyses have said. the premiums are going to go up, the access is going to go down, there is a limitation that this is a drop in the bucket of what the cost burden is going to be. but i think the larger discussion not being addressed here are all the other things that we're not doing to make a dent in the health care costs in this country. prescription drug kocoverage, a the layers between doctor and patient coverage. >> 175 say yes, 18 says no. dr. torres, there is a lot of talk about this upton amendment, this $8 billion that's supposed to go to the high risk pools. it's supposed to offset the costs of these preexisting conditions. the average 40-year-old with

preexisting conditions would pay an average of $3400 for allergies, up to $142,650 for cancer. are those numbers enough? >> they're not enough. the earlier contributor saying they're a very liberal think tank group so some people are looking at it cautiously. the aarp said the average premiums for people with preexisting conditions, $27,000 a year. like dr. azar said, just because it's available, going without insurance means they're not covered. they're talking about the employer sponsored health care. the fact that a lot of people are covered by that, most people don't realize half the people that have that type of health care also have preexisting conditions. if that goes by the wayside,

they're not covered. 85% of 55 to 65-year-olds have a preexisting condition. >> the original one said 24 million could lose their health insurance. obviously this bill looks slightly different than that did, but again, we don't have a cbo score so we don't have an independent watchdog looking to what these numbers mean. dick, let's talk about the surcharges for cancer. $142,000, as i said, 650. 142,650, excuse me. what does this bill do for patients who are fighting for their lives? >> we talk a lot about people with preexisting conditions, and the question is, who are they? there are 15 million cancer survivors living in the united states today, many of whom will have very difficult time accessing affordable health insurance.

you know, they've set up this waiver system that will enable states if they choose to set up high risk pools, but what that will do is that will segment the sickest people, including cancer patients, into those pools, and they won't have enough money to do it. everybody says that there's not sufficient funding. if you look at the history of high risk pools which existed in states prior to passage -- >> i'm sorry, dick, i'm going to interrupt you. they have 216 republicans saying yes, which means, if i'm incorrect and somebody stop me if i'm saying this wrong, it means that republicans have passed -- wait, sorry, we're not confirming it yet. i apologize. i'm looking at the screen. we're not confirming it yet. i'm sorry, dick, for interrupting you. go on. >> i believe they're voting on the mcsally bill, but i could be wrong. >> are they still? i apologize. they already voted on mcsally. i'm sorry, dick, keep going with what you were saying about those who might not be able to afford the coverage and are fighting

for their lives. >> no worries. the risk of high risk pools which they would put cancer patients and pre-ex into, they used to have waiting periods of six to 12 months. if you have a cancer diagnosis, you can't wait 6 to 12 months to get coverage. they generally had higher premiums than the regular market. it's really not a solution for people with preexisting conditions. what works in the employer-based market, what works in medicare is you have everyone in the same market, sick people, healthy people, they support each other. that's the american way. that's the way we should be doing it in the private market. it's worked for the past six years. when this bill goes over to the senate, we're going to change it and hopefully it will be more reasonable for patients. >> when the bill passes, if it does pass, what recourse are people with preexisting conditions going to have? >> katy, i think people need to know -- they need to be given something to work with.

what concerns me about this $8 billion allocation, which is woefully inadequate, who is going to be eligible for that? how many states are going to submit for the waivers? if all the $8 billion is going to one state, that's fantastic. >> i'm sorry, the bill has passed. republicans have passed their repeal of obamacare, repeal and replacement. >> from california, mr. rice, to expand the rules and pass hr-64. >> hr-1644 with respect to transactions related to north korea and other purposes. >> they pass the bill as members record their votes by electronic device. this will be a five-minute vote. >> there you have it. republicans going to be celebrating. on their way in a moment or so to the white house. now they're going to be voting

on north korea sanctions. i want to go back to mike vacarra who is there on the hill. mike, this is a legislative victory for the republicans, but very unclear what this is going to mean for the senate, or whether or not this bill is going to look anything like what we see right now. >> katy, i've been doing this for a lot of years covering the house of representatives and the congress. we see the members spilling down the stairs now after this vote. i've never heard them cheering "hey, hey, goodbye, nana, nana" as we heard in the chamber a minute ago. those are republicans, and they're doing it because they're sick of doing this. the sixth time they've had to do this alteration appeal of the affordable health care act. they want to get it to the senate side. they want to move to other things, tax reform and other things on their plate. very happy. over here you see a protesting group that has gathered on the east end of the capitol.

shame, shame, shame, you hear them say. the buses here where the press is waiting for them to jubilantly spill down these steps. taking them to the beautiful rose garden for celebration for this long-awaited moment, though it may be a short-lived victory because again, this bill now goes to the other side of the capitol to the united states senate where it's expected to be altered significantly. you see some democrats coming down. that's hank johnson, a georgia democrat, cheering on some of the protestors across the street. we don't know how many republicans are going to be down here. we have two big buses being fired up ready for them to go. obviously republicans playing this to the hilt. this is a long-promised move to if not necessarily repeal the affordable care act, to alter it

significantly, they're going to play it up as much as possible as a promise delivered to their base, a long-held promise dating to 2009. >> we also have matt chapp, chairman of the conservative union. matt, this is something they needed to prove that they could get something done, certainly something paul ryan needed to prove. is there concern in the republican party that this was not done the right way, that this was not the best bill they could have put forward? 50% of americans, 50% of voters have little to no confidence in this health care law. >> katy, there's all kind of ways in which the process in the house could have been improved. but what ended up happening when they didn't vote on it the first time is republicans really dug in and had a big debate. that debate played out in almost every media outlet across the country about what a republican

alternative will look like. the problem with health care generally, and i think we all know this, is that it impacts all of our very lives. and it's one of the most sensitive things you can do in politics. this is a very difficult thing to do, which is why hillary clinton had so much trouble since she was the first lady. it took years to pass obamacare. and it's true, republicans have been talking about a need to have a more free market version of health care reform, and i don't think we looked like we had it all together at every moment of this, but i think nobody on the republican side cares right now. i think they were just very happy that it passed knowing this is simply the first step. the senate has to take it up now, and the nation is going to have a big debate continually on what this looks like. >> matt, so many republicans criticized obamacare saying it was done in the dark, that there wasn't enough time for the public to see it, that they didn't know what was in this bill. they don't even have a cbo score on this bill. they rushed this through. was this more about looking like they can get something done

rather than actually doing something that's going to benefit the american public? >> i think that's very unfair. there's already been two cbo scores on the other iteration of this bill. >> why not a cbo score on this bill? why the rush here? >> because you're not going to learn anything we don't already know. the biggest tax drive is the federal tax. the problem with taking that approach is, remember, millions of people lost health care under obamacare. the cbo got that all wrong. the fact is the mandate did not result in everybody, all these younger people buying health care, many people refused to do that even though the supreme court upheld that piece. so much of what the cbo did with obamacare was just flat out 180 degrees incorrect. nobody should assume that's some kind of gold standard. i do think it's better to wait for scores when it comes to

passing legislation. as i said, we already got two on previous iterations. we know the pluses that occurred with fred upton and others. we know this saves a hell of a lot of money over obamacare in the next 10 years. >> we also have jen from the clinton campaign. jen, what do democrats do now? >> well, i think this is all the momentum that we see behind this bill is a lot about short-term gain for the republican party within the republican party, and i think that you'll see -- i have seen situations before where in politics you're on a train, it's headed for certain destruction, and for some reason you can't seem to stop it. i think that's what happened here for republicans. the fact they are leaving now to go on recess, i think when they head home, they'll be facing a lot of angry voters who have a lot of questions about coverage they're going to lose and preexisting conditions that

aren't going to be covered, and i think it's going to be a really rough week for them. and many rough months to follow in terms of trying to answer their questions of why they took a vote like this without enough information. that's going to have a big impact and result in people losing their coverage and a lot of people having their costs increased. guys stay with us. we also have congress sman berra. react for me, please. >> this is not a day for us to celebrate anything. a lot of patients are going to lose health care coverage. it tells us 25 million americans are going to lose health care coverage. it's not a good bill. >> what are you going to do now? you didn't win this bill in the house.

do you hope the senate brings it back and makes it more moderate? what's next? >> we have to make sure the american public knows how bad this bill is. as a physician, i don't want to go back to a day where patients who might have breast cancer or heart disease can't get health coverage. those states that opt out, those individual are not going to be able to afford to get health care coverage. what do they want to do? they want to give a big tax cut to millionaires and billionaires. this is not what we ought to be doing. >> congressman, in your assessment, what was specifically wrong with this bill? >> a couple things. we ought to want to get more people covered. the first cbo score that came out said millions of americans will lose their health care coverage. that's bad. this is a bill that allows health care companies to raise premiums on older americans. that's bad. this is a bill that, with any of the savings, they're giving a massive tax cut to the richer americans. that's moving in the wrong direction.

let's go republicans. . let's talk about how to lower the cost of care, let's talk about how to get competition in here. that's been the problem the last seven years. you haven't tried to cover this health care. >> they're headed to the rose garden. are you concerned about the optics of that, coming back to a arm. >> until there's a signature on a piece of legislation, hopef hopefully a lot of this is trying to find voters in the senate. they view themselves as the upper chamber. let me say this about a cbo score once again. if you're going to be so focused on the need for a cbo score, and

i'd like to see one swshl, you o look at the cbo score for obamacare, which was way off and people did lose their coverage under obamacare. and millions of americans might not have insurance, so under this plan, they could choose not to have insurance bears that fee or tax demanded. and finally on prices, you have to have tort reform. if both parties could actually do something to restrain the child bar, we could actually lower costs. >> matt, thanks. i want to thank congressman ami berra who had to run. we're looking at protests on the steps of the capitol right now. protestors a moment ago were saying "shame, shame, shame" as republicans tried to board those buses on the way to the white

house for that celebration. we have chris matthews, host of "hardball" with us. chris, you've done this a long time, you've seen the votes. what do you think of republicans going to celebrate before this bill is signed? >> i think this is a celebration on both sides. i remember the clinton tax increase back in '93 where the republicans were able to kill some democrats in the next election. i think it's like that. i'm looking at -- you know, katy, i'm looking at the republicans who didn't vote for this today and they tell you a whole story. you'll be familiar with these names, charles dent from allentown, pennsylvania, promotions city, new jersey. chris smith from new jersey. these are all moderate republicans from very swing districts, and they're careful here not to vote for this. so the safest vote today was any democrat who voted against it, which is all democrats, they're very safe on this vote. nobody is going to blame a

democrat for not voting for this bill today. these republicans who voted against the bill are somewhat safe, but in a strange political way they'll be blamed for what their party did, even if they didn't vote for the party. but it's clear the republican leadership corralled these people and protected them from having to vote. what did they vote? 217. just enough to squeak by this thing. they didn't miss a single vote, meaning get somebody to vote for this who didn't want to. that little chorus of "you're going to get yours" is exactly reticent of the mid-'90s when martha of montgomery, pennsylvania voted for that tax and got her seat knocked off for it. >> chris, i hesitate to call this a legislative win for the

president, because it hasn't been signed, first of all. it's unclear how this will reflect. >> doesn't it seem like this is more than health care? >> getting on a bus doesn't seem right for me. why do they look like they want to be associated with trump? i wouldn't want to associate with him on a bus, anyway. i think these guys are going to look like they did it for trump, not for the voters back home. when they go to a doctor and they get a bill for their medicine or whatever, and they go, wait a minute, why isn't that covered, who do they blame now? they're probably going to blame the republicans and say, wait a minute, they've been screwing around with this system. you made a good point there.

who thinks this is going through the senate. >> chris, hold on a second. we have house majority leader. who is to say this wouldn't get through the senate? what happens with that? >> look at the headlines this week. if you look at iowa, they now have 94 counties out of 99 that have no health care. that means no coverage, no preexisting conditions. you now have aetna today announcing that they're pulling out of virginia. you have 16 counties now in tennessee that have no health care coverage. you have roughly 3,000 counties in america. one-third of those only have one provider. in short, there will be some with none. that is what obamacare has given

us. >> how did your bill help that? >> because obamacare did three things. it gave you. anybody currently on it will not be removed in the process. we create a system for those who can't afford it -- >> just for two years. >> no, if you're on it today, there is no difference for it. if somehow you improve and make more money, then we giff you a t tax. instead of america the government dictating the plan you have. maybe my kids are young, so i look for a plan that takes braces and others. i get that choice and i take a tax cut to do that. you know what happens when you

have competition? prices are controlled and cost goes down. >> are you concerned that when this gets out there, when it stays where it is, the independent sessions, that's not going to be near enough to make sure they can still maintain affordable health care. yeah, they may have a choice, but they're not going to be able to afford it. >> the 78 billion only goes to those states who take the waiver, only then do not have continued coverage, are guaranteed and somewhere fell in that they would have a preexisting condition. that would then buy down the premium so their costs wouldn't be high. it's only in that small group. they said that would cost 5 billion so we put 8 billion in to make sure there was enough. you have to read the whole bill

to make sure you read the portions well. >> do you think we have enough time to read through the whole bill? >> obamacare was less than 2,000 pages. this is less than 130 pages, it has been out there -- >> but a lot of them are amendments to obamacare. to say it's smaller is not really correct. >> the amendment last night was two pages. yes, i am correct that 130 pages is less than 2,000. the other point you have to make in all of this, if we do nothing. obamacare is in a downweird. >> the health care community is. n where from ama to aarp are really concerned what this will cost. not for the young, but for the poor and for the sick and for

the elderly recalled. congressman, can you guarantee your constituents -- hold on, i'm asking a question. can you guarantee your constituents, yours in california, can you guarantee they're not going to go up, period? >> i just maryland, the top plan they have. they're requesting a 50% increase under obamacare and the premiums to go. those stay right where they are. those that need a tax credit will get more choice. this does nothing, instead of that 50-employee rule for small businesses or 30 showers so they

won't increase. they can get a full-time job instead of having to work, too. >> do you think it will be better than obamacare? >> it will be better than obamacare and we won't have constituents pulling out of the market where they have no choice. i look forward to moving through the debate. i would be willing to sit down with anybody because it's them we're most concerned about. i want them. more people chose to have the penalty or the exemption that even sinld. the 23 co-ops that are given to obamacare, some of those have failed. i'm looking forward to us moving forward providing a low premium.

>> house. i here hear uf to join them right now. >> 75% of americans said fix the affordable care act. every democrat since 2011 has been saying, we will work with you to make the affordable health care act work as well as it can for every american. jimmy kimmel got it. jimmy kimmel had a little boy who has a heart problem. and jimmy kimmel knew that he needed a preexisting condition to be covered. every medical group that has expressed an opinion on this bill says this bill does not protect preexisting conditions. and the bill that was originally introduced and still exists and

passed the house today will take 24 million people off the insurance rolls. it will pose an additional age tax on millions of seniors. it will, in fact, increase from 24 to 29% the premiums of those who have insurance either through their employer or on the private market. the majority of members of the house of representatives knew this was a bad bill today. america should lament the fact that all of them didn't vote that way. and america will hold them accountable. i now yield to my friend, the assistant leader from south carolina, my friend jim clyburn. >> thank you very much. >> democrats speaking right now about the health care vote,

clearly not pleased with how it went down. republicans, meanwhile, have all boarded buses on their way to the white house to celebrate the passage of the bill, at least in the house. this is before the president of the united states leaves washington and comes here to new york to attend an event on the intrepid. we do expect the president to make a statement or to at least release a statement within the hour. we should say there are a lot of independent health care groups that are coming out and saying that this bill is not going to be good for the sick, for the poor and for the elderly. the aarp saying none of the legislative tweaks under consideration changes the serious harm to patients and the health care delivery system that the bill would cause. tinker at the edges of that, remedying the failing of the bill that millions of americans will lose their health insurance as a direct result of this

proposal. chris matthews, i was talking to senator joe mageo yesterday. he's in a red house, somebody who is sensitive not only to the success of obamacare in his state, so many people have signed on to it, but also somebody in a state who have voted for donald trump. he said he called the president and he gave him a pretty stark warning. voters aren't going to remember who gave them health care, they're going to remember who took it away from them. is there concern from anybody on the republican side that this could potentially take health care away from the very voters that voted for donald trump? >> well, that's true, and i think 20 million people mainly from the east coast, pennsylvania to new jersey, who wouldn't vote with the majority of republicans today are personally worried about this today, not just for their constituents but from their own seats.

voters are negative voters. a voter generally goes out and votes against the great depression. they might vote against a war. they might vote against segregation, but they vote for something, generally. they don't like what's going on. we saw that with the hillary clinton health care experience where they voted against the clinton health care plan in '94. they voted against obama in 2010. they didn't like his health care. the pattern is to vote negative. it's just the way people are. they look at their bills, and the bills are too high. not enough is covered or they feel like they were left out entirely. notch babies were left out. they had to have somebody to blame and voting for congress was a perfect target. i think this is a very difficult thing for the republicans to do. then, as i said, the imagery of packing themselves onto these buses and going down to the white house like they're working for this president. trump is not going to be up for reelection in '18. he may not get reelected in 2020, who knows, but these folks are all really kind of yolking

themselves to this guy. they're saying, we're trumpites. we're with trump on health care. they may have had a legislative win today, but they'll be doing a lot of explaining between now and next november. >> the american medical association said the bill passed in the house today will cause many americans to lose access to quality health insurance and those with preexisting conditions face the possibility of going back to the time when insurance companies charged them premiums that made health care out of the question. is there any chance that donald trump will face a primary challenger in 2018 from the republican side? >> probably. because he's controversial, and there are people like george whelan in the "washington post," there are true blue conservatives, they don't like him. and some see it as an opportunity to make hay.

he'll have a tough renomination fight. who knows what will happen. but i want to get back to that preexisting issue. what they did over the last 48 hours, republicans papered over that issue, use ing a band-aid,o use a medical metaphor. they said we're going to pass a bill that says $8 billion will be spent by the american taxpayer to help those who have to go into the high risk pool, those with serious health problems, because they're harder to insure. most people don't think the people will cover that. >> kevin mccarthy does? >> he says that. and based on recent history, there just isn't enough there. over five years, that's 8 billion. that's 1.86 a year. there's just not enough there to cover all the people who have to be insured. >> so do people bury their head

in the sand. >> i think they're getting on that bus and that will be the most expensive bus trip in their entire life. what are we hearing from the voters? what are we hearing from the constituents back home? they're going to hear a lot because people think the worst. nobody thinks you can repeal and replace at the same time. nobody thinks you can square a circle. you can't do it. they talk like this over and over. we're going to repeal and then we're going to replace. which is it? are you going to replace the good stuff? now, ever since i can remember, conservative, but once people have that program, they'll never do it. it has a ratchet effect. you give people something because they voted for it and they want it. my conservative father loved medicare. for the first time in his life,

he felt like he was getting something for nothing. he paid into it, but he said, gosh, i got something good here. this is something the republicans were right about. their big mistake was letting obamacare pass the first time. people want to keep it. >> chris, let's play devil's advocate. obamacare was getting gutted before this by president trump. >> he was quoting from the newspaper. i read the same article that you read, too, in the "washington post" about iowa and the minnesota-based insurance company. that same article he could have alluded to further argued that what's going on in these insurance companies, they're scared about what's going on in capitol hill right now. that's where occurs the lack of program in their plan. >> my question is, if, you know, the democrats knew that the republicans were going to come at obamacare with all that they could, they were going to try and make it as weak as they

possibly could in order to get a bill like this passed, why did the democrats -- and could they have even done this if they had wanted to? why did the democrats not come out and say, look, we have an idea for fixes. >> that's my speech. i said to democrats, if you want to hardball, look, get together with maybe a couple of these 20 republicans who don't like what the majority is doing and say, go break the rule. go to the floor and say, we want to change the rules and have a vote on our plan to refine and improve and save obamacare. i don't know why they don't do it. it's a good question. >> chris matthews. realso have -- >> kreswe should bring in steve is excellent going on the inside. steve, you're the pro. explain the nuances of why the democrats were cheering

yesterday and the republicans were confident enough to get on that bus. i wouldn't get on that bus. they're getting into a bus and they're going to the white house to kiss the guy for being their boss? what's the imagery here? i think it's terrible. i wouldn't get on a bus. >> you talk about that cheering on the house floor and i'm seeing conflicting reports who is doing it, but you mention 1993 and the republicans, they're all chanting "bye, bye, marge margery." she ran on that tax hike in '94 and she was defeated. that's what democrats sense on this vote. we've been crunching the numbers. when democrats look to the 2018 midterms, there is a very particular type of district they're looking at. keep in mind they basically need two dozen seats. they have to pick off two dozen republican seats if they want to win back the house in 2018. there are 23 -- you're basically right there -- 23 districts that

are held by republicans that hillary clinton actually won in the presidential race last fall. republican incumbents in clinton won districts. how did those republican members -- >> here's the list, steve. these are the people that see them them coming. these are the republican moderates who think they're targeted. they voted against them. >> here's the thing. in those clinton districts, districts that republicans represent and that hillary clinton won. most vulnerable. 14 of the 23 voted yes. voted for it. so only 9 went against it. if you extend it a little further where hillary clinton was within 5 points, republican held districts, 11 of those, nine yes votes. there are some republicans. you look at the northeast, you certainly see republicans sensing vulnerability. the districts that democrats are looking at to give them that majority in 2018, there are a fair number of republicans here

who cast the vote that democrats wanted them to cast. a vote that you'd better believe they're going to make them hear an awful lot about in 2018. >> do you know why they did that? the leadership needed 217 and they said you've got to do it. what do you in politics, what you should never do. there is the bus, coming home to papa. i can't believe these people. they are going to the white house to get the thank you notes or whatever, the party favors from the president. the leadership needed the 216 so they demanded to those people, as you pointed out that votes against their own local interests. which is a bad thing for leadership to do. they would rather be loyal to trump than their members. >> you look at the list. it is not necessarily strategic. a republican congresswoman from down in south florida, she announced the other day. not running for re-election in 2018. she does not have to worry about the voters.

she comes from the most pro clinton area. she still voted no. if you're leaning these folks, that could be a yes. that could free up somebody from one of these other districts. but right next door, carlos, he comes from the second most clinton, pro clinton district of all republicans in the house. supposedly a rising star in the republican party. clinton won his district by 16 points. he was a yes vote on this. the single most surprising one that i see here. >> i don't think that's a smart move. the districts like the cuban american districts tharks very right wing on foreign policy, they still have their domestic interests which are more like most people. so it's an odd one. who do we have joining us? chris jansing at the white house. i think you might be right where the action is. all these people who just voted for the president's position, i'm not sure he read the bill, the president's position on health care are coming down for

their thank yous. >> reporter: yeah. and they're saying this is a celebration, a party. not like one we're used to seeing after a supreme court move that favors whoever is in the white house or obviously the passage of a bill that is actually passed. this bill has not been passed, in terms of it doesn't become legislation. we've been talking about how hard it will be in the senate but clearly there is a sigh of relief among the republicans. the selling point that the president had over and over again, this is what i ran on. this is what you ran on. do you want to go back to your district some we promised we would repeal and replace obamacare and we haven't done it. this is your opportunity to make that stand, do what you promised to do. they sent us here to blow up washington. you have to do it and you have some front page headlines in difficult places like iowa. having said that, you have this emotional component and i'm not sure that we have sustain last

of it. we know that the american medical association, we know the aarp is against it. but you have at least ten patient groups including those representing cancer patients, as we're waiting to see members of congress who have come out against this hooflt are going to express their concern about what it might mean for people with pre-existing conditions. the senate won't do anything until they get cbo score. as democrats expect the news is bad, if the headlines again are as they were in march the first time this came around, unsee the problem this is will cause. having said that, they're getting the rose garden set-up. this is a president who likes the pomp and ceremony of what places like the rose garden represent. earlier he talked about it a couple times. he said to the religious leaders

something like, you never thought you would be here. and they gave him a standing ovation. he mentioned the rose garden several times. he also announced officially his first foreign trip. for this administration which saw all the coverage going into the first 100 days about he never had a major legislative accomplishment, about all the promise that's were not kept, they see today as a representation, and health care being number one, that things are getting done here. >> i want to get back to steve. is steve cokornacki still with ? >> we don't to have wait for the cbo to crunch the numbers. if you're talking $8 billion to cover all the people to be insured for all the people with the pre-existing conditions. everybody who has diabetes or heart problems, all those people will be insured for $1.5 billion? it did you have seem logical. >> so play this forward. now you go to the senate. you have two votes there if you're a republican trying get

there. twou votes you can spare in the senate if you're doing republicans only. so what objections will you hear? exactly what you just said. pre-existing conditions. are we really living up to the promise of protecting people with pre-existing conditions? people are very mindful of that issue. what happens when you send it to the house? does the freedom caucus balk at that? how about funding for planned parenthood? how about trying get someone like susan collins on from maine, or lisa murkowski from alaska. anything you change to playing it more palatable to the senate where the political realities on the republican side are different than the house. any change you make in the senate, you have to turn around and sell back to the house. we just saw the sway that the freedom caucus, the purists, the

most conservative members hold in the house. anything do you to moderate this even more, you risk a rebellion kicking this back. so this is just legislatively speaking. republicans try to have the goal of passing something on health care. legislatively speaking, a victory today to. get to that finish line, they are a long way off right now. >> i think that's why they're having the celebration today at the white house as we're watching. you only missed one point. that is that they need 60 votes in the senate. that means they need 88 democrats, which means they have to make concessions juicy enough for a democratic senator to sign off on this trump bill which didn't get a single vote if he a democrat in the house. >> i think they're using the same parliamentary procedure here democrats with able to use to pass with 50 only in 2010.

>> okay. reconciliation. >> i think you're looking at republicans only. on the republican side, you have objections you can foresee from a rand paul, a mike lee, the libertarian wing. this is too wishy washy for they will. then the other side, you can look at the middle. in 2018 you'll have jeff flake, republican, up for re-election in arizona. a state trump wanted. that's a battle ground state. does he want to run on this? take a look at nevada. that's a state hillary clinton actually won. does he want to run on this in 2018? you look on the senate side. how about ohio? west virginia? how about medicaid expansion states? you have all sorts of different calculations on the republican side. it is different than what you just got through in the house. if you're doing 50 votes here, you can only do it with two republican defections at the

most. any concession you make, that means it has to go through the house and you saw what a tortured process that is. >> what i think we're watching at the white house is one of those iconic pictures that we'll be hearing about from here to next november. this is the most important vote perhaps of this congress. voting on the republican side, in a party line vote, voting for the health care proposal of president trump. basically a party vote and a trump vote, so much so that they're all trooping down. we have the pictures through leaves of a bus with a lot of members of the republican side of the congress who have come down to receive their thank yous from trump. a very strange moment. and i think it will be theed kind of video the democrats had use in the next election showing they're not voting for the district, they're voting for the president. they're all down there getting their pictures taken. doing bidding of a republican

president who is not universally loved in this country. let me go back to chris jansing. can you get a good idea of what the ceremony will be after this vote? >> reporter: well, they had it set up earlier for this earlier thing. the white house is billing this as a celebration. you saw that the president tweeted today that the members would come over here to do a press conference. so the supposition was that there would be an opportunity to and the president questions. now, chris, obviously the press has a lot of questions. the press has questions about pre-existing conditions about, how many americans will and won't be covered, how many might lose their coverage, what it might mean overall. but now white house is saying that the president is not expected to take questions. so while you certainly will see members of the press corps who will shout some things, that's not what we expected. we expected to have an opportunity for the president to