Senate debate on health bill squeaks to life
Ailing McCain joins 51-50 majority, rips GOP tactics
WASHINGTON — The Senate voted narrowly Tuesday to begin debate on a bill to repeal major provisions of the Patient Protection and Affordable Care Act, taking a pivotal step forward after the return of Sen. John McCain, R-Ariz. McCain cast a crucial vote days after being diagnosed with brain cancer.
The 51-50 vote to start debate, with Vice President Mike Pence breaking a tie, came a week after the Republican effort to dismantle former President Barack Obama’s health care law appeared all but doomed. It marked an initial win for President Donald Trump, who pushed senators in the past few days to at least begin debating the repeal of the health care law.
Hours after voting to proceed with health care debate, 57 senators blocked a
wide-ranging GOP proposal to repeal and replace much of the Affordable Care Act.
Nine Republicans — including U.S. Sen. Tom Cotton of Arkansas — sided with Democrats to vote against the amended proposal. U.S. Sen. John Boozman of Arkansas was one of the 43 Republicans to vote in favor of the proposal.
The rejected proposal included language cutting Medicaid but also adding $100 billion to help states ease costs for people losing Medicaid. The measure needed 60 Senate votes.
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 health care system — roughly one-sixth of the U.S. economy. But Senate Republicans still had not come to an agreement on a bill that they could ultimately pass to uproot the law that has provided health insurance to millions of Americans.
“Now we move forward towards truly great health care for the American people,” Trump said from the White House Rose Garden, where he was holding a news conference with the visiting prime minister of Lebanon. “This was a big step.”
Trump continued to celebrate the vote at an evening rally in Youngstown, Ohio.
“We’re now one step closer to liberating our citizens from this Obamacare nightmare and delivering great health care for the American people,” he said.
The Republican legislation is aimed at undoing the Affordable Care Act’s mandates for most people to carry insurance and businesses to offer it. The GOP would repeal taxes imposed under the 2010 law and unwind an expansion of the Medicaid program for the poor, the disabled and nursing home residents.
Only two Republicans, Sens. Susan Collins of Maine and Lisa Murkowski of Alaska, voted against the procedural motion, though several other Republicans had been seen as possible holdouts. No Democrats voted in favor of the motion.
Both U.S. senators from Arkansas voted to begin debate. Neither was available for comment, but they explained their decision in written statements.
“Arkansans have been calling for a repeal ever since Obamacare was forced upon them. Today, we moved closer to making that a reality,” said Boozman, a Republican from Rogers. “While much work remains to be done, this vote signals to the American people that we remain committed to repairing our health care system by putting into place a system that ensures access to affordable, quality care for every American.”
Both Boozman and Cotton referred to Tuesday’s vote to begin debate as a “first step.”
“Obamacare continues its downward spiral, sending premiums through the roof and leaving people with far fewer choices. We owe it to Arkansans to finally give them some relief from this law,” said Cotton, a Republican from Dardanelle. “It’s important we get this right, so that we create a health-care system that works for Arkansans.”
Before senators cast their votes, protesters in the Senate gallery chanted, “Kill the bill, don’t kill us!” and “Shame, shame, shame!”
While the Senate was voting and before McCain showed up on the Senate floor, the majority leader, Sen. Mitch Mc- Connell of Kentucky, engaged in a tense conversation with Sen. Ron Johnson, R-Wis. Johnson had been an early critic of McConnell’s repeal bill, and on Tuesday, he held back his vote until McCain arrived. When McCain voted to move ahead, so did Johnson.
Greeted by cheers, McCain, 80, smiled and dispensed hugs — but with the scars from recent surgery starkly visible on the left side of his face.
Despite voting “yes,” he served notice that he would not vote for the GOP legislation as it stands now, and he launched into a speech that at its conclusion received a standing ovation.
“I voted for the motion to proceed to allow debate to continue,” he said. “I will not vote for this bill as it is today. It’s a shell of a bill right now.”
He also offered harsh words for the secretive process by which Senate Republican leaders came up with their bill to repeal and replace the health law.“Asking us to swallow our doubts and force it past a unified opposition, I don’t think that’s going to work in the end — and probably shouldn’t,” McCain said, adding that it “seems likely” that the current repeal effort will end in failure.
And he issued a plea for Democrats and Republicans to work together for the people.
“Stop listening to the bombastic loudmouths on the radio, TV and Internet,” McCain said. “To hell with them!”
Arizona is one of the 31 states that expanded Medicaid under the 2010 health law, and McCain’s remarks could be an ominous sign for other senators from states that expanded Medicaid, including the junior Republican senator from his state, Sen. Jeff Flake.
“We are ground zero for the failure of the exchanges, but we are also an expansion state,” Flake said. “I think all of us are concerned that we don’t pull the rug out from people.”
McCain wasn’t the only senator to say he wouldn’t vote for the proposed health care bill, the Better Care Reconciliation Act.
Sen. Jerry Moran, R-Kan., echoed these sentiments, tweeting, “I support a full repeal of Obamacare & will continue to oppose the BCRA.”
Just before the Senate procedural vote, the Democratic leader, Sen. Charles Schumer of New York, made an impassioned plea to Republicans.
“We know that [the Affordable Care Act] is not perfect,” Schumer said. “But we also know what you’ve proposed is much worse. We can work together to improve health care in this country. Turn back now before it’s too late and millions and millions and millions of Americans are hurt so badly in ways from which they will never, ever recover.”
The proposal that failed late Tuesday on a 43-57 vote included disparate amendments calculated to appeal to conservatives and moderates in the Republican caucus.
Language by McConnell erased the Obama law’s tax penalties on people not buying insurance.
One proposal, offered by Sen. Ted Cruz, R-Texas, 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.
“You shouldn’t have to buy what the federal government mandates you must buy,” Cruz said. “You should choose what meets the needs for you and your family.”
The legislation also included money to help pay outof-pocket medical costs for low-income people, including those who buy private insurance after losing Medicaid coverage as a result of the Senate bill. This proposal was devised by Sen. Rob Portman, R-Ohio, and other senators from states that have expanded Medicaid under the Affordable Care Act.
The Senate is also expected to vote on a measure that would repeal the health law without putting in place any replacement, but that approach does not appear to have enough support to pass, either.
Information for this article was contributed by Thomas Kaplan, Robert Pear, Avantika Chilkoti, Emily Cochrane, Julie Hirschfeld Davis and Jennifer Steinhauer of The New York Times; by Erica Werner, Alan Fram, Andrew Taylor, Matthew Daly, Mary Clare Jalonick and Stephen Ohlemacher of The Associated Press; by Sean Sullivan, Juliet Eilperin and Kelsey Snell of The Washington Post; and by Frank E. Lockwood of the Gazette. Arkansas Democrat
After returning to Washington on Tuesday to vote for debate on the GOP health care legislation, Sen. John McCain, R-Ariz., admonished his colleagues on both sides to start working together.
Senate Majority Leader Mitch McConnell on Tuesday discusses the Senate vote to start debate on a health care repeal bill. With him are Republican Sens. John Barrasso of Wyoming, John Thune of South Dakota and Majority Whip John Cornyn of Texas.