Toronto Star

U.S. Senate begins health-care debate

Republican­s clear one hurdle, then suffer a setback in effort to repeal Obamacare

- THOMAS KAPLAN AND ROBERT PEAR

WASHINGTON— The U.S. Senate voted narrowly Tuesday to begin debate on a bill to repeal major provisions of the Affordable Care Act, but hours later, Republican leaders suffered a setback when their most comprehens­ive plan to replace former president Barack Obama’s health law fell far short of the votes it needed.

The Tuesday night tally needed to reach 60 votes to overcome a parliament­ary objection. Instead, it fell 4357. That the comprehens­ive replacemen­t plan came up well short of even 50 votes was an ominous sign for Republican leaders still grappling with a formula to pass final healthcare legislatio­n this week.

For Republican­s, the failure ended the day on a sour note, hours after a more triumphant scene. Lawmakers from both parties had risen to their feet in the afternoon and applauded when Arizona Sen. John McCain showed up in the Senate chamber despite his diagnosis of brain cancer. He cast a crucial vote in favour of opening what promises to be a freewheeli­ng, hard-fought debate over the future of the Affordable Care Act.

The 51-50 vote to start debate, with Vice President Mike Pence breaking a tie, came only a week after the Republican effort to dismantle a pillar of Obama’s legacy appeared all but doomed. It provided an initial win for President Donald Trump, who pushed, cajoled and threatened senators in recent days to at least begin debating the repeal of the health-care law.

But the victory could be fleeting: Senate Republican­s still have no agreement on a repeal bill that they can ultimately pass to uproot the law that has provided health insurance to millions of Americans.

The Senate is now moving ahead with debate, amendments and ultimately a final vote in the coming days on legislatio­n that would have a profound effect on the American healthcare system. But it is entirely possible that by week’s end, they will have passed nothing. “Now we move forward towards truly great health care for the American people,” Trump said from a news conference in the White House Rose Garden. “This was a big step.”

Only two Republican­s, Susan Collins of Maine and Lisa Murkowski of Alaska, voted against the procedural motion, although at least several other Republican­s had been seen as possible holdouts. No Democrats voted in favour of the motion.

The Tuesday night vote was on a comprehens­ive amendment that included disparate proposals calculated to appeal to conservati­ves and moderates in the Republican caucus.

One proposal, offered by Texas Sen. Ted Cruz, would have allowed insurers to sell stripped-down health plans, without maternity care or other benefits required by the Affordable Care Act, if they also sold plans that included such benefits. The amendment also included money to help pay out-of-pocket medical costs for certain low-income people, including those who buy private insurance after losing Medicaid coverage as a result of the Senate bill. But nine Republican­s defected from the package, from all ends of the party’s ideologica­l spectrum.

 ?? MARK WILSON/GETTY IMAGES ?? John McCain returned to the Senate for the first time since being diagnosed with brain cancer, casting a crucial vote to open debate on a health-care bill.
MARK WILSON/GETTY IMAGES John McCain returned to the Senate for the first time since being diagnosed with brain cancer, casting a crucial vote to open debate on a health-care bill.

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