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 Republicans, deeply divided over the proper role of the government
in helping low-income people receive healthcare, eked out a
procedural win on Tuesday when the Senate voted 51-50, with Vice
President Mike Pence breaking a tie, to allow debate to start on
legislation.
The outcome came as a huge relief to President Donald Trump, who has
called Obamacare a "disaster" and pushed fellow Republicans in
recent days to follow through on the party's seven-year quest to
roll back the law.
But hours later, Senate Republican leadership suffered a setback
when the repeal and replace plan that they had been working on since
May failed to get enough votes for approval, with nine out of 52
Republicans voting against it.
Usually, bills reach the floor with a predictable outcome: Senators
have received summaries of the legislation to be debated that were
written in an open committee process, leaders have counted the
number of supporters and opponents, amendments are debated and
everybody knows the likely outcome: passage.
All that is out the window now, as the Senate on Wednesday continues
a freewheeling debate that could stretch through the week on undoing
major portions of former Democratic President Barack Obama's
signature Affordable Care Act, which expanded health insurance to
about 20 million people, many of them low-income.
Republican leaders have insisted they can devise a cheaper approach
this week and with less government intrusion into consumers'
healthcare decisions than Obamacare.
Democrats and other critics of the Republican effort said it would
deprive millions of health coverage.
"We’ve tried to do this by coming up with a proposal behind closed
doors in consultation with the administration, then springing it on
skeptical members, trying to convince them it’s better than nothing,
asking us to swallow our doubts and force it past a unified
opposition," Republican Senator John McCain said on Tuesday.
"I don’t think that is going to work in the end. And it probably
shouldn’t," he added.
The veteran Arizona lawmaker made his remarks after receiving a
standing ovation from his colleagues, as he returned to the Senate
just days after surgery and being diagnosed with brain cancer.
McCain appealed to Senate Majority Leader Mitch McConnell to start
over by having a Senate committee, in a bipartisan way, craft new
healthcare legislation.
His proposal was promptly ignored.
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'SKINNY' BILL GETS TRACTION
As senators grind through potentially scores of amendments in coming
days - in a process called a "vote-a-rama" - they will have more
than McCain's scorn to worry about.
Healthcare industry organizations are similarly troubled.
"We strongly oppose all plans so far to replace the Affordable Care
Act and have no confidence lawmakers can overcome the flaws in these
proposals," said America's Essential Hospitals, a group representing
hospitals that treat poor people.
Like McCain, the group urged the Senate, narrowly controlled by
Republicans, to halt its work on Obamacare repeal legislation and
begin a bipartisan effort on healthcare.
The Republican drive to "repeal and replace" Obamacare has taken
many unexpected turns since the House of Representatives began
working on its version of legislation last March.
For now, many Republican senators are wondering whether they may end
up going to a Plan B - a "skinny" healthcare bill that would simply
end Obamacare's penalties for individuals and employers that do not
obtain or provide health insurance, as well as abolish a medical
device tax.
It would then be up to a special Senate-House committee to come up
with a final bill that could take many turns during the negotiation.
After Tuesday's nail-biter Senate vote setting up the floor debate,
McConnell may have best summed up the landscape facing the chamber's
100 senators.
"This is just the beginning," he told reporters.
(Reporting by Richard Cowan; additional reporting by Susan Cornwell;
Editing by Mary Milliken, Peter Cooney and Michael Perry)
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