Opinion writer
House Ways and Means Committee Chairman Kevin Brady (R-Tex.), left, listens to the committee’s ranking member, Richard Neal (D-Mass.), on Capitol Hill in Washington on March 8. (J. Scott Applewhite/Associated Press)

By my count, six Republicans in districts that voted for Hillary Clinton voted in favor of the American Health Care Act in committee before they had the Congressional Budget Office scoring. These were: Reps. Dave Reichert (R-Wash.), Carlos Curbelo (R-Fla.), Mimi Walters (R-Calif.)Erik Paulsen (R-Minn.), Ryan Costello (R-Pa.) and Leonard Lance (R-N.J.). (We cross-checked Clinton districts where the Republican House members won against the votes in the Ways and Means Committee and the Energy and Commerce Committee.) In some cases Clinton won by big margins in these Republicans’ districts. (In Curbelo’s district, she won by more than 16 points; in Paulsen’s by 9.5 points.) One supposes Democrats will put these members at or near the top of their list of incumbent targets in 2018.

The argument writes itself. How could they vote for a bill this important, not knowing what its impact would be? Lance is already trying to do damage control. CNN reports:

Republican Rep. Leonard Lance, a moderate from New Jersey who Democrats believe will be vulnerable in 2018, told CNN that he believes the House bill will fail in the Senate. As he eyes his own reelection campaign next year, Lance said he doesn’t want to support a legislation that would be rejected by his Republican colleagues across the Capitol.

“I do not want to vote on a bill that has no chance of passing over in the Senate,” Lance said. “The CBO score has modified the dynamics.”

In light of the new CBO report, Lance said House leaders must make changes to their existing bill and only bring to the floor a version that can survive in the Senate.

Well, he already did vote for it in the Energy and Commerce Committee. In retrospect that seems like a highly irresponsible vote.

Washington state is deep blue, and Reichert has faced tough competition in the past. He has gone out of his way to try to reassure nervous voters worried about losing Obamacare. The Seattle Times noted, “Last month, in an interview with KCTS 9 before the legislation was released, Reichert said: ‘No one is going to lose coverage, let me just make that clear, again, no one will lose coverage.'” He was off by 24 million. That’s sure to come up in 2018.

The Trump administration and House Speaker Paul D. Ryan are defending the Republican bill to supplant the Affordable Care Act, while facing criticism from Democrats and fellow GOP lawmakers. (Bastien Inzaurralde/The Washington Post)

Curbelo may find it especially uncomfortable since his Florida colleague Rep. Ileana Ros-Lehtinen (R-Fla.) opposes the bill because of the number of people who will lose insurance. “With her opposition, Ros-Lehtinen is breaking with fellow Miami Republican Rep. Carlos Curbelo, who last week voted for the bill in the House Ways and Means Committee. Both lawmakers represent Democratic-leaning districts won by Hillary Clinton.” Interestingly, Curbelo doesn’t seem anxious to brag about his vote. (“Curbelo hasn’t commented on the CBO report. On Monday, American Action Network, a Republican political group linked to House Speaker Paul Ryan, started airing TV ads in Miami to give Curbelo cover for his support.”)

By contrast, Walters put out a statement cheering passage of the AHCA in committee. “Our constituents need healthcare plans and programs that work for them, not Washington. It’s our duty to rescue this failing healthcare system and develop a system that offers Americans access to quality, patient-centered care. Passage of the #AHCA is a critical step towards that goal.” Considering the millions who will lose coverage, the price hikes for older Americans and those who will be priced out (including those dropped by Medicaid), she may have some difficulty explaining that.

Paulsen already has drawn fire from the Democrats’ congressional committee. In a statement after his vote on the Ways and Means Committee, Democrats blasted him: “Erik Paulsen is now on the record in favor of jacking up health insurance premiums and ripping away coverage from millions so that Republicans can cuts taxes for health insurance CEO’s.” Remember, Clinton won his district by more than 9 points so he’s going to face an onslaught in 2018. Paulsen didn’t show up for a town hall meeting but voters held one anyway last month, blasting him for, among other things, opposing the Affordable Care Act.

In Costello’s district Clinton won by less than a point, but he’s only in his second term. Although the district has been reliably Republican in House races, nothing prevents a Republican primary challenger from emerging. He likes to think of himself as a “pragmatic conservative” but pragmatists usually insist on having the facts before making decisions of enormous consequence.

We’ll see if these members come to regret their votes. But keep in mind there are a total of 23 Republicans who sit in districts who went for Clinton. Given the reception the bill has gotten and the CBO score, it will be interesting to see how many risk their seats by voting for Trumpcare. The bill will need 216 votes to pass the House. Between this group and the larger Freedom Caucus, which is fiercely criticizing the bill, there are plenty of votes to sink it in the House. And if not, one wonders how the Clinton-district Republicans will fare when the Senate almost surely refuses to pass it.