(CNN) The House passed a bill Thursday afternoon aimed at shoring up protections for those with pre-existing health conditions, part of Democrats' plans for protecting the Affordable Care Act under the Trump administration.
The legislation was approved 230 to 183, mostly along party lines with four Republican members joining Democrats. While it's not expected to be picked up by the Republican-controlled Senate, the vote gives Democrats another messaging tool in the politically divisive fight over health care.
The bill would nullify a Trump administration guidance that would allow states to ask for waivers to make major changes to their Obamacare markets.
The Centers for Medicare & Medicaid Services laid out in November four examples of what states could request -- opening the door for people to use subsidies to buy coverage outside the Obamacare exchanges. This would include short-term health insurance plans that can reject people with pre-existing conditions or charge them higher premiums. The Trump administration last year made these policies more attractive by extending their terms to just under a year, instead of three months.
However, no states have taken the agency up on its offer. Last week, it issued a request for more ideas on waiver concepts and programs states could consider under the so-called State Relief and Empowerment Waiver plan.
House Democrats are looking to strengthen their claim of being the party to protect those with pre-existing conditions, which helped them regain control of the chamber in last year's midterm election. They passed a resolution last month condemning the Trump administration's effort to take down the Affordable Care Act in court and calling it "an unacceptable assault on the health care of the American people."
Also in the pipeline are bills to repeal the administration's extension of short-term plans and to restore funding for outreach and assistance during Obamacare's open enrollment period in the fall. Signups for Obamacare coverage have drifted downward over the past two years after Trump slashed the budgets for enrollment help and advertising.
House Democrats and Republicans traded barbs Thursday over the name of the bill -- the Protecting Americans with Preexisting Conditions Act of 2019 -- one of several Democrats have teed up to counter the Trump administration's efforts to undermine Obamacare. Democrats stressed that the expanded waivers could hurt those with spotty medical histories.
"By encouraging states to promote and expand short-term insurance plans, the Administration is giving insurers the green light to directly discriminate against people with pre-existing conditions," Energy and Commerce Chairman Frank Pallone, Jr., of New Jersey, said Thursday. "It's giving the greenlight for these plans to charge people with pre-existing conditions more money. And it's giving these plans the greenlight to refuse to cover any treatment that is related to someone's pre-existing condition."
However, the Trump administration and Republican lawmakers insist that states could not waive the Affordable Care Act's comprehensive protections for those with pre-existing conditions.
"The misleading title of this bill confirms the Democratic majority's passion to score political points instead of governing," said Rep. Greg Walden of Oregon, the Energy and Commerce Committee's top Republican. "Let me be very clear: this bill has nothing to do with protecting Americans with preexisting conditions. This bill has everything to do with eliminating health care options and choices for states."