Senate Votes To Proceed On Health Care Bill That Doesn’t Exist Yet
With Vice-President Pence casting the tie-breaking vote, the Senate voted this afternoon to proceed forward with debate on a health care reform bill without knowing which bill they’d be debating:
WASHINGTON — The Senate narrowly voted on Tuesday to begin debate on a bill to repeal major provisions of the Affordable Care Act, taking a pivotal step forward after the dramatic return of Senator John McCain, who cast a crucial vote despite his diagnosis of brain cancer.
Vice President Mike Pence cast the tie-breaking vote.
The 51-50 vote came only a week after the Republican effort to dismantle a pillar of former President Barack Obama’s legacy appeared all but doomed. It marked an initial win for President Trump, who pushed, cajoled and threatened senators over the last days to at least begin debating the repeal of the health care law.
But even with that successful step, it is unclear whether Republicans will have the votes they need to uproot the law that has provided health insurance to millions of Americans. The Senate will now begin debating, amending and ultimately voting in the coming days on legislation that would have a profound impact on the American health care system.
By a single vote, the Senate cleared the way for an epic battle over the future of the health law. Only two Republicans, Susan Collins of Maine and Lisa Murkowski of Alaska, voted against the motion. The debate has broad implications for health care and households in every state.
Senate Republican leaders have struggled all year to fulfill their promise of repealing the 2010 health care law, and the procedural vote in the Senate on Tuesday risked being another big setback for the party. The House narrowly approved a repeal bill in early May, but only after Republicans overcame their own difficulties in that chamber.
President Trump kept up the pressure on Tuesday by posting on Twitter. “After 7 years of talking,” he said, “we will soon see whether or not Republicans are willing to step up to the plate!”
The successful procedural vote on Tuesday is an important step forward for the Senate majority leader, Mitch McConnell of Kentucky, who only a week ago appeared to have failed in his effort to put together a health bill that could squeak through the narrowly divided Senate.
That said, it remained far from certain whether Republicans would actually be able to agree on a bill in the days to come — and what exactly the contents of that bill would be.
Perhaps the most dramatic moment of this afternoon’s vote came at the end, when Senator John McCain, who just last week was revealed to have brain cancer after undergoing surgery some two weeks ago, arrived after landing at Reagan National Airport to come to Washington to participate in the vote. In the end, McCain ended up voting in favor of the Motion To Proceed, a vote which proved to be crucial given the fact that two Republican Senators, Susan Collins and Lisa Murkowski, had voted with the Democratic caucus and the Senate’s two Independents to block the bill from proceeding. This left the bill at a 50-50 tie, and it was left to Vice-President Pence to cast the tie-breaking vote so that the Senate could proceed to debate on the bill and a final vote that could come as early as the end of this week, this weekend, or early next week. McCain’s return after his diagnosis was marked by a bipartisan standing ovation that lasted for several minutes. After the vote was over, McCain spoke for several minutes from the Senate floor, although he did not make direct reference to his health. Somewhat ironically, though, McCain did call on his fellow Senators about the need to return to “regular order” in the consideration of legislation. It’s worth noting that this call for regular order came just minutes after McCain himself voted to proceed with final debate on a bill on which there have been no Committee hearings or other public debate that would ordinarily take place in the consideration of proposed legislation.
Going forward from here, the Senate will proceed on a rather expedited basis to consider this matter even though we still don’t know what bill will be voted on when the final vote is held in the coming days. As The New York Times explained in an article posted earlier today, the procedure from here is the process under which that final bill will take shape. First, there will be roughly twenty hours of debate on the floor equally divided between Republicans and Democrats on the bill, a debate that should be interesting, to say the least given the fact that nobody seems to know which version of health care reform they’ll ultimately be voting on. After that debate is over, the Senate will proceed to consider amendments from both sides of the aisle, many of which would replace the original bill in its entirety and others which would add or remove only certain provisions. There’s no word right now on how many Amendments the Senate will consider, but each one will have to be subject to its own roll call vote, which could lead to another one of the all-night “Vote-A-Rama” sessions that we’ve seen from the Senate in the past. At any point in this process, any Senator would be free to raise a point of order to the overall bill or one of the Amendments. The main intention of this process would be to either prevent the bill from being considered under the Senate’s reconciliation rules, which would make final passage more difficult or to delay the process as long as possible. After each of those points of order and amendments is considered, Majority Leader MitchMcConnell will propose a Final Amendment that would essentially end up being the final bill. The Senate would vote on this amendment, and then, if it passes, on the final version of the bill.
Officially, the bill that the Senate voted to proceed to debate on is the American Health Care Act that the House narrowly voted to pass in early May, though it’s unlikely that this bill will make it through the week unscathed. Instead, Republicans will apparently be proposing a number of amendments including everything from the revised version of the Better Care Reconciliation Act, which was pulled from the floor earlier this month due to the fact that it lacked sufficient to pass even under reconciliation, the repeal-only bill that Senator McConnell proposed last week, which was never put on the floor for largely the same reasons, and a version of the repeal bill called “skinny repeal” that would only repeal certain provisions of the Affordable Care Act such as the individual and employer-provided coverage mandates. This final idea is something that is just being discussed now and would be meant to give Senate Republicans something they could pass that would move the process forward. Presuming the Senate is able to pass something, that bill would either go to the House for consideration or become the basis for the Senate and House entering into an agreement to form a Conference Committee that would try to hammer out a bill that would pass both chambers.
At this point, it’s hard to say exactly what’s going to happen. Since we don’t know what the Senate will ultimately be voting on, using the outcome of today’s roll call vote to predict the outcome of a final vote would be mistaken. Given how things have proceeded in the Senate over the past two months, it’s entirely possible that the final bill could end up losing the support of at least one more Republican Senator, which would be enough to kill the reform effort overall, or it could result in the passage of a bill that can’t pass the House for one reason or another. Things would become additionally complicated if Congress proceeds with the Conference Committee process since it could be several weeks if not longer before we see final votes in the House and Senate on a bill that could conceivably make it to the President’s desk. As it stands, though, the fact that the Senate was able to pass this procedural hurdle makes it more likely that it will be able to pass something, and more likely that Republicans will ultimately succeed in their seven-year quest to ‘repeal and replace’ the Affordable Care Act. As things stand right now, though, the Senate and House will have to vote on a bill before we find out what’s in it.