On Thursday, May 4, the American Health Care Act passed the House of Representatives 217 to 213. The vote came just one day after Majority Leader Kevin McCarthy (CA) announced that the House would hold a vote for the bill.

  The vote was largely along party lines, with all 192 Democrat members of Congress present voting against and the 238 Republican members of Congress losing only 21 votes.

  The revival of the American Health Care Act came after successful negotiations between the Freedom Caucus and Paul Ryan to prevent the same opposition from the far-right that caused the first bill to be pulled on March 24.

  The decisive factor in the Freedom Caucus’ support for the bill was the MacArthur Amendment, which would allow states to opt out of numerous Obamacare provisions, including the 10 essential health benefits.

  Now, it must pass the Senate, where Republicans hold a 52 to 48 majority. While vote counts on the Senate are still early and fluid, more than enough senators opposed the original bill to block it.

  Like the House, internal opposition in the to the original bill in the Senate came from opposing factions of the Republican party: moderates and far-right conservatives

  On the tea party end of the spectrum, Senators Rand Paul (KY), Ted Cruz (TX), Mike Lee (UT) and Tom Cotton (AR) opposed the original bill because it did not repeal enough of Obamacare.

  On the centrist end of the spectrum, Senators Susan Collins (ME), Bill Cassidy (LA) and Dean Heller (NV) opposed it because it repealed too much of Obamacare.

  Furthermore, before the bill was originally introduced, Senators Cory Gardner (CO), Rob Portman (OH), Shelley Moore Capito (WV) and Lisa Murkowski (AK) vowed in a letter to Senate Majority Leader Mitch McConnell (KY), “We will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states” (the bill does not include this stability).

  Even some senators whose rhetoric indicates that they will likely vote for the bill are showing criticism for how it is being dealt with. Senator Lindsey Graham (SC) was critical of the rush to pass the original bill and questioned its passibility. Just days after its introduction, Senator Mike Lee (UT)  said “[the bill was a] missed opportunity and a step in the wrong direction.” Senator John McCain (AZ) has criticized how the timetable for the bill seems more important to the leadership than its contents.

  Although Senate Democrats are in the minority, they can still find ways to thwart the bill. On March 23, Senate Minority Leader Chuck Schumer met with Patty Murray (WA), Ron Wyden (OR) and Bernie Sanders (VT). Their intention, according to a VOX article two days later, was to argue that several provisions of the bill violate the rules of budget reconciliation, meaning that the vote threshold for passage would rise to 60. If successful, this would make it impossible to pass, unless every Republican and eight Democrats voted for it.