Defying predictions last week that efforts to replace the Affordable Care Act were dead in the water, the U.S. Senate on Tuesday narrowly voted to proceed with legislation that would repeal the law.
With Vice President Mike Pence presiding over the chamber in his duty as president of the Senate, the chamber voted 51-50 to proceed with the legislation. The initial tie vote placed the responsibility for whether or not to move forward with the legislation on the shoulders of Pence, who cast the tie-breaking vote to proceed.
All 48 Senate Democrats were present and cast their votes in opposition to proceeding. Only two Republicans – Sens. Lisa Murkowski (R-Alaska) and Susan Collins (R-Maine) — abandoned their caucus to vote “no.”
The vote was held open with only 48 senators voting to proceed before Sen. John McCain (R-Ariz.), who was recently diagnosed with brain cancer, entered the chamber and voted “yes,” followed by Sen. Ron Johnson (R-Wis.). Senators on both sides of the aisle applauded McCain as he entered the chamber before he gave a thumbs up to indicate support for the motion to proceed.
McCain, who had a visible scar above his left eye after his recent surgery to remove a blood clot, said in a speech on the Senate floor even though he voted to proceed, he’d oppose final approval without changes to the bill as it currently stands.
“We Republicans have looked for a way to end [Obamacare] and replace it with something else without paying a terrible political price,” McCain said. “We haven’t found it yet, and I’m sure will. All we’ve managed to make popular is a policy that wasn’t very popular when we started to get rid of it. I voted for the motion to proceed to allow debate to continue and allow amendments to be offered, I will not vote for this bill as it is today.”
Prior to the vote, there was an open question about whether Sens. Shelley Moore Capito (R-W.Va.) and Rand Paul (R-Ky.), who said they’d oppose efforts to repeal Obamacare without replacement, or Sens. Mike Lee (R-Utah) and Jerry Moran (R-Kansas), who said they opposed the replacement plan, would vote “yes.”
They ended up following the rest of their caucus, but it remains to be seen if they’ll approve the final legislation produced by the Senate.
Sen. Patrick Leahy (D-Vt.) issued a statement after the vote decrying the motion to proceed with Obamacare repeal as the first step in the process to deprive millions of health care.
“These decisions mean health or illness and life or death to countless Americans,” Leahy said. “And let’s be clear: Republican senators have no idea what they voted for with this motion to proceed. Millions upon millions of Americans’ health is at stake.”
The bill with which senators agreed to proceed was the House version of Obamacare repeal. Media reports indicated the Republican majority would seek to amend it with a “skinny” version of Trumpcare that includes repealing the Affordable Care Act’s individual mandate, the employer mandate, and the medical device tax.
According to the Committee for a Responsible Federal Budget, the “skinny” version of Trumpcare would save about $225 billion over a decade and result in 15 million more uninsured by 2026.
LGBT groups opposed efforts to repeal Obamacare on the basis that many LGBT people gained insurance as a result of President Obama’s signature legislative achievement and because the measure would deny Medicaid reimbursements to Planned Parenthood, which touts its health services for LGBT people.
A major criticism from LGBT groups — as well as HIV/AIDS advocacy groups — was the inclusion in GOP plans to replace Obamacare of a provision to undo the Medicaid expansion under the Affordable Care Act. That increased the income level to qualify for care under that program to 133 percent of the poverty level — provided the states agreed to it.
An estimated 40 percent of people with HIV — which continues to disproportionately affect LGBT people — received health care under Medicaid coverage.
However, the “skinny” Trumpcare repeal bill seems to avoid the question of whether or not to repeal the Medicaid expansion and defund Planned Parenthood for political expediency.
Condemning the motion to proceed with Obamacare repeal in a statement was JoDee Winterhof, the Human Rights Campaign’s senior vice president for policy and political affairs.
“We are deeply disappointed in the continued reckless attacks on millions of Americans and their access to critical health care,” Winterhof said. “It is unconscionable that any senator would vote in favor of the Motion to Proceed without knowing what the underlying bill to repeal the ACA actually includes, without any public committee hearings, or even a score from the Congressional Budget Office. The Trump-Pence-McConnell plan would result in millions of Americans losing their health care and billions of dollars in tax breaks for the wealthiest in our country — this is unacceptable.”