When the American Health Care Act passed the House of Representatives on May 4, Democrats waved and sang, "nah nah nah nah, hey hey hey, goodbye," to their GOP colleagues. (U.S. House of Representatives)

As House Republicans proudly passed their health-care bill on Thursday, Democrats trolled them — hard. They sang “Na na na na, na na na na, hey hey hey, goodbye!” and waved bye-bye at the GOP.

It was a pretty good one, as political gimmicks go. But was it accurate? Are some Republicans signing their own death warrants in the 2018 election?

There is no doubt that votes such as a health-care bill can have long-term and far-reaching electoral implications. Look no further than Democrats and Obamacare. They were arguably still paying the price for that one in the 2016 election.

And it's pretty clear that the Affordable Care Act did cost specific members their seats. A study from Brendan Nyhan, Seth Masket, the Monkey Cage's John Sides and others in 2012 found that, in the 2010 midterm elections — the first one after Obamacare's passage and the one in which the GOP took over the House — Democrats who supported Obamacare did 5.8 points worse than Democrats in similar districts who opposed it.

They calculated that if every Democrat in a tough district voted against the bill, Democrats could have saved 25 seats and probably their majority:

Could support for health-care reform have cost the Democratic Party not only votes but seats? We simulate the Democratic seat share in the House of Representatives in a counterfactual scenario in which all Democrats in competitive districts opposed health-care reform. In this scenario, Democrats would have retained an average of an additional 25 seats and would have had a 62 percent chance of winning enough races to maintain majority control of the House.

That 25 number, by the way, happens to be the exact number of seats Democrats need to regain the House majority in 2018.

(A separate study from Masket and Steven Greene in 2011 determined that 13 Democrats who voted for the bill pretty clearly lost their seats because of it — a number that today would wipe out just more than half of Republicans' House majority.)

And there are clearly some Republicans who may have jeopardized themselves Thursday. According to Stephen Wolf of Daily Kos Elections, 24 House Republicans who voted for the bill come from districts where President Trump didn't get a majority of the vote, and 14 come from districts that went for Democrat Hillary Clinton. Those are two-dozen districts where this vote can quickly be thrown in the GOP members' faces. And, again, Democrats need 25 seats.

(Philip Bump has much more detail on who voted how.)

What's more, the GOP's health-care bill certainly seems unpopular enough to really do some damage to them politically. We only have polling of the previous version of the bill, which was abandoned when it faced defeat in March. But polls then showed very strong opposition.

A CBS News poll showed Americans opposed it 62 percent to 29 percent.


And a Quinnipiac poll showed they opposed it 56 percent to 17 percent. (17 percent support!)


The biggest change to the bill since then has been to scale back Obamacare's preexisting coverage mandate — the so-called MacArthur amendment — which could lead to higher costs for those with such conditions by allowing states to obtain waivers for insurers to charge them different prices.

And that could actually make the bill even more unpopular; a Washington Post-ABC News poll two weeks ago showed 70 percent of Americans opposed allowing states to obtain waivers to allow insurers to charge higher prices or not cover people with preexisting conditions. (The change would do the former, not the latter — though coverage could wind up being so expensive that it prices such people out of the market.)


That aside, the CBS and Quinnipiac polls showed Americans opposed the law by 33 points and 39 points, respectively. By contrast, the worst Washington Post-ABC poll ever conducted for Obamacare showed Americans opposed it by a 17-point margin (57-40 in November 2013), and the worst Kaiser Family Foundation tracking poll also showed the law 17 points underwater (51-34 in October 2011).

In other words, the GOP's bill may already be more unpopular than Obamacare ever was.

Obamacare wasn't the only vote weighing down Democrats in 2010, of course. The cap-and-trade energy bill also appeared to be an albatross, with the 2012 study showing Democratic supporters of the bill doing 3.1 points worse, on average, than opponents. Part of the reason Obamacare may have had a bigger impact is because its effects were felt nationwide, while cap-and-trade was much more controversial in coal country. This is the danger of big bills like health care: The impact is vast, and you can alienate voters across the country in one fell swoop if you mess it up.

Another big difference between Obamacare and cap-and-trade, though, is that Obamacare became the law; cap-and-trade did not. And that's a key point here. House Republicans voted for a bill Thursday that is likely to be substantially altered by the Senate. If the Senate can pass a bill, the two versions will have to be reconciled into another bill that will be different from what the House passed today. That would then get a vote in both chambers. Perhaps they'll never even get to that point! Which would mean the vote today would be more a footnote than anything else.

But that footnote would still grant Democrats all kinds of attack lines in TV ads. And those attack ads wrote themselves Thursday afternoon.

We don't have an updated Congressional Budget Office score, but the previous version of this bill was scored, and this was one of the conclusions: 24 million fewer people would be insured by 2026 under the legislation. “Congressman XYZ voted to take 24 million people off health insurance” is a pretty easy line.

The GOP bill also scaled back Obamacare's guarantee for those with preexisting conditions — a portion of the Affordable Care Act law that 87 percent of Americans say they like, according to a CNN poll. Republicans made it so insurers can charge these people more, but also threw in $8 billion in funding for high-risk pools to allay the increased costs. Regardless of whether that's enough, “Congressman XYZ voted to cut coverage for preexisting conditions” will be used in campaign ads.

And just one more example: The previous CBO estimate also found that premiums for older, poorer Americans would increase exponentially — as much as 750 percent, to $14,600 per year for a senior citizen making $26,500 per year. And older people, it bears emphasizing, are people who vote. “Congressman XYZ voted to raise premiums by 750 percent for low-income senior citizens” is another damning line that Democrats can use.

Republicans opened themselves up to all these lines of attack on Thursday, and you can bet Democrats will use them. But it's likely that the backlash won't be quite as big if the GOP ultimately fails to turn this bill into law — or if it manages to somehow push through something more popular than the bill that passed today.