photo by: AP File Photos

? All four members of the Kansas delegation to the U.S. House voted in unison Thursday in favor of a bill to repeal major portions of the Affordable Care Act, following through on their campaign pledges to “repeal and replace” the law commonly known as Obamacare.

The new law, known as the American Health Care Act, or AHCA, passed on a narrow, 217-213 margin.

Among other things, the new bill would roll back the expansion of Medicaid under Obamacare. That expansion enabled states to extend Medicaid to millions of modest-income Americans with incomes up to 138 percent of the federal poverty level.

The bill, which faces an uncertain future in the Senate, would not revoke coverage for people who have already been enrolled in Medicaid through the expansion, but it would cut off new enrollment through the expansion and it offers states incentives to drop expansion altogether.

Earlier this year, the Kansas House and Senate passed a bill to take advantage of the expansion opportunity, but Gov. Sam Brownback vetoed the bill and the House failed to override that veto.

The AHCA also would give states the option of receiving their federal share of Medicaid costs in the form of a block grant and adding work requirements for Medicaid eligibility.

In addition, the bill repeals the Obamacare mandate that all individuals carry health insurance or pay a tax penalty. It also repeals the subsidies currently available to people who buy individual coverage on the exchange markets and replaces those with refundable tax credits.

The bill also repeals a number of taxes on high-income taxpayers that are part of the funding mechanism for Obamacare.

According to a Congressional Budget Office analysis, an estimated 14 million Americans would lose health coverage under those provisions. Federal expenditures would be cut by $1.2 trillion over the next 10 years, which would be offset by a reduction in federal revenues of about $883 billion.

All four members of the Kansas delegation issued statements after the vote insisting that the bill would not allow insurers to deny coverage due to pre-existing medical conditions. They also asserted that the bill is more market-oriented than Obamacare, and that it would increase competition in the insurance market.

“The current healthcare system is not working — as noted by the countless Kansans who have called, emailed, written and met with me since Obamacare went online in 2013,” 2nd District Rep. Lynn Jenkins of Topeka said in a statement posted on her congressional website.

Third District Rep. Kevin Yoder, of Overland Park, also said that the current law is in “a dangerous collapse.”

“Rather than forcing Americans to buy plans they don’t want or can’t afford, regulating insurance providers out of the market altogether or leaving people with no options to choose from, the AHCA makes the necessary changes to repair our health care system that’s collapsing before our eyes,” Yoder said in a statement posted on his website.

First-term Rep. Roger Marshall of the 1st District in western Kansas, said that as a physician in Great Bend he had seen the effects of Obamacare firsthand.

“Since President Obama signed the Affordable Care Act on March 23, 2010, there have been few moments that my career as a physician has not been impacted,” he said in an op-ed article published in the Hutchinson News. “I’ve seen it drive up premiums and deductibles, decrease reimbursements to Kansas hospitals for Medicare patients, and turn nurses and doctors into data-entry professionals.”

The state’s newest member of Congress, 4th District Rep. Ron Estes of Wichita, posted a statement on his website calling the new bill “a historic first step toward putting people — not politics — back at the center of our health care system.”

The Kansas Democratic Party, meanwhile, is already using Thursday’s vote as a fundraising tool against Yoder, whose district tilted slightly in favor of Democrat Hillary Clinton in the 2016 presidential election.