Se­nate de­bate on health bill squeaks to life

Ail­ing McCain joins 51-50 ma­jor­ity, rips GOP tac­tics

Northwest Arkansas Democrat-Gazette - - FRONT PAGE -

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

AP/C-SPAN2

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.

AP/J. SCOTT APPLEWHITE

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.

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