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There's a good reason 20 Republicans voted against the GOP healthcare bill

It looks like a lot of Republicans voted against the American Health Care Act because they're worried about losing their seat in 2018.

Rep. Leonard Lance (R-NJ).

The American Health Care Act squeaked by the House on Thursday, passing with a vote of 217 to 213.

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The unanimous opposition by Democrats made up most of the "no" votes, but 20 Republicans also voted against their party's bid to overhaul the US healthcare system.

While there may be policy reasons for these members to vote against the bill — concerns over preexisting conditions or the bill not going far enough in repealing Obamacare — there's also a compelling political reason.

The Cook Partisan Voting Index, which takes the average margin of victory in a district over the past two election cycles and calculates the partisan lean of that area, shows that many of the "no" votes by Republicans came from representatives in vulnerable seats.

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The average Cook PVI for the 20 Republicans against the AHCA was 3.6 points toward Republicans. But when you remove the districts of conservative Reps. Thomas Massie, Walter Jones, and Andy Biggs (who voted against the AHCA because they didn't think it went far enough in repealing Obamacare), the score drops to 1.6 points toward the GOP. In fact, four members that voted against the AHCA are in districts that, based on Cook's score, lean Democratic.

Here's a full list of Republicans who voted against the bill:

  • Michael R. Turner (Ohio, 10th district) R+4
  • David Joyce (Ohio, 14th district) R+5
  • Andy Biggs (Arizona, 5th district) R+15
  • Mike Coffman (Colorado, 6th district) D+2
  • Ileana Ros-Lehtinen (Florida, 27th district) D+5
  • Thomas Massie (Kentucky, 4th district) R+18
  • Walter B. Jones (North Carolina, 3rd district) R+12
  • Frank A. LoBiondo (New Jersey, 2nd district) R+1
  • Christopher H. Smith (New Jersey, 4th district) R+8
  • Leonard Lance (New Jersey, 7th district) R+3
  • Dan Donovan (New York, 11th district) R+3
  • John Katko (New York, 24th district) D+3
  • Ryan Costello (Pennsylvania, 6th district) R+2
  • Patrick Meehan (Pennsylvania, 7th district) R+1
  • Brian Fitzpatrick (Pennsylvania, 8th district) R+2
  • Charlie Dent (Pennsylvania, 15th district) R+4
  • Will Hurd (Texas, 23rd district) R+1
  • Barbara Comstock (Virginia, 10th district) D+1
  • Jaime Hererra Beutler (Washington, 3rd district) R+4
  • Dave Reichert (Washington, 8th district) Even

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