Republicans officially moved forward on repealing Obamacare.
And the yeas have it. Amidst “kill the bill” and “shame” chants, the Senate voted on Tuesday to begin debate on repealing the Affordable Care Act, after mounting pressure from the president and Senate leadership. Republican leaders have not yet said which version of their health care bill they’ll pass before leaving for August recess, leaving millions of Americans unsure about their future health insurance.
Several senators were undecided Tuesday morning on whether they would vote yes on the motion to proceed, a senate procedure to begin debate. After some arm-twisting at the senate luncheon, they voted in favor.
The vote count: All Democrats voted no. 50 Republicans voted “yes,” to begin debate on the Affordable Care Act, and Vice President Mike Pence broke the tie. Senator Susan Collins (R-ME) and Lisa Murkowski (R-AK) were the only Republicans to vote no.
Here’s a list of key senators who previously expressed hesitation but voted yes:
- Senator Rand Paul (R-KY)
- Senator Shelley Moore Capito (R-WV)
- Senator Mike Lee (R-UT)
- Senator Dean Heller (R-NV)
- Senator Jerry Moran (R-KS)
- Senator Rob Portman (R-OH)
The Senate will now begin debating the House-passed bill, the American Health Care Act (AHCA). This debate could last up to 20 hours, spread out over the next several days. After the debate is over, they will begin a “vote-a-rama,” a period of successive votes on offered amendments.
Senate Democrats will likely propose protest amendments. During this process, Majority Leader Mitch McConnell (R-KY) will introduce a substitute amendment that would replace all previous amendments.
After the vote-a-rama, the legislation goes up for a final vote. If it passes, then the House needs to approve it or “conference the bill” before sending it to the president. The Senate is allegedly pursuing the latter.
No one is entirely sure what McConnell will introduce as the substitute amendment. Given the secretive nature of this process, congressional reporters are forced to speculate. Senate aides are telling reporters that McConnell will likely introduce a repeal-only bill to circumvent all other aforementioned amendments pitched during vote-a-rama. A repeal-only bill offers no replacement health coverage for Americans currently on the ACA.
The public is currently only privy to the Obamacare Repeal Reconciliation Act (ORRA). This repeal-only bill will leave 32 million uninsured by 2026, according to the nonpartisan Congressional Budget Office.
This bill will likely be revised. As of Tuesday afternoon, the revised repeal-only bill is reportedly only eliminating the Obamacare individual and employee mandates — financial penalties on Americans who did not purchase health insurance — as well as one Obamacare excise tax on medical devises.
Repealing the insurance mandate will undercut the ACA marketplace. The CBO estimates that the repeal of the mandate would cause a substantial reduction in the number of people with insurance. Additionally, patients who purchase care from the Obamacare marketplace — roughly 7 percent of the total population — could see their premiums spike 20 percent. We know health plans value the insurance mandate, said Chris Sloan, senior manager of the health care consultant firm Avalere Health. “If it goes away, premiums will go up.”
When asked to what degree people will drop coverage if the mandate is repealed, Sloan said it’s hard to tell. “It’s an assumption based on information that we have, but it cannot be tested until mandate goes away.”
This piece was updated with Democratic Senators’ vote count.
BREAKING: The Senate will begin debate on the Republican health care bill was originally published in ThinkProgress on Medium, where people are continuing the conversation by highlighting and responding to this story.