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In a Monday night vote, members of the conservative House Freedom Caucus voted to only accept a repeal of the Affordable Care Act that’s as extensive as the 2015 repeal bill, HR 3762 (link), that was vetoed by then-President Barack Obama.

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The 2015 repeal bill is a wrecking ball, eliminating the Affordable Care Act’s various mandates as well as its tax credits and the Medicaid expansion. Those latter two are sticking points for a number of Republicans in the House and across the country. House Majority Leader Rep. Paul Ryan has floated tax credits as part of a replacement for the Affordable Care Act, and the Medicaid expansion is popular with moderate Republicans and a number of Republican governors who adopted the Medicaid expansion and saw the uninsured rate fall drastically afterward.


“If it’s less than the 2015 [bill], we will oppose it,” Freedom Caucus Chairman Mark Meadows (R, NC-11) told Matt Fuller of the Huffington Post and other media on Monday night.

The Freedom Caucus’ vote to take an official (and stringent) stance on a repeal of the Affordable Care Act further complicates House Majority Leader Paul Ryan’s repeal and replace efforts. If there’s a bright spot, it’s that Meadows also said Freedom Caucus members support voting for a replacement alongside a repeal bill.

The House Freedom Caucus consists of about 30 members of the House of Representatives, and the GOP has just 247 seats in the chamber as a whole. It needs 218 votes to claim a majority. Should they choose to vote against a repeal bill in a group, Ryan might need the support of House Democrats to move a repeal bill through the House.

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