Health law fight heats up
Senate OKs bid to open debate, but blocks GOP move to repeal Affordable Care Act
WASHINGTON — Republicans’ determined but beleaguered effort to repeal the Affordable Care Act took a step forward Tuesday when the Senate narrowly agreed to open debate on a replacement to the landmark health care law after days of pressure from President Trump.
But hours later, the Senate blocked a wide-ranging proposal by Republicans to repeal much of former President Barack Obama’s health care law and replace it with a more restrictive plan.
Senators voted 57-43 late Tuesday to reject the plan in the first vote on an amendment to the bill. Those voting “no” included nine defecting Republicans.
The vote underscores problems the Republicans will have in winning enough votes to recast Obama’s statute.
The rejected proposal included language by Senate Majority Leader Mitch McConnell, R-Ky., erasing the Obama law’s tax penalties on people not buying insurance, and cutting Medicaid.
Language by Texas Republican Sen. Ted Cruz would let insurers sell cut-rate policies with skimpy coverage. And there was an additional $100 billion to help states ease costs for people losing Medicaid
sought by Midwestern moderates.
“It’s not clear what the final product will be,” Cruz said, but Republicans will “focus on keeping our promise to repeal Obamacare.”
Tuesday’s vote to begin the debate opens a narrow path for McConnell to forge legislation that can be melded with a similar House version and sent to the president for his signature.
The slim Republican victory came just a week after the Senate’s attempts to dismantle Obama’s signature health care law appeared all but dead, done in by opposition from a handful of GOP moderates on one side and conservatives on the other.
But days of public and private pressure from Trump to persuade and cajole holdouts seemed to make the difference. The motion passed on a 51-50 margin with Vice President Mike Pence casting the deciding vote.
Just two Republican senators, Susan Collins of Maine and Lisa Murkowski of Alaska, sided with a unified Democratic bloc against moving toward repealing the law.
Arizona Sen. John McCain returned to the Senate to vote with the majority less than a week after revealing he has brain cancer.
“Now we’re all going to sit together and try to come up with something really spectacular,” Trump said during a Rose Garden news conference shortly afterward.
Republicans appeared to be coalescing around what they called “skinny repeal,” which would, among other things, end the mandate that employers and individuals buy insurance coverage.
The mandate was originally borrowed from conservative health policy analysts as a way to extend insurance market access to more people, but when adopted by Democrats as a central element of Affordable Care Act became a flash point of GOP criticism. Removing the mandate would likely lead to a collapse of the Affordable Care Act exchanges that allow people who are not covered by their employers to buy insurance.
“Instead of lowering Americans’ costs, Republicans would be openly shoving the marketplaces into a death spiral,” House Minority Leader Nancy Pelosi, D-San Francisco, said. “Premiums will soar, options will evaporate, and millions of families will lose health coverage.”
On the eve of Tuesday’s vote, Trump threatened and exhorted Republican senators, reminding them of their sevenyear promise to repeal what he and other Republicans deride as Obamacare.
McConnell echoed Trump’s words Tuesday, telling his members that voters had elected a House and Senate majority and a president who campaigned on repeal.
“Surprise elections come with great opportunity to do things we never thought possible,” McConnell said, referring to Trump’s victory in November. “The president will sign what passes this time. We can’t let this moment slip by. We’ve talked about this for too long.”
As the vote got under way, every seat in the chamber was filled. At one point, a group of protestors were removed from the visitors gallery by Capitol police after yelling “Kill the bill” and “Shame” and “Murder.”
Democrats protested in their own way, sitting stone-faced, withholding their votes until it became clear that Pence would break the 50-50 tie and allow the motion to pass.
Characterizing the procedural vote as a pivotal turning point in the Republican repeal effort, Senate Minority Leader Chuck Schumer, D-N.Y., implored wavering GOP senators to “Turn back! Turn back now before it’s too late.” He said Democrats would be eager to work with Republicans to fix the parts of the current law that have led to higher premiums for middle-class people.
Republicans still face numerous obstacles. Deep divisions remain between moderates who want to keep the Affordable Care Act’s expansion of coverage, and conservatives who want nothing less than a full repeal of the law with nothing to replace it.