WASHINGTON, D.C. (KTHV) – All four congressman from the Natural State have joined a slim Republican majority in Washington to replace provisions of the Affordable Care Act, colloquially referred to as “Obamacare.”

Arkansas Congressmen Rick Crawford, French Hill, Steve Womack, and Bruce Westerman voted in favor of the American Health Care Act.

Since the ACA’s passage, which historians often regard as former President Barack Obama’s signature legislative achievement, the Department of Health and Human Services estimates that 20 million Americans have gained health insurance coverage. The department also noted that these increases in coverage have been shared “broadly across population groups.”

The “repeal and replace” of the ACA has long been a campaign promise from both Republicans in Arkansas and across the nation. House Speaker Paul Ryan has noted that his party has been campaigning on this issue for “seven years,” and the time for a vote is now.

Of particular concern for Republicans were the premium increases in a minority of insurance plans. According to a HHS tally, the average cost for a benchmark plan obtained through the government-run exchanges rose 25 percent nationwide. However, this increase can be misleading, as the costs had considerable discrepancies across different states. For example, premiums in Arizona rose nearly 116 percent, but states like Indiana saw a decrease in premium costs.

Congressman Hill, who represents Arkansas’s Second Congressional District, supported the broad, general principles of the AHCA. Mr. Hill’s office noted that the vote Thursday was the “first step in a long negotiation,” but that his “yea” vote reflected his support of the bill’s “mechanisms to achieve the goal” of “repeal and replace.”

“The status quo is not working for Arkansas and not working for our country," said Mr. Hill in a released statement.

The bill will now head to the Senate, where Mr. Hill is confident that the members of both legislative chambers will work together. However, the Republicans hold an extremely narrow majority in the Senate, with only 52 GOP members. So the GOP margin for error in the 100-member chamber is much smaller than it was in Thursday’s House vote, as the party could only lose one party vote. The ACA passed the Senate with a 60-vote super-majority in 2009. The AHCA vote will only require a simple-majority vote—meaning just 51 votes—because of a unique Senate protocol of reconciliation, which is normally reserved for budget-related bills.

No Democrat in the House voted for in favor of the AHCA, and no Democratic Senator is currently expected to break party lines and join Republicans. The Republicans had initially introduced the bill in March, but the bill was pulled just hours before voting began after the too many Republicans announced their opposition.

The nonpartisan Congressional Budget Office, whose mission is to issue “credible forecasts of the effects of both Democratic and Republican legislative proposals,” estimated that in just one year 14 million more Americans would be uninsured. The CBO noted that a majority of those newly uninsured would steam from the ACHA’s repeal of the ACA’s individual mandate. The office’s analysis also predicted that the number of uninsured Americans would rise to “21 million in 2020 and then to 24 million in 2026” because of the AHCA’s significant cuts and alterations to the Medicaid expansion provision of the ACA.

Thursday’s passage of the AHCA came before the CBO issued a new analysis of the revised AHCA, marking a stark deviation from past legislative action on healthcare. White House spokesperson Sarah Huckabee Sanders, daughter of former Arkansas Governor Mike Huckabee, told reporters ahead of the vote that the bill is “impossible” to score because of its many fluid provisions.

If it becomes law in its current form, the AHCA would freeze new enrollment in Medicaid expansion starting in 2020. This will impact states like Arkansas, where Medicaid expansion has been warmly received by enrollees. As of January 2017, nearly 310,951 Arkansans had enrolled in the state’s Medicaid expansion private option program, Arkansas Works.

The AHCA also repeals the ACA’s tax credits, which are currently based on income and the local costs of health insurance, and replace those with less generous age-based tax credits.

The Affordable Care Act does bar insurance companies from discriminating against those with pre-existing conditions, such as such as cancer, asthma, diabetes, or even pregnancy. The Republican healthcare bill significantly weakens that crucial protection, as it would allow states to seek a waiver for insurance companies to charge people with pre-existing conditions higher premiums.

The AARP has announced its opposing the AHCA, stating, "On top of the hefty premium increase for consumers, big drug companies and other special interests get a sweetheart deal." The American Medical Association, America's Essential Hospitals, American Hospital Association, Association of American Medical Colleges, Catholic Health Association of the United States, Children's Hospital Association, and other medical associations have joined AARP in opposition.

After the vote, Democratic House Minority Leader Nancy Pelosi criticized the AHCA vote, saying that the GOP's desire to "give tax breaks to the rich trumped" the need to provide affordable coverage to Americans.

“There is no doubt that Obamacare is in its death throes due to increased costs and market manipulation which has led to limited options and high deductibles for Americans on the healthcare exchange,” said the Republican Party of Arkansas in a released a statement after the vote. “The effort to repeal and replace this burden on Arkansans was inevitable as proven by the results of the last election.”