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Senate votes to begin debating health act repeal

Pence breaks tie, opening debate on Obamacare repeal

- By Noam N. Levey and Lisa Mascaro Washington Bureau noam.levey@latimes.com

The Senate voted narrowly to begin debate on a bill to repeal major provisions of the Affordable Care Act, a pivotal step after the return of Sen. John McCain, who cast a crucial vote despite his diagnosis of brain cancer. But the victory could be a fleeting one: Senate Republican­s still had no agreement on a repeal bill that they could ultimately pass. Story,

WASHINGTON — Republican­s narrowly advanced their campaign to roll back the Affordable Care Act on Tuesday, as the Senate voted by the slimmest of margins to begin debating legislatio­n to repeal and potentiall­y replace large sections of the 2010 law signed by President Barack Obama.

But the partisan 51-50 vote — with Vice President Mike Pence breaking a tie — does not assure the success of the GOP’s seven-year quest to dismantle the sweeping law, often called Obamacare.

With health coverage for tens of millions of Americans at stake, it remained unclear Tuesday what kind of health care bill, if any, might emerge by the time a final Senate vote is held, possibly as early as Thursday.

Senate Majority Leader Mitch McConnell, R-Ky., has set up a series of votes this week on competing proposals to repeal much of Obamacare, or repeal and replace pieces of the law.

Tuesday’s procedural vote to kick off that process marked a victory for McConnell, who has been laboring for months behind closed doors to rally his divided caucus, and for President Donald Trump, who has been publicly calling on GOP senators to stick with the repeal push.

Trump praised the Senate vote as a “big step” during a news conference at the White House. “We’re going to give you great health care,” the president said, adding that Republican­s would “over the next week or two, come up with a plan.”

To get to this point, McConnell had to abandon the customary legislativ­e process, foregoing public hearings and committee debate in a way almost never seen for major legislativ­e proposals.

And he left Republican lawmakers with a series of legislativ­e options — which polls show are unpopular with Americans — that would leave as many as 32 million more people without health coverage and weaken health protection­s for tens of millions more.

The GOP plans have been widely panned by independen­t analysts and opposed by every major patient advocacy group and every leading organizati­on representi­ng physicians, nurses and hospitals.

Before the vote, Senate Minority Leader Chuck Schumer, D-N.Y., pleaded with GOP lawmakers in the Senate chamber to stop their repeal rush and work with Democrats on bipartisan fixes to the current law.

As voting began, protesters filled the gallery, chanting “Kill the bill!” and “Shame!” before being escorted out of the chamber.

The proceeding­s came to a momentary standstill as Sen. Ron Johnson, R-Wis., who had yet to vote, huddled at McConnell’s desk. But Sens. Susan Collins of Maine and Lisa Murkowski of Alaska were the only Republican­s who voted against the motion.

In a moment of drama, senators waited at their desks for the return of Sen. John McCain, R-Ariz., following his surgery last week and a diagnosis of brain cancer. He arrived in the chamber to cheers and a standing ovation from his colleagues before casting a critical vote to back McConnell.

He then delivered a speech criticizin­g the process the Republican leader has used to push the repeal legislatio­n forward and called for more bipartisan­ship.

“Why don’t we try the old way of legislatin­g in the Senate, the way our rules and customs encourage us to act?” McCain said. “If this process ends in failure, which seems likely, then let’s return to regular order.”

Democrats waited until Republican­s had finished voting, before casting theirs, all of them opposed.

Patient advocates and health care groups condemned the Senate vote.

As Republican­s move to crafting a final bill, one leading GOP option, favored by conservati­ves, is to repeal major parts of Obamacare, then try to pass a new health care law in the future.

After the vote Tuesday, McConnell submitted this proposal as the first amendment to be considered by lawmakers.

Then McConnell is expected to offer a revised version of the Republican bill, the Better Care Reconcilia­tion Act, which would replace most of the law while at the same time dramatical­ly scaling back federal funding of the Medicaid insurance program that covers some 74 million low-income, elderly and disabled Americans.

None of these approaches has garnered the necessary 50 votes from the Republican­s’ 52-seat Senate majority, and that math does not appear to have changed, despite Tuesday’s vote to begin debate.

To help build support, leaders are expected to add two key provisions to the BCRA — one from Sen. Ted Cruz, R-Texas, to allow health insurers to sell skimpier plans that do not include basic benefits such as prescripti­on drugs, maternity care, and mental health and substance abuse services, and another from Sen. Rob Portman, R-Ohio, would add $100 billion to help those on Medicaid.

That package, though, would likely not reach the 60-vote threshold needed for passage under budget rules. Other proposals would only need 51 votes using special budget rules.

 ?? WIN MCNAMEE/GETTY ?? Senate Majority Leader Mitch McConnell mustered just enough votes Tuesday to advance debate to repeal Obamacare.
WIN MCNAMEE/GETTY Senate Majority Leader Mitch McConnell mustered just enough votes Tuesday to advance debate to repeal Obamacare.

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