Republicans muscled their health care bill through the House Thursday, taking their biggest step toward dismantling the Obama health care overhaul since Donald Trump took office.

With the 217-213 votes, Republicans obtained just enough support to push the legislation through the House, sending it to the Senate for consideration.

Some senators have already voiced displeasure with the health care bill. They cited concerns about potential higher costs for older people and those with pre-existing conditions, along with cuts to Medicaid.

The American Health Care Act will change the rules and subsidies for people who buy their own insurance coverage, and make major cuts to the Medicaid program, which funds care for the poor and disabled.

For some, insurance will become more affordable or their taxes will be lower, others will lose out on financial support or health care coverage, according to some analysis published over the printed media.

Over all, the gap between the tax subsidies and the cost of needed care could widen, even for some people who will get extra financial help. Poor Americans are much more likely to become uninsured under the bill, and those who retained coverage would pay much more of their limited incomes on premiums and deductibles.

People with pre-existing health conditions, particularly in some states would be the more affected. The bill allows states to waive rules on minimum benefit standards and rules that prohibit insurance companies from changing higher prices to customers with a history of serious illness, or even minor diseases. The benefit changes could also affect Medicaid beneficiaries, and they could mean cutbacks on coverage for mental health and drug addiction treatment. States that waive the rule about prices would be required to set up a program for high-risk customers, and would get some federal funding to do so, but the details are unclear.

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